What is prostate cancer?

The prostate is a small gland below the bladder. It sits in front of the rectum. It helps make the fluid in semen. Prostate cancer starts when cells in the prostate grow out of control. Other than skin cancer, it is the most common cancer in men in the US. It is more common with older age, in Black men, and in families with prostate, breast, ovarian, or pancreatic cancer.

When should I call my care team?

New back pain with weakness, numbness, or tingling in your legs; Trouble controlling your bladder or bowels that is new; You cannot pass urine at all; Fever of 100.4 F (38 C) or higher, or chills, especially during chemotherapy; Severe or new bone pain that does not get better with your usual pain medicine; Blood in your urine with clots, or heavy bleeding from the rectum; Chest pain, shortness of breath, or a racing or irregular heartbeat; Sudden confusion, fainting, a seizure, or signs of a stroke such as face drooping or slurred speech; Swelling, pain, and redness in one leg; Severe dizziness, muscle weakness, or cramps while on abiraterone.

Prostate cancer

Prostate cancer is common, and many people live for years with it, often with a wide range of treatment choices at every stage.

Hi, I'm Rosa. Today we'll go through prostate cancer together, one step at a time. I'll keep it simple, and you can pause me, go back, or skip ahead whenever you like. Just so you know, this is for learning only. It is not medical advice, so please check everything with your own doctor and care team. Okay, let's get started.

What prostate cancer is

Let's start with the basics. The prostate is a small gland below the bladder. It helps make the fluid in semen. Prostate cancer starts when cells there grow out of control. It is more common as men get older. Many prostate cancers grow very slowly. Some may never cause harm. Others grow faster and need treatment. This cancer often needs the hormone testosterone to grow. That is why many treatments lower it. Your care team will use test results to learn which kind you have.

Types and disease stages

Let's talk briefly about the types. Almost everyone has a type called adenocarcinoma. It starts in the gland cells. Doctors also describe where the disease is. Localized cancer stays in or just around the prostate. Sometimes a blood test rises after treatment, but scans look clear. That is called biochemical recurrence. Hormone sensitive cancer has spread, but still responds to lowering testosterone. Castration resistant cancer keeps growing even when testosterone is very low. There are still many options then. A rare, fast growing kind is called small cell prostate cancer.

Tests you may have

Now let's talk about tests. The PSA blood test measures a protein made by the prostate. A rectal exam lets the doctor feel the prostate for lumps. A prostate MRI takes detailed pictures and can guide a biopsy. A biopsy takes small samples to confirm cancer and its grade. A special PET scan can find small spots that other scans miss. Bone scans and CT scans look for spread. A testosterone blood test shows if hormone therapy works. A bone density scan checks how strong your bones are.

What the stage and grade mean

Next up, let's talk about stage and grade. The grade tells how abnormal the cells look. A higher number may mean faster growth. The stage tells how far the cancer has spread. Your team looks at the stage, the grade, and your blood test together. This puts the cancer in a risk group. Why do doctors do this? It helps them plan the right treatment for you. It also helps everyone talk the same language. Your doctor will explain your group.

Gene tests and markers

Before we move to treatment, there are some things to know. Some prostate cancers have gene changes. Some are inherited, and some are only in the tumor. Knowing about them can open more treatment choices. There are many different markers. Each one has a different role. Inherited results may matter for your family too. Your doctor will tell you which markers you have. They will also explain what they mean for you. You can read more in the guide. The Questions to ask page can help too.

Main treatment options

Now let's look at treatment. Active surveillance means close watching of low risk cancer. Surgery removes the whole prostate. Radiation uses high energy beams or tiny seeds. Hormone therapy lowers testosterone with shots, implants, or pills. Newer hormone pills block testosterone even more. Chemotherapy is medicine that kills fast growing cells. Some pills work best with certain gene changes. A radioactive medicine can seek out cancer cells in advanced disease. Clinical trials are research studies that may offer new options. Ask your care team if one is right for you.

Side effects and what helps

Let's talk about side effects. Leaking urine is common after surgery. Pelvic floor exercises often help. Erection problems can happen, and there are treatments for that. Radiation can irritate the bladder and bowel for a while. Hormone therapy can cause hot flashes and tiredness. Walking and strength exercise help a lot. Hormone therapy can also thin your bones. Calcium, vitamin D, and exercise help protect them. It is okay to bring up any of this with your team. We have a whole side effects guide on this site.

Living well with it

Last, let's talk about living well. Many people live a long time with prostate cancer. You will have regular blood tests after treatment. Your team looks at the trend, not one number. Stay active, eat well, and do not smoke. Your feelings, bladder, and sexual health matter too. Counseling and support groups can help. Call right away for new back pain with leg weakness. Also call if you cannot pass urine, or have a fever. If it feels very bad, call 911. Also see our new Screening, prevention and survivorship section.

You did great today. That was a lot, and you took it one step at a time. Write down your questions and bring them to your next visit. Call your care team any time something worries you. You are not alone in this.

Call your care team right away if you have

New back pain with weakness, numbness, or tingling in your legs
Trouble controlling your bladder or bowels that is new
You cannot pass urine at all
Fever of 100.4 F (38 C) or higher, or chills, especially during chemotherapy
Severe or new bone pain that does not get better with your usual pain medicine
Blood in your urine with clots, or heavy bleeding from the rectum
Chest pain, shortness of breath, or a racing or irregular heartbeat
Sudden confusion, fainting, a seizure, or signs of a stroke such as face drooping or slurred speech
Swelling, pain, and redness in one leg
Severe dizziness, muscle weakness, or cramps while on abiraterone

Side effects: what helps

Sources

Quick answers

What is prostate cancer?: The prostate is a small gland below the bladder. It sits in front of the rectum. It helps make the fluid in semen. Prostate cancer starts when cells in the prostate grow out of control. Other than skin cancer, it is the most common cancer in men in the US. It is more common with older age, in Black men, and in families with prostate, breast, ovarian, or pancreatic cancer.
When should I call my care team?: New back pain with weakness, numbness, or tingling in your legs; Trouble controlling your bladder or bowels that is new; You cannot pass urine at all; Fever of 100.4 F (38 C) or higher, or chills, especially during chemotherapy; Severe or new bone pain that does not get better with your usual pain medicine; Blood in your urine with clots, or heavy bleeding from the rectum; Chest pain, shortness of breath, or a racing or irregular heartbeat; Sudden confusion, fainting, a seizure, or signs of a stroke such as face drooping or slurred speech; Swelling, pain, and redness in one leg; Severe dizziness, muscle weakness, or cramps while on abiraterone.

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.