Prostate cancer is a common cancer that affects men and males assigned at birth. If you or someone you love has recently been diagnosed with prostate cancer, you likely have a lot of questions. Collaborating with a skilled medical team is the most important thing — but this guide can also help you learn about prostate cancer, its causes, symptoms, risk factors, and possible treatment options.

How Common Is Prostate Cancer?

Prostate cancer is the most common cancer diagnosed in men in Canada. Approximately 24,700 men were estimated to be diagnosed with prostate cancer in 2023, and the disease was projected to account for 4,700 deaths. Luckily, there are treatment options, and with early intervention, positive outcomes are much higher.

In the U.S., prostate cancer is highly prevalent among men. The American Cancer Society reports that an estimated 299,010 men will be diagnosed in 2024, and since 2014, the diagnostic rate has increased year-over-year by 3% and 5% for advanced-stage cases.

Despite its prevalence, many men still do not know much about their prostates, let alone how to detect the signs of prostate cancer or when to get screened. This guide is here to help you learn more about prostate cancer, so you can protect yourself, pass information along, and help protect your loved ones.

The Importance of Prostate Cancer Awareness

Prostate cancer is on the rise. Although it can be life-threatening, it is also treatable. The most positive outcomes are in cases where the patient caught their symptoms early and received treatment.

By understanding the prostate and the cancer risks you may face, it's easier to identify potential warning signs and know when to seek a professional medical opinion.

Demystifying the Prostate Gland

Your prostate is a small gland that plays a vital role in your reproductive system. To better understand how it works, let’s look at two important components: its function and location.

Function & Role in the Male Reproductive System

The prostate gland produces and secretes prostatic fluid, a key element of semen. This fluid is important for sperm mobility. It contains the prostate-specific antigen (PSA), which makes semen thinner and more watery. Men with prostate problems may have lower fertility rates and struggle to conceive a child.

Location in the Body

• Anatomical Position: The prostate sits directly beneath the bladder, in front of the rectum, and above the pelvic floor muscles.
• Size and Shape: It is about the size of a walnut, but it starts to increase in size after age 25 and throughout a man’s life. After age 40, men face a higher risk of an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH).

Detecting Prostate Cancer Symptoms

Prostate cancer is located in the male reproductive system, close to other important organs like the bladder and rectum. Because of its location, cancer of the prostate can spread to surrounding tissues and structures, which makes it harder to treat and can cause more serious symptoms that may progress to life-threatening conditions.

Prostate cancer grows slowly, but when it does affect other parts of the body, it can cause additional symptoms, such as difficulty urinating or pain when urinating. Because early-stage prostate cancer does not typically have noticeable symptoms. This is why detecting it early by recognizing the less-obvious warning signs is so critical.

Many men mistake the signs of prostate cancer as bladder issues. Recognizing this, you should seek professional treatment if you notice any changes to your urination habits, such as your ability to urinate, the onset of pain, or increased urination.

Common Symptoms and Warning Signs

While these symptoms do not mean you have prostate cancer, they can indicate the disease. You should immediately follow-up with a doctor who can perform the right tests to diagnose prostate cancer.

‍Common symptoms can include:

• Difficulty maintaining a steady flow of urine when you go to the bathroom
• Blood in urine (hematuria)
• Blood in semen (hematospermia)
• Painful urination (dysuria)
• Painful ejaculation (dysorgasmia)
• Feeling the urge to urinate more frequently
• Not feeling as though you can fully empty your bladder
• Needing to urinate more often at night (nocturia)

BPH can also cause similar symptoms, and you cannot know whether you have an enlarged prostate or prostate cancer without diagnostic tests. Although BPH is non-cancerous, it is still a serious condition that merits treatment.

Addressing any new changes to your bladder habits or reproductive health is key to catching prostate cancer early.

Symptoms at Different Stages of Prostate Cancer

Early-stage prostate cancer is usually asymptomatic. As it progresses, it can cause more symptoms related to bladder control and function. In more advanced stages, prostate cancer can cause symptoms such as undesired and unplanned weight loss, erectile dysfunction, pelvic pain, bone pain, and difficulty urinating.

Early Detection Can Save Your Life

The sooner you catch prostate cancer, the more effective treatment can be. Because it is so slow-growing, this cancer can take up to eight years to reach other parts of the body. This is a good thing, but it also means that detecting the signs as soon as they appear and reaching out for medical evaluation is crucial.

