Around 1 in 8 men will develop prostate cancer during their lifetime. This common disease develops in the prostate gland and affects millions of men worldwide, especially those over age 50.
Fortunately, it is among the most curable cancers when caught early. Because early prostate cancer often causes no noticeable symptoms, early detection are critical.
Various treatment options, including lifestyle changes, may help manage the disease and improve outcomes.
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[shortcut_anchor id=”anchor_1754688085242″ label=”Stages”]What Are the Types and Stages of Prostate Cancer?[/shortcut_anchor]
Prostate cancer typically falls into several main types, with adenocarcinoma being the most common, accounting for more than 90 percent of cases.
The cancer progresses through stages, from early—confined to the prostate—to advanced, meaning it has spread to other parts of the body. When caught in stages 1 and 2, treatment outcomes are generally excellent.
- Stages 1 and 2: The tumor is in its early phase and remains confined within the prostate.
- Stage 3: The tumor has grown beyond the prostate but is still limited to nearby tissues, making it a locally advanced stage.
- Stage 4: The cancer has spread to distant parts of the body, such as lymph nodes, bones, liver, or lungs.
[shortcut_anchor id=”anchor_1754688129115″ label=”Symptoms”]What Are the Symptoms and Early Signs of Prostate Cancer?[/shortcut_anchor]
Prostate cancer often causes no symptoms in its early stages. Symptom severity depends on the cancer’s location and stage, and even as the disease spreads, some men may still not experience noticeable signs.
Urinary Symptoms
Changes in urinary habits are among the most common signs of prostate problems, including cancer. These symptoms often develop gradually and may be mistaken for normal aging or other conditions.
- Frequent urination, particularly at night
- Inability to urinate or trouble starting or stopping urination
- Weak or interrupted urine stream
- Dribbling at the end of urination or sensation of incomplete bladder emptying
- Pain or burning during urination
- Blood in the urine
Sexual Symptoms
Prostate cancer can also affect sexual function. These symptoms may appear alongside urinary changes or on their own.
- Trouble achieving or maintaining an erection
- Pain during ejaculation
- Decreased semen volume
- Blood in the semen
- Pain in the testicles
Other Symptoms (Usually Later Stages)
As prostate cancer advances, it may cause symptoms in other areas of the body due to tumor growth or metastasis.
- Pain or stiffness in the abdomen, lower back, spine, ribs, hips, or upper thighs
- Swelling, weakness, or numbness in the legs
- Unexplained weight loss or decreased appetite
- Discomfort or pain in the rectal area
- Fatigue, which may be related to anemia
- Compression of the spinal cord
- Kidney problems or kidney failure in advanced stages
Many of these symptoms can result from other conditions. For instance, benign prostate enlargement—a noncancerous condition common in aging men—can cause similar symptoms, such as difficulty urinating.
[shortcut_anchor id=”anchor_1754688140755″ label=”Causes”]What Causes Prostate Cancer?[/shortcut_anchor]
Prostate cancer develops when genetic mutations build up in the DNA of prostate cells, leading to uncontrolled growth and the formation of a tumor. The exact triggers for these genetic changes are unclear, but inherited and acquired genetic factors are thought to play a role.
Inherited Gene Mutations
Inherited gene mutations are responsible for approximately 10 percent of prostate cancer cases.
Several genes help maintain DNA integrity and prevent cancer. The BRCA1, BRCA2, CHEK2, ATM, PALB2, and RAD51 genes repair DNA damage. The MSH2, MSH6, MLH1, and PMS2 genes correct DNA replication errors; mutations in these genes can cause Lynch syndrome, which raises cancer risk. The RNASEL gene triggers cell death in abnormal cells, and HOXB13 is essential to prostate development.
Acquired Gene Mutations
Most genetic changes that lead to prostate cancer develop during a man’s life and are not inherited from his parents. These mutations arise from errors during DNA replication when prostate cells divide. The faster the cells divide, the greater the chance of mutations occurring.
Risk factors:
- Age: Risk increases with age, with most cases occurring in men aged 50 and older; however, the disease tends to be less aggressive in advanced age.
- African ancestry: African American men in the United States and Caribbean men of African ancestry have a significantly higher risk of developing prostate cancer compared with other racial groups.
- Family history: Risk more than doubles if a man has a father or brother with the disease. Having a close female relative with breast cancer may also increase prostate cancer risk.
