What it is
Prostate cancer starts when cells in the prostate — a walnut-sized gland below the bladder — begin to grow out of control.[1] Many prostate cancers grow slowly and may never cause problems; others grow and spread more quickly. Tests, not symptoms, usually find it early.[1][2]
Almost all prostate cancers are adenocarcinomas: they start in the gland cells that make prostate fluid.[1] The prostate wraps around the urethra just below the bladder, with the seminal vesicles behind it and the rectum directly behind. Most cancers arise in the outer (peripheral) part of the gland, which is why some can be felt on a digital rectal exam, while non-cancerous enlargement (BPH) usually affects the inner part around the urethra.[3]
Prostate adenocarcinoma is graded by how abnormal the cells look under the microscope (Gleason score, reported today as a Grade Group from 1 to 5) and staged using the tumour's extent, the PSA level and the grade.[1] Risk groups that combine stage, PSA and grade guide whether active surveillance, local treatment or systemic therapy is discussed. Local spread can involve the seminal vesicles, bladder neck or rectum; the most common distant sites are lymph nodes and bone.[1]
See the prostate in 3D, below the bladder and wrapped around the urethra.
See it in 3DThe rectum is not a separate part in this model; it lies directly behind the prostate, which is why a clinician can feel the prostate during a rectal exam.
How common it is
Other than skin cancer, prostate cancer is the most common cancer in men in the US, and the second-leading cause of cancer death in men after lung cancer.[4] The American Cancer Society estimates about 333,830 new cases and about 36,320 deaths in the US in 2026.[4] Risk is higher in Black men than in men of other races.[4]
Causes and risk factors
Things you can't change
- Age. Prostate cancer is rare before 40, and the chance rises quickly after 50.[5]
- Race. It develops more often in African American men and in Caribbean men of African ancestry; the reasons aren't clear.[5]
- Family history. Having a father or brother with prostate cancer more than doubles a man's risk.[5]
- Inherited gene changes such as BRCA2 (and BRCA1) or Lynch syndrome genes, which account for a small share of cases.[5]
Things you can change
- The evidence on diet, weight and smoking is less clear. Most studies have not found that smoking causes prostate cancer, though some link it to a higher risk of dying from it.[5] Staying active and not smoking help your health overall.
Symptoms worth reporting to a doctor
- Problems urinating, including a slow or weak stream or needing to go more often, especially at night
- Blood in the urine or semen
- Trouble getting an erection
- Pain in the hips, back, chest or other bones, or weakness or numbness in the legs or feet — these can happen if cancer has spread
Early prostate cancer usually causes no symptoms. Urinary changes are far more often caused by a non-cancerous enlarged prostate (BPH) than by cancer — but any of these is worth a conversation with a clinician.[2]
Get urgent care if…
Screening: who, when and how
The PSA test measures prostate-specific antigen, a protein made by the prostate, in the blood. A raised level can be caused by cancer but also by BPH, infection or inflammation.[7]
- Ages 55–69: the US Preventive Services Task Force says the decision to be screened should be an individual one, made after talking through benefits and harms with a clinician (grade C).[8]
- 70 and older: it recommends against routine PSA screening (grade D).[8]
- Higher risk: the American Cancer Society suggests starting the conversation at 45 for Black men and men whose father or brother was diagnosed before 65, and at 40 for men with more than one close relative diagnosed early.[9]
The trade-off, in numbers: over about 13 years, screening 1,000 men aged 55–69 may prevent about 1.3 deaths from prostate cancer and about 3 cases of cancer that has spread. Harms include false-positive results, biopsies, and overdiagnosis — finding cancers that would never have caused harm — which USPSTF estimates at 20–50% of screen-detected cancers.[8] The USPSTF is currently updating this recommendation.[8]
How it's diagnosed
- PSA blood test
- Often the first test. Results are interpreted with age, prostate size and earlier results.[7]
- Digital rectal exam (DRE)
- A clinician feels the back of the prostate through the rectum wall for lumps or hard areas.[1]
- MRI of the prostate
- Imaging that can show suspicious areas and guide a biopsy.[1]
- Biopsy
- Small samples of prostate tissue are taken with a needle and examined under a microscope. This is the only way to confirm cancer and give it a grade.[1]
- Staging scans
- For some cancers, scans such as CT, bone scans or PET look for spread.[1]
Stages in general terms
Doctors describe how far a cancer has spread in broad terms:[10]
- Localised: still within the prostate.
- Regional: grown through the capsule into nearby tissue such as the seminal vesicles, or into nearby lymph nodes.
