Prostate Cancer

Prostate cancer begins when cells in the prostate (a walnut-sized gland below the bladder) grow and divide abnormally. It is the most common cancer in U.S. men after skin cancer, and risk rises with age. Most prostate cancers are found at a localized or regional stage and can often be treated successfully.

About 1 in 8 men will be diagnosed in their lifetime; many live long, full lives after treatment.

Prostate Basics

The prostate helps make seminal fluid and surrounds the urethra, the tube that carries urine outside the body. As men age, the prostate often enlarges (BPH), which can mimic some urinary symptoms of cancer but is not cancer. A thorough assessment distinguishes BPH and other benign conditions from malignancy.

Signs & Symptoms

Prostate cancer may cause no symptoms early on. When present, symptoms can include:

Weak or interrupted urine flow, frequent urination (especially at night), trouble starting urination, or feeling unable to empty the bladder fully
With advanced disease: bone pain (back, hips, pelvis), profound fatigue or anemiarelated symptoms

These symptoms can be caused by noncancer conditions; persistent or worsening symptoms should be evaluated.

Risk Factors

Older age, Black race, and family history of prostate cancer increase risk.
Certain inherited mutations (e.g., BRCA2) can elevate risk; genetics may also shape treatment choices if cancer is diagnosed.

Prevention & Risk Reduction

Large trials show that finasteride or dutasteride can reduce prostate cancer incidence (mainly lowergrade disease), but no proven mortality benefit has been established; these drugs are not routinely used for prevention. Healthy lifestyle choices (e.g., weight control, physical activity, smoking cessation) support overall wellbeing.

Screening (PSA & DRE): Shared Decision Making

There is no one-size-fits-all approach to prostate cancer screening. A shared decision with your clinician—reviewing benefits and potential harms—is essential. Screening uses a prostatespecific antigen (PSA) blood test with or without a digital rectal exam (DRE).

Evidence that PSA/DRE screening reduces mortality is inconclusive, while harms include overdiagnosis and potential overtreatment of cancers that may never cause symptoms.
Decisions are individualized based on age, overall health, risk factors (e.g., family history, race), and personal preferences.

Diagnosis

If screening or symptoms raise concern, your team may recommend:

(often guided by imaging) to confirm cancer and assess its grade (Gleason/Grade Group).

(e.g., bone scan, CT, PET in select cases) help determine if cancer has spread.

How Prostate Cancer Is “Classified” for Treatment

Staging (I–IV) describes how far cancer has spread, while grade (Gleason/Grade Group) indicates how the cells look under a microscope. Together with PSA and other features, these determine risk categories used to tailor therapy (e.g., low, favorable intermediate, unfavorable intermediate, high, very high risk).

Many localized, low-risk cancers grow slowly. Some men may live their whole lives without symptoms or the need for immediate treatment.

Treatment Options

Your plan is individualized based on stage, risk, overall health, and personal goals—and often decided in a multidisciplinary setting (urology, radiation oncology, medical oncology, imaging, genetics).

Localized / Low-Risk or Selected Intermediate-Risk

Active surveillance with scheduled PSA testing, repeat imaging/biopsy, and symptom checks—aims to delay/avoid treatment (and side effects) unless the cancer shows signs of change.
Surgery (radical prostatectomy, often nervesparing) to remove the prostate and nearby nodes when appropriate.
Radiation therapy: externalbeam modalities and/or brachytherapy; techniques are chosen based on anatomy, risk, and preferences. [cancer.gov]

Unfavorable Intermediate-Risk to High/VeryHigh Risk (Localized/Locally Advanced)

Radiation therapy plus androgen deprivation therapy (ADT) for a defined duration, or
Radical prostatectomy with consideration of adjuvant or salvage radiation depending on pathology/PSA course. Discussion focuses on cancer control and quality of life.

Metastatic Disease

Metastatic hormone-sensitive prostate cancer: ADT is standard, often intensified with androgen receptor pathway inhibitors and/or chemotherapy to improve outcomes.
Metastatic castration resistant prostate cancer: options include androgen receptor pathway inhibitors, chemotherapy, radio pharmaceuticals (for bone predominant disease), and clinical trials. Sequencing depends on prior therapies and disease tempo.

Many men with advanced disease live for years with modern systemic therapies; your team will discuss benefits, side effects, and how treatments fit your priorities.

Side Effects & Supportive Care

Urinary, sexual, and bowel side effects vary by treatment and can often be prevented, reduced, or managed with proactive strategies, pelvic floor therapy, medications/devices, and supportive care. Your plan will include follow-up and resources to maintain quality of life.

Prognosis

Prostate cancer is often highly treatable—especially when localized. U.S. 5year relative survival exceeds 99% for local/regional disease; for distant disease it is lower, but outcomes continue to improve with earlier detection and new therapies. Your doctor will explain what your stage, risk, and health mean for you.

Follow-Up & Survivorship

After treatment—or while on active surveillance—follow-up usually includes:

PSA monitoring and clinical assessments at regular intervals; targeted imaging as indicated.
Managing long-term effects (urinary/sexual/bowel health, bone/cardiometabolic health on ADT), mental health, and healthy lifestyle support.

Why Choose Illinois CancerCare

Experienced, multidisciplinary prostate team providing risk-adapted care, modern radiation and surgical pathways, and supportive services—close to home.
Clinical trials access (e.g., precision diagnostics, intensified hormone therapy, novel systemic agents) and referral pathways when appropriate. Current Clinical Trials – Illinois CancerCare
Shared decision making for screening and treatment—so your plan reflects your values and goals.

Sources & Patient Friendly References

All information was taken from the NCI (National Cancer Institute) and ACS (American Cancer Society).