- Overweight or obesity: Research has linked being overweight in one’s 50s and beyond to an increased risk of advanced prostate cancer.
- Western-style diet: A diet high in fat, calcium, and dairy products may increase prostate cancer risk.
- Exposure to certain chemicals: Arsenic, certain pesticides, cadmium, phthalates, and bisphenol A (BPA) may raise risk. Agent Orange, used during the Vietnam War, has also been linked to the disease. A 2024 study identified 22 pesticides consistently associated with higher risk, including 2,4-dichlorophenoxyacetic acid, a commonly used herbicide in the United States.
- Sexual health: Having multiple partners or engaging in sexual activity at an early age may raise risk, while regular ejaculation may be protective.
- Tall height: Greater adult height has been linked to increased risk, possibly due to genetics, nutrition, and prolonged exposure to growth-related hormones like insulin-like growth factor 1. Taller people also have more cells in their bodies, increasing the likelihood of genetic mutations that could lead to cancer.
[shortcut_anchor id=”anchor_1754688155331″ label=”Diagnosis”]How Is Prostate Cancer Diagnosed?[/shortcut_anchor]
Early detection can make all the difference in treatment outcomes, especially for high-risk or aggressive cases. Modern screening and diagnosis typically involve the following steps:
1. Screening Tests
Early prostate cancer detection is possible through two main screening tests.
Prostate-specific antigen (PSA) test: This blood test measures PSA levels, an enzyme produced by the prostate. Elevated PSA levels can suggest prostate cancer. Confirmation is usually recommended to rule out lab error or variability.
Digital rectal examination (DRE): In this exam, a doctor checks the prostate for abnormalities by inserting a gloved, lubricated finger into the rectum. However, the U.S. Preventive Services Task Force does not recommend DRE for screening because of limited evidence of its effectiveness.
Routine screening remains controversial because most prostate cancers grow slowly and may never become serious, while treatment can be costly and have significant side effects. For slow-growing cases of prostate cancer, active surveillance is a commonly used management strategy. It is important to know your risk and work with your health care provider to decide whether routine screening is appropriate.
2. Diagnostic Tests
If PSA or DRE results are abnormal (and confirmed), additional tests may be performed to determine whether prostate cancer is present.
- Multiparametric-magnetic resonance imaging: An advanced imaging test used to detect, assess, and stage prostate tumors.
- Prostate cancer gene 3 (PCA3) test: A urine test that looks for the PCA3 gene, which is overexpressed in prostate cancer and not found in normal prostate tissue.
- Prostate health index: A blood test that combines different PSA markers to produce a more accurate score, improving on the standard PSA test.
- Biopsy: The only definitive test for prostate cancer. It involves removing tissue from the prostate, usually via a transrectal ultrasound-guided approach. To reduce infection risk, some doctors use a transperineal method instead.
3. Other Tests
Tests to determine whether the cancer has spread may include a whole-body bone scan, a computerized tomography scan, a positron emission tomography/computed tomography scan, and lymph node biopsy.
[shortcut_anchor id=”anchor_1754688180052″ label=”Treatments”]What Are the Treatments for Prostate Cancer?[/shortcut_anchor]
Prostate cancer treatment depends on the stage, the cancer’s aggressiveness, and a person’s overall health.
In some cases, monitoring may be all that’s needed. In others, a combination of local and systemic treatments may help control the disease or extend life expectancy.
1. Expectant Management
Early-stage prostate cancers often grow slowly and may not require immediate treatment. However, it is important to discuss available options along with their risks, benefits, and alternatives, and the timing of treatment with your doctor.
Active surveillance: Involves regular monitoring through PSA testing, digital rectal exams, and imaging. Treatment is initiated only if signs of progression appear.
Watchful waiting: Typically recommended for older men or those in poor health, where the cancer is unlikely to shorten lifespan or where treatment may not be feasible.
2. Local Treatments
Also referred to as definitive therapy, local treatments aim to cure prostate cancer by targeting tumors confined to the prostate.
Surgery
Surgical approaches may involve removing the prostate and, in some cases, nearby lymph nodes.
- Radical (open) prostatectomy: Completely removes the prostate and seminal vesicles, sometimes including pelvic lymph nodes.
- Robotic or laparoscopic prostatectomy: A minimally invasive alternative to open surgery.