- Distant: spread to other parts of the body, most often bones or distant lymph nodes.
Alongside stage, the Grade Group (Gleason score) describes how aggressive the cells look, and the PSA level adds information. Together these place a cancer in a risk group.[1]
An illustration, not a stage. Human Atlas never assigns a stage. Only your own tests and your care team can do that.
Types of treatment
- Active surveillance. For many low-risk cancers: regular PSA tests, exams, MRI and repeat biopsies, with treatment started only if the cancer changes. Watchful waiting is a gentler follow-up approach focused on symptoms.[1]
- Surgery (radical prostatectomy). Removes the prostate and seminal vesicles. Possible side effects include urine leakage and erection problems.[1]
- Radiation therapy. External beam radiation or radioactive seeds placed in the prostate (brachytherapy).[1]
- Hormone therapy. Lowers or blocks male hormones that prostate cancer cells use to grow; often used with radiation or for cancer that has spread.[1]
- Other treatments. Chemotherapy, targeted therapy, immunotherapy, radiopharmaceuticals and treatments aimed at bone, mainly for advanced cancer.[1]
Which option fits depends on the details of each person’s situation. Your care team decides with you.
What you can do
Know your risk
Find out whether your father or brother had prostate cancer and at what age, and tell your clinician.[9]
Have the PSA conversation
At 55–69 (earlier if higher risk), ask about the benefits and harms of PSA testing for you.[8][9]
Stay active
Aim for 150–300 minutes of moderate activity a week plus strength training on 2 days — good for your heart, weight and recovery from any treatment.[11]
Train your pelvic floor
Pelvic floor (Kegel) exercises are often taught before and after prostate surgery to help bladder control. Ask your care team.
Follow-up usually means regular PSA tests. Side effects such as urine leakage or erection problems can often be helped — raise them with your care team rather than living with them.[1]
Questions to ask your doctor
- Based on my age and family history, should I have a PSA test? When?
- What could a raised PSA mean besides cancer?
- If I have prostate cancer, what is its Grade Group and stage, and what risk group am I in?
- Is active surveillance an option for me? How would it work?
- What are the likely side effects of each treatment, and how are they managed?
- Should I have genetic testing?
Myth vs. fact
Guided lesson
Plus Chapter 1 is free for everyone.
The Prostate, Start to Finish: where it is, what it does, BPH, PSA and prostate cancer.
Start chapter 1 freeRelated topics
Bladder cancer
Much more common in men than women. Blood in the urine — even once, even painless — is the sign never to ignore.
Enlarged prostate (BPH)
A non-cancerous enlargement of the prostate that becomes common with age and can change how you urinate. It's treatable — and not cancer.
Erectile dysfunction (ED)
Trouble getting or keeping an erection is common and treatable — and it can be an early clue to heart and blood-vessel problems worth checking.
Low testosterone (hypogonadism)
Testosterone falls only slowly with age. Real hypogonadism needs symptoms plus two low morning blood tests — and treatment isn't right for everyone.
Understanding cancer: the basics
What cancer is, how screening differs from diagnosis, what 'stage' means, and the main types of treatment — in plain English.
Sources
- National Cancer Institute. Prostate Cancer Treatment (PDQ®) – Patient Version. Checked 23 October 2026.
- American Cancer Society. Signs and Symptoms of Prostate Cancer. Checked 23 October 2026.
- National Cancer Institute. Understanding Prostate Changes: A Health Guide for Men. Checked 23 October 2026.
- American Cancer Society. Key Statistics for Prostate Cancer (2026 estimates). Checked 23 October 2026.
- American Cancer Society. Prostate Cancer Risk Factors. Checked 23 October 2026.
- NIH National Institute of Diabetes and Digestive and Kidney Diseases. Prostate Enlargement (Benign Prostatic Hyperplasia). Checked 23 October 2026.
- National Cancer Institute. Prostate Cancer Screening (PDQ®) – Patient Version. Checked 23 October 2026.
- US Preventive Services Task Force. Prostate Cancer: Screening (May 2018; an update is in progress). Checked 23 October 2026.
- American Cancer Society. American Cancer Society Recommendations for Prostate Cancer Early Detection. Checked 23 October 2026.
- National Cancer Institute. Cancer Staging. Checked 23 October 2026.
- US Department of Health and Human Services. Physical Activity Guidelines for Americans: Top 10 Things to Know. Checked 23 October 2026.
The owner of this website is not a doctor. Human Atlas provides educational anatomy information and does not diagnose, stage, or treat disease. Talk to a qualified clinician about anything concerning your own health.