How does prostate cancer start?

Prostate cancer begins when cells in the prostate gland start to grow out of control. The prostate is a gland found only in males. It makes some of the fluid that is part of semen. The prostate is below the bladder (the hollow organ where urine is stored) and in front of the rectum (the last part of the intestines).

cancer.org - What Is Prostate Cancer? - American Cancer Society

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What Is Prostate Cancer? Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer cells, and can then spread to other areas of the body. To learn more about cancer and how it starts and spreads, see What Is Cancer? Prostate cancer begins when cells in the prostate gland start to grow out of control. The prostate is a gland found only in males. It makes some of the fluid that is part of semen. The prostate is below the bladder (the hollow organ where urine is stored) and in front of the rectum (the last part of the intestines). Just behind the prostate are glands called seminal vesicles that make most of the fluid for semen. The urethra, which is the tube that carries urine and semen out of the body through the penis, goes through the center of the prostate. The size of the prostate can change as a man ages. In younger men, it is about the size of a walnut, but it can be much larger in older men.

Types of prostate cancer

Almost all prostate cancers are adenocarcinomas. These cancers develop from the gland cells (the cells that make the prostate fluid that is added to the semen).

Other types of cancer that can start in the prostate include:

Small cell carcinomas

Neuroendocrine tumors (other than small cell carcinomas)

Transitional cell carcinomas

Sarcomas

These other types of prostate cancer are rare. If you are told you have prostate cancer, it is almost certain to be an adenocarcinoma. Some prostate cancers grow and spread quickly, but most grow slowly. In fact, autopsy studies show that many older men (and even some younger men) who died of other causes also had prostate cancer that never affected them during their lives. In many cases, neither they nor their doctors even knew they had it.

Possible pre-cancerous conditions of the prostate

Some research suggests that prostate cancer starts out as a pre-cancerous condition, although this is not yet known for sure. These conditions are sometimes found when a man has a prostate biopsy (removal of small pieces of the prostate to look for cancer). The patterns of prostate cells appear almost normal. High-grade PIN: The patterns of cells look more abnormal. Low-grade PIN is not thought to be related to a man’s risk of prostate cancer. On the other hand, high-grade PIN is thought to be a possible precursor to prostate cancer. If you have a prostate biopsy and high-grade PIN is found, there is a greater chance that you might develop prostate cancer over time. PIN begins to appear in the prostates of some men as early as in their 20s. But many men with PIN will never develop prostate cancer.

Proliferative inflammatory atrophy (PIA)

In PIA, the prostate cells look smaller than normal, and there are signs of inflammation in the area. PIA is not cancer, but researchers believe that PIA may sometimes lead to high-grade PIN, or perhaps directly to prostate cancer.

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How would you feel if you had prostate cancer?

Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night. Blood in the urine or semen. Trouble getting an erection (erectile dysfunction or ED) Pain in the hips, back (spine), chest (ribs), or other areas from cancer that has spread to bones.

cancer.org - Prostate Cancer Signs and Symptoms - American Cancer Society

Signs and Symptoms of Prostate Cancer

Most prostate cancers are found early, through screening. Early prostate cancer usually causes no symptoms. More advanced prostate cancers can sometimes cause symptoms, such as: Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night

Blood in the urine or semen

Trouble getting an erection (erectile dysfunction or ED)

Pain in the hips, back (spine), chest (ribs), or other areas from cancer that has spread to bones Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord Most of these problems are more likely to be caused by something other than prostate cancer. For example, trouble urinating is much more often caused by benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate. Still, it’s important to tell your health care provider if you have any of these symptoms so that the cause can be found and treated, if needed. Some men might need more tests to check for prostate cancer.

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