- Bilateral orchiectomy: The surgical removal of both testicles, which reduces androgen production to help shrink or slow prostate cancer.
Radiation therapy
Radiation therapy uses high-energy rays to destroy cancer cells. Common types include:
- External beam radiation therapy: Delivers radiation to the prostate from outside the body using various advanced techniques such as intensity modulated radiation, volumetric modulated arc therapy, and stereotactic ablative radiotherapy.
- Proton beam radiation therapy: Uses positively charged particles to deliver energy directly to the tumor while minimizing damage to surrounding healthy tissues.
- Internal radiation therapy (brachytherapy): Places radioactive seeds or temporary catheters directly into the prostate to treat early-stage or higher-risk cancers.
- Radiopharmaceuticals: Radioactive drugs injected into the bloodstream to target cancer cells throughout the body.
Focal therapy
Focal therapies are minimally invasive treatments that destroy small tumors without treating the entire gland. They are often used for low- to intermediate-risk prostate cancer, and include methods like cryosurgery and high-intensity focused ultrasound.
3. Systemic Treatments
If the cancer has spread beyond the prostate, a cure is less likely. Systemic treatments aim to control disease progression and relieve symptoms.
- Hormone therapy: Lowers androgen levels to slow cancer growth. Often used in combination with or after radiotherapy to reduce recurrence risk.
- Targeted drug therapy: Targets genes or proteins that drive cancer growth. These include androgen receptor pathway inhibitors like abiraterone and darolutamide, and PARP inhibitors like rucaparib and olaparib, which block DNA repair in cancer cells.
- Chemotherapy: Uses cancer-killing drugs such as docetaxel and cabazitaxel. Often recommended for advanced or castration-resistant prostate cancer.
- Immunotherapy: Stimulates the immune system to recognize and attack prostate cancer cells.
4. Traditional Chinese medicine (TCM)
Offers a complementary approach alongside conventional treatments.
Acupuncture: Acupuncture may help relieve symptoms in prostate cancer patients, such as chemotherapy-induced nausea and vomiting, pain, and hot flashes.
5. Supplements
Vitamin D: Low vitamin D levels have been linked to a higher risk of prostate cancer and worse survival outcomes. Supplementation may help improve outcomes, especially in those with a deficiency.
[shortcut_anchor id=”anchor_1754688205365″ label=”Lifestyle Approaches”]What Are the Natural and Lifestyle Approaches for Prostate Cancer?[/shortcut_anchor]
In addition to medical treatment, certain lifestyle changes and natural approaches may help support prostate health, ease treatment side effects, and improve overall well-being. While these strategies are not a substitute for medical care, they can be valuable parts of a comprehensive plan.
1. Certain Foods
Certain foods may help reduce the risk of prostate cancer or slow its progression.
Turmeric: The active compound curcumin has been shown to inhibit the growth and spread of prostate cancer cells in lab studies. It may also help slow PSA level increases in people with prostate cancer.
Green tea: In a 2014 study, green tea was found to reduce PSA levels, suppress cellular damage markers in urine, and inhibit activity of a specific protein in prostate tissue.
Tomatoes and tomato products: Men who ate tomato sauce four times a week had a 40 percent lower risk of prostate cancer compared with those who rarely or never did.
Pomegranate: A 2013 study found that pomegranate extract slowed the time it took for PSA levels to double to six months or more, without harmful side effects.
Cruciferous vegetables: These contain glucosinolates, which, when broken down, may hinder tumor growth and trigger cancer cell death in lab studies.
Allium vegetables: Garlic, onions, and leeks were found to significantly lower prostate cancer risk in men who ate more than 2.2 grams.
White button mushrooms: May have cancer-fighting properties, though research is ongoing.
2. Nutrition
Research shows that several eating patterns may improve prostate cancer outcomes:
- Plant-based diet: A 2024 study found that a diet high in fruits, vegetables, grains, and nuts may aid recovery of sexual and urinary function after prostate cancer treatment.
- Mediterranean diet: This diet emphasizes nuts, seeds, and foods rich in unsaturated fats like fish and seafood. It may help lower prostate cancer risk by providing vitamin E to protect cells and by reducing DNA damage through healthy fats.
- High-omega-3, low-omega-6 diet: A 2024 study suggests that eating omega-3s from fish, walnuts, and leafy greens may slow cancer growth, especially when combined with a lower intake of omega-6 oils from processed foods.
