Prostate Cancer
Overview
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Prostate cancer is a type of cancer that forms in the tissues of the prostate. The prostate is a gland in the male reproductive system, located just below the bladder and in front of the rectum. It is described as being about the size of a walnut and surrounds part of the urethra, the tube that carries urine from the bladder. The prostate gland makes fluid that is part of the semen.
Cancer, in general, is the result of abnormal cell growth that takes over the body’s normal cell function. In healthy cells, DNA gives instructions for growth, multiplication, and death at a set rate. In cancer cells, DNA changes cause them to grow and multiply quickly and continue living when healthy cells would die, leading to too many cells. These abnormal cells can form a mass called a tumor. Prostate cancer develops when these abnormal cells form and grow in the prostate gland.
Not all abnormal growths are cancerous (malignant); some, like benign prostatic hyperplasia (BPH), are non-cancerous and do not spread. However, cancerous growths, such as prostate cancer, can spread (metastasize) to nearby organs and tissues like the bladder or rectum, or to other parts of the body like lymph nodes, bones, liver, or lungs. Prostate cancer can be life-threatening if it spreads far beyond the prostate.
Prostate cancer is one of the most common types of cancer among men. In the United States, about one out of eight men will be diagnosed with it. It is most common in older men. While prostate cancer often grows slowly and is frequently found early, it can be curable, especially when identified and treated early.
Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, and the global cancer burden is projected to increase by 47% between 2020 and 2040. Within this broader context, prostate cancer is a significant health concern, particularly in the United States, where it is the most diagnosed noncutaneous malignancy among men. It also ranks as the second most common cause of cancer death for men in the US.
Specific estimates for the United States provide a clearer picture of the disease's impact. For the year 2024, projections indicate approximately 299,010 prostate cancer diagnoses and 35,250 deaths attributable to the condition. Looking ahead to 2025, the estimated numbers rise slightly, with about 313,780 new cases and 35,770 deaths projected. The incidence rate for prostate cancer in the US has been increasing since 2014, and a rapid increase in morbidity is also noted in South Korea.
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Risk Factors and Early Detection Considerations
Factors that can increase risk include older age (5), race/ethnicity (Black men have a greater risk), family history (close relative or certain types of other cancers), and inherited gene changes (18).
Family history is considered one of the most important risk factors (5).
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Diagnosis, Staging, and Detection
Learning about a diagnosis can be a shock, bringing feelings like numbness, fear, confusion, anger, and feeling all alone, even if others were present.
The initial period after diagnosis can be difficult, potentially causing trouble with thinking, eating, or sleeping.
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Sexual Function & Intimacy
Prostate cancer is a prevalent disease with significant physical and psychological ramifications that extend beyond the patient to impact their intimate relationships.
Effective management requires a multidisciplinary approach to treatment and pain, alongside robust support systems that address the complex "total pain" experience and the specific challenges related to sexual health for both patients and their partners.
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Dietary Considerations
A diet that supports prostate health is often described as being much like a diet that is beneficial for overall health, particularly a heart-healthy diet(1).
Many dietary recommendations for prostate cancer prevention or treatment align with good health practices that are likely to benefit overall mental and physical well-being (2). Adopting a Mediterranean diet is one dietary change recommended (2), while other sources highlight the benefits of a plant-based diet (3).
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Treatment Approaches
Multiple treatment options are typically available, with decisions that are often complex and significantly impact daily life (22).
Seeking multiple opinions from various specialists is encouraged to fully understand options, with early detection often leading to more effective treatments (23).
Immediate treatment is not always necessary; sometimes monitoring is sufficient.
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Treatment Side Effects
Treatments can cause various side effects impacting quality of life(1). Common issues include urinary incontinence (1), bowel complications1, and significantly, erectile dysfunction and reduced sexual desire (1). Surgery often leads to urinary/sexual dysfunction (2).
Radiotherapy can cause bowel/bladder issues and ED(2). Hormone therapy causes loss of libido, hot flashes, hormonal changes, and increased risks (1). Chemotherapy may cause tiredness, hair loss, and nerve damage.
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Mental Health
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