Merck Manual

Please confirm that you are not located inside the Russian Federation

Quick Facts

Prostate Cancer


The Manual's Editorial Staff

Last full review/revision Oct 2018| Content last modified Oct 2018
Click here for the Professional Version
Get the full details
NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
Topic Resources

Cancer is the out-of-control growth of cells in your body. Cells are the tiny building blocks of your body. Cells specialize in what they do. Different organs are made of different kinds of cells. Almost any kind of cell can become cancerous. 

What is prostate cancer?

The prostate is a gland found only in men. It's located just below a man’s bladder. The tube (urethra) that carries urine from the bladder and out the penis runs right through the middle of the prostate. The prostate also makes fluid that helps keep sperm healthy.

Prostate cancer is out-of-control growth of cells in your prostate.

  • Prostate cancer is the most common cancer in men over 50 in the United States

  • Your chance of getting prostate cancer goes up as you get older

  • Prostate cancer may grow very slowly and cause no problems or it may grow quickly and be fatal

  • You usually have no symptoms for a long time

  • As the cancer gets bigger, you may have trouble peeing or see blood in your urine

  • Doctors may suggest screening tests for men over 50, or for those over 40 with risk factors

  • Doctors treat most prostate cancer with surgery or radiation therapy

Male Reproductive Organs

Male Reproductive Organs

What causes prostate cancer?

Risk of prostate cancer is increased in:

  • Older men

  • Black or Hispanic men

  • Men with close relatives who had prostate cancer

  • Men with close relatives who had breast or ovarian cancer

What are the symptoms of prostate cancer?

Most men don't have symptoms. Usually symptoms only happen when your prostate cancer is large or has spread to other parts of your body. You may have:

  • Trouble peeing (urinating)

  • A need to pee right away or often

  • Bloody urine

  • If the cancer has spread to your bones, pain in your back, pelvis or ribs

How do doctors tell if I have prostate cancer?

Doctors may do screening tests to see if you have prostate cancer, even if you have no symptoms. Screening tests include:

  • A rectal exam, in which a doctor feels inside your butt with a finger to tell if your prostate is enlarged

  • A blood test to measure a substance made by your prostate called PSA

Your PSA level usually goes up when you have prostate cancer. But your PSA can also go up from other causes.

If doctors suspect you have prostate cancer, they’ll do other tests:

  • Take a sample of your prostate tissue to look at a microscope (biopsy)

If you have prostate cancer, doctors will give your cancer a number (Gleason score) from 1 to 5. The score is based on how abnormal the cancer cells look under the microscope. Cancers with a score of 5 are the most aggressive and very likely to spread. This score helps you and doctors decide on a treatment plan.

If you have bone pain or doctors think cancer may have spread to your bones, brain, or spinal cord, doctors will do:

How do doctors treat prostate cancer?

Your doctors will work with you to decide which treatment is best for you. Recommended treatments depend on:

  • Whether the cancer has spread from your prostate

  • Your Gleason score

  • Your age and overall health

Options include the following:

  • Just watching the cancer (active surveillance)

  • Treatments to get rid of the cancer

  • Easing your symptoms if the cancer can't be cured

Active surveillance

Since prostate cancer with a low Gleason score grows very slowly, you may choose not to be treated right away, especially if you’re older. Older men with many health problems often die of those conditions before the prostate cancer gets bad. Doctors will do regular checkups and measure your PSA level. They'll do more biopsies to see whether your cancer is growing and needs treatment.

Treating the cancer

If you and your doctors think treatment will help you live longer or have fewer severe symptoms, they’ll do:

Surgery is done to remove your whole prostate. Some doctors do the surgery with the help of a surgical robot through a few tiny incisions. Other doctors make a larger incision by hand at the bottom of your belly.

There are several kinds of radiation therapy for prostate cancer. For example, some use beams of radiation. Others implant small radioactive pellets ("seeds") inside your prostate.

However, these treatments may have side effects. They can cause problems with erections (erectile dysfunction) or trouble controlling your urine.

Treating your symptoms (palliative care)

If your cancer has spread outside your prostate, doctors don't do curative surgery or radiation. That's because those treatments don't help the cancer outside your prostate, so it's not worth the side effects. However, doctors will give treatments to slow the cancer down and relieve your symptoms. These treatments include:

  • Hormonal therapy to block the effects of testosterone, a hormone that helps prostate cancer grow

  • Radiation therapy to relieve bone pain

  • Chemotherapy to slow the cancer’s growth

  • Medicines to strengthen your bones

No matter which choice you and your doctors make, doctors will usually check your PSA levels 1 to 3 times every year for the rest of your life.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
Others also read

Also of Interest


View All
The Kidneys
The Kidneys
The Testes and Scrotum
The Testes and Scrotum