Understanding the Underlying Causes of Prostate Cancer

As with many other types of cancer, the exact cause is unknown, and it can change from one patient to another. Many people develop cancer because a lifestyle or environmental factor turns “on” the cancer gene — this is studied by epigenetics. During carcinogenesis, cancer cells become active and begin to divide. As they continue to multiply, they can spread to other parts of the body, a process called metastasis. 
Let’s look closer at how prostate cancer can develop in different scenarios.

Exploring Potential Causes and Triggers

The potential causes of prostate cancer range from family history to age and lifestyle factors. Those who have a direct relative diagnosed with the disease are more likely to develop it themselves. Current Research on the Causes of Prostate Cancer Researchers are still unsure exactly what causes prostate cancer, but they do know that family history increases risks and that risk increases with age. The average age of prostate cancer diagnosis is 67, and it is rare among men under 40. The Metastatic Prostate Cancer Project

Understanding Risk Factors for Prostate Cancer

• Family history. Family history of prostate cancer increases personal risk. Men with a brother or father diagnosed with prostate cancer are 2-4 times more likely to develop the disease.
• Ethnicity. Black men are more likely to develop prostate cancer, with one in six developing the disease some point in their lives versus the one in eight average for men in other ethnic groups.
• Age. Prostate cancer risks increase with age, and it is extremely rare in males under 40.
• Diet. Eating a large amount of processed meats and saturated fats while consuming few vegetables can also increase the risk of prostate cancer.
• Weight. Men who are obese or overweight have an increased chance of developing an aggressive form of prostate cancer.

Risk factors are unique to every individual, and sometimes, genes and hormones may be the leading cause of prostate cancer. This is why you can see healthy men who eat a well-balanced diet and maintain a healthy weight still develop the condition. However, lowering your lifestyle risks can still be beneficial, especially if you are over 40.

The Importance of Prostate Cancer Screenings

Prostate cancer does not usually show signs in its early stage, so getting treatment as soon as possible is important to prevent the disease from progressing or spreading to other parts of your body.

If you have a higher risk factor, screening can help you start treating the disease with the most effective option, as well as determine whether prostate cancer has spread and stop it from causing further damage.

Common Screening Methods

• PSA tests. Your doctor can use blood work to measure your prostate-specific antigen (PSA) levels. Normal levels vary by age group.
• DRE. A digital rectal examination (DRE) is one of the most common ways to diagnose prostate cancer; during a DRE, your doctor inserts a gloved, lubricated finger into your anus to check for any signs of abnormalities. Because of its anatomical location, a physician can feel your prostate through a DRE.

Screening Guidelines and Recommendations

Men with an elevated risk of prostate cancer or a history of prostate problems should be screened more frequently. General guidelines suggest that men should be screened for prostate cancer every 2-3 years starting at age 55, or earlier if they have a first-degree relative who has had the disease.

Benefits and Limitations of Screening

Screening for prostate cancer can detect it before it causes serious health complications. The sooner it is caught, the sooner you can start treatment. This can stop the disease from spreading.

It is important to note, however, that screening often has to span beyond PSA levels to accurately diagnose prostate cancer. Even men with normal PSA levels can have cancer.If screening tests are abnormal, your doctor will likely order additional tests to confirm prostate cancer, such as an ultrasound, MRI, or biopsy.

A prostate biopsy involves taking tissue from the prostate gland using a device inserted into the rectum. The collected tissue samples are examined for cancer. The biopsy takes around 10 minutes to complete, and it is the best way to definitively make a diagnosis.

Evaluating Grades and Stages in Prostate Cancer

The Gleason score is a cancer grading system that describes how a cancer progresses and what the best treatments are at each stage.

• Grade 6 or lower — low-grade and well-differentiated. This means cancer cells are active in their original tissues.
• Grade 7 — intermediate and moderately differentiated. Cancer cells at this grade are growing and spread faster than tumors of lower grades.
• Grade 8-10 — High-grade or poorly differentiated. Grade 8-10 cancer cells behave abnormally, and they are more likely to spread to other parts of the body.

The TNM staging system can also help explain how prostate cancer advanced. It describes the general process of how cancer advanced, starting with a tumor, advancing to lymph nodes, and eventually affecting other parts of the body.

