From Awareness to Action: Understanding Prostate Cancer
- Sherry Ainsworth
- 12 hours ago
- 6 min read
By Sherry Ainsworth, MSN, RN, ARNP
Just What Is the Prostate Gland?
It is an organ in the male body about the size of a walnut, or later in life, of a ping-pong ball or even a tennis ball. It is tightly wedged in between the bladder and the penis. It is difficult to palpate. Even with a digital rectal exam, only a small part of the prostate can be felt.
Most of us know the prostate only for the problems it causes, and not for its vital functions in sexuality and reproduction. However, it protects the sperm by producing PSA (Prostate Specific Antigen), which liquefies the semen. It neutralizes the female cervix’s blocking enzyme, allowing the sperm unrestricted access to the uterus and possibly a female egg. It also helps regulate urinary flow and produces ejaculate fluid.
As men grow older, at least two disorders can develop. One is benign prostatic hyperplasia (BPH), which is non-cancerous prostate enlargement, a common condition that restricts urine flow. Another condition, prostate cancer, is what we will focus on now.
What is Prostate Cancer?
For unknown reasons, sometimes prostate cells begin dividing at a rapid rate, forming a lump called a tumor. Parts of the tumor can then separate and spread elsewhere in the body (metastasize). Fortunately, prostate cancer usually grows slowly, and is very treatable while it is still in the gland.
Prostate Cancer – How Common Is It?
It is the most common kind of cancer found in males. The American Cancer Society (ACS) estimates that there will be approximately 313,780 new cases in 2025. It also estimates that we will have approximately 35,770 deaths from prostate cancer in 2025 (ACS, 2025). Since 2014, the incidence rate has increased by about 3% each year.
Who Is At Risk?
Approximately one out of eight men will be diagnosed with prostate cancer in their lifetime. It is most likely to develop in men over 50, typically in individuals aged 65 or older. The average age of diagnosis is about 67. The risk is greater for African American men and Caribbean men with African ancestry. It can be genetic; you are much more likely to develop it if a close family member has had it. Most men diagnosed with prostate cancer, who have treatment or monitoring, do not die from the cancer (ACS, 2025). Other possible risk factors include smoking, a history of prostatitis (inflammation of the prostate), obesity, sexually transmitted infections, and exposure to Agent Orange (a chemical used during the Vietnam War).
Signs and Symptoms
Many times, prostate cancer has no signs until the later stages of the disease. These are signs to watch for: urinary frequency, especially at night; weak urine flow; painful urination; loss of bladder or bowel control; painful ejaculation or erectile dysfunction; bloody semen or urine; or pain in your lower back, hip, or chest.
How to Find Out If It Is Cancer
Historically, the first test done is the digital rectal exam. Your provider inserts a gloved finger into the rectum and determines if there is prostate enlargement or any lumps or hardened areas. However, the effectiveness of this test has recently been debated, as only a small section of the prostate gland can be examined in this manner. There is also a blood test to determine the level of PSA in your blood. A high level could indicate cancer. However, many other conditions can cause this level to rise, so its accuracy for determining cancer is in question. The most accurate test is an MRI of the prostate (a painless type of imaging) or a transrectal ultrasound. These imaging methods can visualize the entire prostate. The only way to confirm prostate cancer is through a needle biopsy, where a needle is inserted into the prostate and a tissue sample is removed for a microscopic exam. This can also determine how aggressive the cancer is.
Grades and Stages of Prostate Cancer
The Gleason score, based on the type of cells viewed in the biopsy sample, determines the degree of abnormality in your cancer cells. The grade, or score can range from 1 to 10, with higher scores indicating a more aggressive cancer.
Staging refers to the extent to which the cancer has advanced or spread. It can be local, regional, or metastasized to lymph nodes, bones, liver, brain, lungs, or other organs.
