Every day with Prostate Cancer raises a new question

What is prostate cancer?

Prostate cancer begins when cells in the prostate grow uncontrollably. The prostate is a small gland below the bladder that helps produce semen. Most prostate cancers grow slowly, but some develop more quickly and can spread beyond the prostate.

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Early prostate cancer often causes no symptoms. Some cancers may never become harmful, while others require prompt treatment. Understanding the stage, grade and growth pattern helps the healthcare team recommend an approach. mama health's guides to what prostate cancer is and what happens after a new diagnosis cover the first weeks.

What causes prostate cancer?

Prostate cancer develops when genetic changes cause prostate cells to grow and survive abnormally. The exact reason these changes occur in a particular person is usually unknown. Age, inherited genes and other biological and environmental factors may contribute.

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Prostate cancer is not caused by sexual activity or by anything a person has done. Benign prostatic hyperplasia, or BPH, and prostatitis can cause similar urinary symptoms, but they are not prostate cancer and are not risk factors for it. mama health's guide to alcohol, smoking and prostate health covers what the evidence says about the factors people ask about most, and the worst foods for prostate health covers the diet questions.

Types and stages of prostate cancer

Most prostate cancers are adenocarcinomas, which begin in the gland cells that produce prostate fluid. Less common types include neuroendocrine and small-cell prostate cancers, which may behave differently and require different treatment.

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Localized prostate cancer remains within the prostate. Locally advanced cancer has grown into nearby tissues or lymph nodes. Metastatic prostate cancer has spread to distant areas, most commonly the bones. Cancer that returns after treatment is called recurrent prostate cancer. mama health's guide to what the stages mean works through each, and how quickly prostate cancer spreads and which organs it reaches first cover the questions that follow.

Understanding PSA, Grade and Stage

PSA provides information about prostate activity but cannot describe the cancer on its own. Changes in PSA over time may be more informative than a single result, and mama health's guides to what a high PSA means and PSA rising after treatment cover both situations.

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The Gleason score and Grade Group describe how abnormal the cancer cells look. Grade Groups range from 1 to 5, where Grade Group 1 usually represents slower-growing cancer and higher Grade Groups are more likely to grow and spread quickly. See the Gleason score explained simply and prostate biopsy results.

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The stage describes where the cancer is located and whether it has spread. PSA, Grade Group, stage, imaging results and overall health are considered together when discussing risk and treatment. MRI reports have their own scoring system, covered in what PI-RADS means. Results and letters can be read back in plain language in the mama health app, a free prostate cancer support app.

How is prostate cancer treated?

Treatment depends on the stage, Grade Group, PSA level, symptoms, genetic features, previous treatment and the person's general health and priorities. mama health's guide to understanding your treatment choices sets out how those factors come together.

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Options may include active surveillance, surgery to remove the prostate, external or internal radiation therapy, and hormone therapy that reduces or blocks testosterone. More advanced cancers may also be treated with chemotherapy, targeted medicines, immunotherapy or radioactive medicines that deliver radiation to cancer in the bones. Clinical trials may provide access to treatments still being studied. Where surgery and radiotherapy are both options, how to compare them and which treatments carry which side effects cover what to weigh with the team. Questions between appointments can be put through mama health, which is free prostate cancer support grounded in medical science and the experience of others.

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Care is usually delivered through a specialist centre, and mama health lists prostate cancer clinics in Italy.

Advanced and metastatic prostate cancer

When prostate cancer spreads, it most commonly affects the bones and lymph nodes. Possible symptoms include persistent bone pain, fractures, fatigue, weakness, weight loss or anemia. Some people have metastatic cancer without obvious symptoms. mama health's guide to what happens when prostate cancer spreads to the bones covers treatment and next steps.

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Treatment may not remove all advanced cancer, but it can slow its growth and relieve symptoms. The cancer may initially respond to hormone therapy and later begin growing despite low testosterone levels, which is called castration-resistant prostate cancer, and additional treatments may then be considered.

Living with treatment and its effects

Fatigue is the most commonly reported effect of treatment and often the least discussed, covered in fatigue during treatment and when treatment starts affecting everyday life. Eating well through treatment is covered in what to eat during treatment.

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Continence and sexual function are affected by several treatments and are often not raised until afterwards. mama health's guides to erections after prostate removal and what changes after prostate removal cover what other men have described.

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Fear, exhaustion and low mood are part of this too, covered in prostate cancer and mental health, and partners carry a share of it, covered in supporting a husband with prostate cancer. What changes week to week can be kept in one place in the mama health app, a free prostate cancer app built with in-house doctors.

Who is at risk of developing prostate cancer?

The likelihood increases with age. Having a father, brother or son with prostate cancer also increases risk, particularly when several relatives were affected or cancer developed at a younger age.

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Inherited changes in genes such as BRCA1, BRCA2 and genes associated with Lynch syndrome can increase risk. People of African ancestry experience higher rates of prostate cancer and are more likely to develop aggressive cancer, although biological, healthcare and social factors may all contribute to this difference.

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Having one or more risk factors does not mean someone will definitely develop prostate cancer. Many people diagnosed with it have no known family history.

What are the symptoms of prostate cancer?

Early prostate cancer usually causes no noticeable symptoms. When symptoms occur, they may include difficulty starting urination, a weak or interrupted urine flow, needing to urinate more often, difficulty emptying the bladder or pain during urination.

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Other possible symptoms include blood in the urine or semen, painful ejaculation and persistent pain in the back, hips or pelvis. These symptoms are often caused by noncancerous conditions, but they should still be assessed by a healthcare professional. Persistent bone or back pain has its own considerations, covered in chronic pain.

How is prostate cancer diagnosed?

Assessment may include a PSA test, a physical examination and a digital rectal examination. If cancer is suspected, an MRI can help identify unusual areas and guide decisions about whether a biopsy is needed.

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A prostate biopsy removes small tissue samples for examination under a microscope, and it is normally required to confirm whether cancer is present and determine how abnormal the cells appear. Additional imaging may be used to check whether the cancer has spread. mama health's guide to questions to ask after a diagnosis covers what is worth taking to the next appointment.