3. Vigorous exercises
Regular exercise, especially vigorous activity, has been linked to significant reductions in the risk of aggressive or fatal prostate cancer.
- Vigorous exercise: Men over 65 who exercised vigorously reduced their risk of aggressive or fatal prostate cancer by up to 70 percent.
- Moderate activities: Walking and other moderate exercises can improve physical function without added fatigue, especially in younger men.
- Aerobic fitness: A 2024 study found that a 3 percent increase in aerobic fitness lowered prostate cancer risk by 35 percent.
- Strength training: Particularly beneficial for men on hormone therapy, helping prevent muscle loss and metabolic issues.
4. Meditation
About one-third of men with prostate cancer experience anxiety, fear, or depression. Studies show that mindfulness practices—such as those in an eight-week Mindfulness-Based Stress Reduction program that included relaxation, meditation, and gentle yoga—can improve sleep, emotional well-being, and quality of life, while also easing fear of cancer recurrence.
[shortcut_anchor id=”anchor_1754688293655″ label=”Mindset”]How Does Mindset Affect Prostate Cancer?[/shortcut_anchor]
Research suggests that targeting a person’s mindset can significantly improve their psychological well-being and overall health.
In a 2023 study, prostate cancer patients who participated in a cancer mindset intervention showed notable improvements in their adaptive coping behaviors and reduced distress from physical symptoms compared with those receiving standard care. The intervention was an online toolkit of seven modules, each featuring short films with cancer survivors and experts discussing the role of mindset in cancer diagnosis, treatment, and recovery, followed by reflection questions.
[shortcut_anchor id=”anchor_1754688300088″ label=”Prevention”]How Can I Prevent Prostate Cancer?[/shortcut_anchor]
Although there is no guaranteed way to prevent prostate cancer, adopting a healthy lifestyle may help lower the risk.
Avoid harmful chemicals: Steer clear of substances linked to prostate cancer, including certain pesticides, arsenic, phthalates, and BPA.
Consider chemoprevention: Some research suggests this approach may help reduce risk, but discuss potential benefits and risks with your doctor.
Helpful Daily Habits
Simple, consistent habits can support overall prostate health and may help reduce cancer risk.
- Adopt a Mediterranean diet: In a 2018 study, men who closely followed a Mediterranean diet had a 32 percent to 34 percent lower risk of developing aggressive prostate cancer and a 51 percent lower risk of being diagnosed with advanced-stage disease.
- Limit processed foods and excessive dairy: Reducing these foods may help improve overall health and lower cancer risk.
- Exercise regularly: Include both cardiovascular and strength training activities.
- Get adequate sleep: Quality rest supports immune function and hormonal balance.
Medical prevention
Ask about 5-alpha reductase inhibitors: If you are at high risk, your doctor can advise whether these medications are appropriate.
Stay current with family history and genetic counseling: This information can help guide screening and prevention strategies.
[shortcut_anchor id=”anchor_1754688325361″ label=”Complications”]What Are the Complications of Prostate Cancer?[/shortcut_anchor]
Prostate cancer and its treatments can lead to a range of physical complications, especially in advanced stages. Recognizing these risks may help guide timely medical care and symptom management.
- Bone fractures: Cancer that spreads to the bones can weaken them, increasing fracture risk.
- Spinal cord compression: Tumor growth near the spine, often in the thoracic or upper lumbar region, can compress the spinal cord, causing pain, leg weakness, and difficulty walking.
- Coagulopathy and disseminated intravascular coagulation: Advanced disease may cause bleeding disorders, ranging from mild (such as blood in urine) to severe clotting abnormalities followed by excessive bleeding.
- Anemia: Advanced metastatic prostate cancer can cause unexplained anemia.
- Edema: Tumor-related blockage of lymphatic or venous drainage may cause swelling in the legs or genital area.
- Erectile dysfunction: More than 75 percent of men may experience erection difficulties after prostate surgery; the condition can also result from the cancer itself.
- Urinary incontinence: Within one year of prostate removal, 5 percent to 10 percent of men may experience urine leakage. This can also occur from cancer-related damage.
- Urinary obstruction: Tumor growth may block urine flow by compressing the urethra or bladder outlet, typically in advanced disease.
- Bowel dysfunction: Radiation therapy can sometimes cause long-term bowel problems.