· STAGE I – Cancer is limited to the prostate gland
· STAGE II – Cancer has spread outside the prostate but is still within the pelvic area
· STAGE III – Has spread to nearby lymph nodes or other tissues outside the gland
· STAGE IV – Has spread to distant organs like bones, lungs or liver
Treatments
Treatments vary depending on the patient’s age, general medical condition, rate of tumor growth, and the extent of tumor spread. For example, in a Stage I slowly growing cancer, especially in a patient over age 75, having no treatment except watchful waiting may be appropriate. Monitoring is conducted at regular intervals, and treatment can commence at any time, resulting in successful outcomes. Suppose monitoring indicates that the tumor is growing. In that case, the oncologist (cancer specialist) may recommend External Beam Radiation Therapy (EBRT), or the implantation of radioisotopes (insertion of radioactive “seeds” into or near the prostate gland to kill tumor cells. Treatment of Stages 2 and 3 is similar, with one or two added possible therapies.
If the cancer progresses and if the patient is in good general health, he can choose to have a radical prostatectomy (removal of the gland and nearby lymph nodes through an abdominal incision) if he understands the risks and side effects involved. There is a nerve-sparing technique designed to preserve potency. A transurethral resection of the prostate (TURP), requiring no incision, can be done, but will only relieve symptoms and not cure the cancer.
Testosterone, a hormone produced by the testicles, has both beneficial and detrimental effects. In addition to its proper functions, it also stimulates the growth and multiplication of cancer cells. It is classified as an androgen, and sometimes, androgen deprivation therapy (ADT) is used to decrease testosterone. Alternatively, the oncologist may recommend surgical removal of the testicles (orchiectomy). This has been shown to produce lower levels of testosterone than ADT (Atta, M.A., Elabbady, A., Sameh, W., Sharafeldeen, M., & Elsaga, M., Nov 13, 2019).
Prevention and Screening
Some of the best preventive measures are those things you already know for general good health, such as changing to lower-fat foods, increasing your intake of fruits and vegetables, achieving a healthy weight, exercising almost daily, and quitting smoking.
The best screening available is a yearly medical checkup, which may include a digital rectal exam and a blood test for your PSA level. Make sure you share with your provider any symptoms you have concerning painful or problematic urination, blood in your urine or other secretions, and any other pain you may have.
Hope For the Future
Other treatments still under investigation are: cryosurgery (killing tumor cells by freezing them), high-intensity focused ultrasound therapy, and photodynamic therapy (National Cancer Institute, May 14, 2025). Other ongoing research, such as that taking place at City of Hope Cancer Centers, includes using biomarkers for better detection of prostate cancer development, using neural stem cells to target and deliver anti-cancer drugs to cancer cells throughout the body, and using reengineered immune cells to target and attack prostate cancer throughout the body (City of Hope, July 1, 2024).
Remember, you are responsible for your own healthcare. Speak up and take action!
Sherry Ainsworth is a nurse practitioner/freelance writer with over 40 years of nursing experience. She now writes educational articles and contributes to health-related websites. She lives in Aberdeen, WA, with her husband and two very active cats.
References
Atta, M.A., Elabbady, A., Sameh, W., Sharafeldeen, M., & Elsaga, M. (November 13, 2019). Is there still a role for bilateral orchidectomy in androgen-deprivation therapy for metastatic prostate cancer? Arab Journal of Urology: An International Journal.
“EAU guidelines on prostate cancer.” (2023). European Association of Urology (EAU). https://uroweb.org/guidelines/prostate-cancer.
“Initial treatment of prostate cancer, by stage and risk group.” (November 22, 2023). American Cancer Society. https://www.cancer.org/cancer/types/prostate-cancer/treating/by-stage.html.
“Key Statistics for Prostate Cancer.” (2025). American Cancer Society. https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html#:~:text=from%20prostate%20cancer-,How%20common%20is%20prostate%20cancer?,35%2C770%20deaths%20from%20prostate%20cancer
Mooney, M.J. (November 9, 2018). What we know about your prostate. UT Southwestern.
“Prostate cancer.” (May 21, 2025). Cleveland Clinic.
"Prostate cancer research at City of Hope” (July 1, 2024). City of Hope. https://www.cityofhope.org/clinical-program/prostate-cancer/research#:~:text=City%20of%20Hope's%20Prostate%20Cancer,improve%20their%20quality%20of%20life
“Prostate cancer treatment (PDQ®) — Patient version.” (May 14, 2025). National Cancer Institute. https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq
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