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What is Prostate Cancer

Prostate cancer starts in the prostate, a small gland below the bladder that helps make semen. Many prostate cancers grow slowly; some can be more aggressive. This page explains the words and steps you may hear in clinic so you can talk with your doctor.

Key points

  • The prostate is part of the male reproductive system and surrounds the urethra.

  • Doctors may use PSA blood tests, an exam, scans, and a biopsy to check the prostate.

  • “Stage,” “Grade Group,” and PSA together help describe the cancer and plan discussions.

  • For severe new back pain with leg weakness or loss of bladder/bowel control, seek urgent medical care.

Prostate basics

The prostate is a walnut-sized gland below the bladder and in front of the rectum. It surrounds the first part of the urethra (the tube that carries urine). The prostate helps make fluid for semen.

Questions to ask your doctor

  • Where is the prostate and what does it do?

  • Could an enlarged prostate (BPH) explain my symptoms?

  • Which symptoms should I watch and when should I seek help?

What is prostate cancer

Prostate cancer happens when cells in the prostate grow in an uncontrolled way. Most prostate cancers are adenocarcinomas (start in gland cells). Some grow slowly; others can be more aggressive and may spread to nearby tissues or bones.

Questions to ask your doctor

  • Based on my tests, what are you checking for?

  • If it is cancer, how fast does it seem to grow?

  • What other conditions can look similar?

Who gets it (India)

Prostate cancer risk increases with age. It is more common after 50. Family history (father, brother with prostate cancer) may raise risk. Other factors are being studied.
In India, many men present to care when urinary symptoms bring them to clinic; awareness and timely evaluation can help earlier discussions.

Questions to ask your doctor

  • Given my age and family history, do I need any testing?

  • How often should I review my prostate health with you?

Symptoms (red flags)

Some men have no symptoms in early stages. Possible symptoms include:

  • Frequent urination, especially at night

  • Weak urine stream or trouble starting/stopping

  • Blood in urine or semen

  • Pain in the hips, back, or chest (can have many causes)

Red flags — get urgent medical care

  • New severe back pain, especially with leg weakness or numbness

  • Loss of bladder or bowel control

  • Inability to pass urine with lower belly pain

Questions to ask your doctor

  • Which of my symptoms need urgent attention?

  • What tests do you recommend to find the cause?

Screening (PSA & DRE)

Screening means checking for possible disease before symptoms appear. For the prostate, doctors may discuss:

  • PSA test: a blood test measuring prostate-specific antigen. Levels can be high for many reasons, not only cancer.

  • DRE (digital rectal exam): a clinician gently feels the prostate through the rectum to check size and texture.

Screening has benefits and limits (false positives/negatives, over-diagnosis). Whether to screen is a personal decision made after discussion with a clinician, considering age, health, and family history.

Questions to ask your doctor

  • Should I discuss PSA or DRE in my situation?

  • What could a high or changing PSA mean for me?

  • If my PSA is normal, do I still need follow-up?

Diagnosis steps

If tests suggest a problem, doctors may follow steps like:

  1. History & exam (including DRE)

  2. Repeat PSA and sometimes free/total PSA or other markers

  3. Imaging such as MRI to look at the prostate

  4. Biopsy (usually needle samples) to confirm if cancer cells are present

  5. Pathology report with Grade Group (see Glossary)

Each step helps understand what is going on and whether further tests are useful.

Questions to ask your doctor

  • Why are you recommending this test?

  • What are the possible results and what would each mean?

  • How do I prepare for a biopsy and what are common after-effects?

Staging & risk groups

If cancer is confirmed, doctors describe it using:

  • Stage (TNM): where the cancer is and if it has spread

  • Grade Group (from biopsy): how the cells look under a microscope

  • PSA level: at diagnosis

These pieces help place the cancer into risk groups (often called low, intermediate, or high). Risk groups help clinicians discuss which options may be considered. They do not by themselves choose a treatment.

Questions to ask your doctor

  • What is my stage and Grade Group?

  • Which risk group do I fall into and what does that mean?

  • What other tests, if any, are needed?

Treatments at a glance

This section describes common approaches. It does not recommend treatment. Your doctor will discuss what may apply to you.

  • Active surveillance: close monitoring with tests; treatment only if changes are seen.

  • Surgery: operations that remove the prostate (various techniques).

  • Radiation therapy: targeted radiation from outside the body or from seeds placed inside the prostate.

  • Hormone therapy (ADT): lowers or blocks androgens that can help prostate cancer grow.

  • Chemotherapy / targeted therapy: medicines that act on cancer cells.

  • Radioligand therapy: medicines that carry radiation to cancer cells.

Questions to ask your doctor

  • Which options may be considered in my case, and why?

  • What are common short-term and long-term side-effects?

  • How will we track how well a treatment is working?

Myths & facts

Myth: “High PSA always means cancer.”
Fact: PSA can rise for many reasons (enlarged prostate, infection, procedures). Doctors look at the full picture.

Myth: “A biopsy spreads cancer.”
Fact: Modern prostate biopsies are designed to minimise such risks; doctors explain benefits and risks before the procedure.

Myth: “No symptoms = no cancer.”
Fact: Some prostate cancers cause no early symptoms. Testing is based on clinical judgement and shared discussion.

Glossary

PSA (prostate-specific antigen): a protein made by the prostate; measured in blood.

DRE (digital rectal exam): a clinician examines the prostate through the rectum.

Biopsy: taking small tissue samples to look for cancer cells.

Gleason / Grade Group: a way the pathologist describes how prostate cancer cells look; used to estimate behaviour.

Staging (TNM): T = tumour in prostate, N = nearby lymph nodes, M = metastasis (spread).

ADT (androgen deprivation therapy): medicines or procedures that lower/block male hormones.

References

  1. National Cancer Institute (USA). Prostate Cancer—Patient Version. (Overview, diagnosis, staging, treatments). Cancer.gov

  2. American Cancer Society. Prostate Cancer: Overview & Early Detection, Diagnosis, and Staging. American Cancer Society

  3. Prostate Cancer UK. About prostate cancer (risk and symptoms) and Information & support hub. Prostate Cancer UK

  4. European Association of Urology. EAU Patient Information—Prostate cancer; EAU Guidelines (professional). patients.uroweb.org

  5. IARC/WHO. GLOBOCAN 2022: India Fact Sheet (dated stats; cite date on page). Global Cancer Observatory

  6. NICE Guideline NG131 (UK): Prostate cancer: diagnosis and management (methods and pathways; professional audience). NICE

  7. USPSTF (US): Prostate Cancer Screening Recommendation and literature on shared decision-making for PSA screening. USPSTF

  8. NICPR/ICMR: Prostate cancer (India context background). cancerindia.org.in

Last updated: 29 Sep 2025

“You are not alone. One step at a time is still a step.” — Anonymous

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