• Tumor — The TNS system looks at the original tumor and its size and primary location.
• Node — As cancer progresses, it typically infects surrounding lymph nodes before reaching other parts of the body. The N model of this staging system looks at the degree of lymph node infection.
• Metastasis — Once prostate cancer infects other parts of the body, it is said to have a metastatic spread. Cancer treatment must target not only the original tumor site but all the subsequent tissues infected as well.

There are four prostate cancer stages — I, II, III, and IV — which determine how advanced the cancer is and how likely it is to respond to treatment. The more advanced the cancer is, the more aggressive treatment has to be. This is why early detection and diagnosis is so important — it improves your prognosis and gives you the most options for treatment.

Comprehensive Approaches to Prostate Cancer Treatment

Modern prostate cancer treatments include surgical removal of cancerous tissue, radiation therapy, and hormone therapy. Your doctor will discuss your options and help you decide on the best course of action depending on the grade and stage of your cancer.

Surgery

Patients may undergo a prostatectomy to have part or all of their prostate removed. In many cases, patients may prefer this method as it ensures the prostate and infected tissues are removed from their body by a skilled surgeon.

A complete prostate removal is called a radical prostatectomy, and it is a major surgery. Potential side effects include urinary incontinence and erectile dysfunction. Completely removing the prostate will also make a man infertile, so if they plan to have children in the future, the doctor will likely suggest collecting sperm before their procedure.

A prostatectomy is used when the cancer is localized to the prostate, meaning the cancer has not spread to other parts of the body. It may also be used in some cases where the spread is minor and closeby. Men with bladder obstruction from prostate cancer may also benefit from a prostatectomy.

Radiation

Radiation can be used before or after other treatments to target cancer cells and shrink tumors. It is also called “"neoadjuvant radiation therapy.” Sometimes, doctors recommend radiation as the primary form of prostate cancer treatment. It can be used to treat patients at any stage, and it is typically administered in a hospital 5 days a week.

There are two types of radiation available for prostate cancer: external beam and brachytherapy radioactive seed placement.  Your doctor will discuss the possible effectiveness of radiation and how it may be used as your main cancer treatment or support other treatments for prostate cancer.

Hormone Therapy

Hormone deprivation therapy for prostate cancer stops the body from producing testosterone or stops the hormone from reaching your prostate. Depriving the prostate of testosterone can make cancer cells grow more slowly or shrink the size of a tumor. Hormone treatments are common for advanced and metastatic forms of prostate cancer.

Your doctor may recommend combining hormone therapy with radiation for the best possible outcome.

Potential Side Effects & Complications

Every treatment has its own potential side effects and complications. These vary from person to person and are also influenced by the level of treatment you receive.

Proactive Measures for Prostate Cancer Prevention

While you may not be able to definitively prevent prostate cancer, there are certain steps you can take to reduce your risks.

• Lower the amount of saturated fat and red meat in your diet.
• Reduce your milk consumption, especially high-fat varieties.
• Maintain a healthy weight.
• Quitting smoking.
• Ejaculate more frequently.

You should also ask your doctor about a prostate screening if you are 55 or older with no known risk factors; if you are younger and concerned about symptoms or the risk of developing cancer, speak with a licensed physician who can perform a prostate cancer screening.

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Sources

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“How Does the Prostate Work?” National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK279291/

“Prostate Enlargement (Benign Prostatic Hyperplasia)”. National Institute of Diabetic and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia

“Prostate Cancer.” Canadian Cancer Society. https://cancer.ca/en/cancer-information/cancer-types/prostate

“How Quickly Does Prostate Cancer Spread?”  Rohini Radhakrishnan, ENT. MedicineNet.  Rohini Radhakrishnan, ENT.  https://www.medicinenet.com/how_quickly_does_prostate_cancer_spread/article.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6279573/

“Black Men and Prostate Cancer.” https://zerocancer.org/black-men

“What Are the Risk Factors?” Prostate Cancer Foundation. https://www.pcf.org/patient-resources/family-cancer-risk/prostate-cancer-risk-factors

“Prostate Cancer: Age-Specific Screening Guidelines.” https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-age-specific-screening-guidelines


“What to Know About Prostate Cancer and Milk.” Medical News Today. https://www.medicalnewstoday.com/articles/prostate-cancer-and-milk#can-milk-cause-prostate-cancer 


“Ejaculation Frequency and Prostate Cancer.” https://www.health.harvard.edu/mens-health/ejaculation_frequency_and_prostate_cancer

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