About Prostate Cancer

Prostate cancer is the second leading cause of cancer death in American men. However, most of the time, prostate cancer grows slowly, and the survival rate is high.

More than 2.5 million men in the United States who have had prostate cancer at some point are still alive today. The death rate for prostate cancer is going down, perhaps because the disease is being found earlier.

The greatest risk factors are age and genetics. One man in seven will get prostate cancer in his lifetime. Within the U.S., black men have a particularly high risk, though the reasons behind this have not yet been determined.

The American Cancer Society recommends that men have a chance to make an informed decision with their healthcare provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks and potential benefits of prostate cancer screening. Men should not be screened unless they have received this information.

The discussion about screening should take place at age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.

This discussion should take place starting at age 45 for men at high risk of developing prostate cancer. This includes black men and men who have a first-degree relative (father, brother or son) diagnosed with prostate cancer at an early age (younger than age 65).

This discussion should take place at age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

After this discussion, those men who want to be screened should be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.

Prostate cancer begins in the cells that make up prostate tissue. It is the second most common cancer in men and usually occurs in older men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland where it may not cause serious harm. Some types of prostate cancer grow slowly and may need minimal, if any, treatment. Other types are more aggressive and can spread quickly. Early detection of prostate cancer (when it's still confined to the prostate gland) has a better chance for successful treatment.

While there are several types of cells in the prostate, nearly all prostate cancers start in the gland cells. Gland cells make the prostate fluid that is added to the semen. The medical term used to identify cancer that starts in gland cells, and describes almost all prostate cancers, is adenocarcinoma. Other types of cancer also can start in the prostate gland, including sarcomas, small cell carcinomas and transitional cell carcinomas. It is extremely rare, however, to find these types of cancers in the prostate.

Prostate cancer cells can spread by breaking away from the tumor they have formed in the prostate. They then enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells then can attach to other tissues and grow to form new tumors that may damage those tissues. The spread of cancer is called metastasis.