Prostate cancer occurs when the cells of the gland grow out of control.
Prostate cancer is a disease that affects many men around the world, especially those over 50 years old.
It is the second most common type of cancer among men in Brazil, behind only non-melanoma skin cancer. The National Cancer Institute (INCA) estimates more than 704,000 cancer cases per year in the country until 2025, over 10% of them located in the prostate.
It is possible to treat the disease with surgery, radiotherapy, chemotherapy, or hormone therapy, depending on the stage and aggressiveness of the cancer.
Prostate cancer usually does not cause symptoms at an early stage. That is why men should be aware of the importance of regular urology visits and periodic tests as recommended by their chosen specialist.
Blood tests can indicate changes, and the results should be combined with those from the digital rectal exam, which can also reveal potential irregularities or nodules.
Keep reading to learn more about this disease, ways to prevent it, and the available treatment options.
What is the prostate?
The prostate is a gland responsible for producing a fluid that is part of semen. This prostatic fluid is slightly alkaline and contains various substances—such as enzymes, zinc, and citric acid—essential for male fertility.
The fluid helps nourish and protect sperm, making the environment more favorable for their survival and thus increasing the chances of fertilization.
In addition, the prostate plays an important role in the male reproductive system. When a man ejaculates, the muscles of the prostate contract, helping to expel semen through the urethra and out of the body.
This mechanism ensures that semen is released with enough force to reach the uterus during sexual intercourse.
What is prostate cancer?
Prostate cancer is a disease that develops in the gland. The tumor forms when prostate cells begin to grow uncontrollably.
It can vary widely in aggressiveness. Some types grow slowly and cause few problems. These cases are actively monitored without immediate treatment—a strategy called active surveillance.
However, other types may be more aggressive and grow rapidly, spreading to other parts of the body, such as bones and lymph nodes. Severity depends on several factors, including the stage and grade of the tumor.
Early stages—when the cancer is confined to the prostate—have a very good prognosis. When it spreads to other parts of the body (metastasis), treatment becomes more complex and prolonged.
What are the causes of prostate cancer?
The most significant risk factor for prostate cancer is age. According to INCA, most cases occur in men over 50, and risk increases significantly with age. About 75% of diagnoses are made in men aged 65 or older.
- Older age: risk rises significantly from age 50.
- Family history: men with close relatives (father or brothers) who had prostate cancer are at higher risk.
- Genetic changes: certain mutations, such as BRCA1 and BRCA2, are associated with a higher risk.
- Race: Black men have a higher chance of developing prostate cancer, which may also be more aggressive.
- High-fat diet: diets rich in fat—especially of animal origin—may be linked to higher risk.
- Sedentary lifestyle and obesity: lack of regular physical activity and excess weight can contribute to the disease.
- Inflammation and infections: chronic inflammatory conditions of the prostate, such as prostatitis, may increase risk. Recurrent urinary infections have also been associated with higher risk.
Related: Does anal sex cause prostate cancer?
Symptoms of prostate cancer
Although it is often a silent disease, some signs may indicate that something is wrong with the prostate.
Abnormalities directly affect urination because the channel that empties the bladder passes through the prostate. It is important to observe the frequency of urination, how many times you wake up at night to urinate, the strength of the urine stream, urinary control, and the sensation after bladder emptying.
Other symptoms of prostate cancer include:
- Blood in the urine or semen;
- Pain when urinating or ejaculating;
- Persistent pain in the lower back, hips, or pelvis;
- Difficulty achieving or maintaining an erection;
- Reduced semen volume;
- Weakness or numbness in the legs.
People with prostate cancer may also experience persistent pain and sexual difficulties. Recognizing these symptoms and seeking medical care promptly can make a significant difference to management and prognosis.
The 5 types of prostate cancer
Prostate cancer is not a single disease but a group of conditions affecting the prostate gland in different ways. Understanding the types helps clarify treatment options.
The most common are:
- Adenocarcinoma: accounts for about 95% of cases and originates in the glandular cells that produce prostatic fluid.
- Small cell carcinoma: grows quickly and spreads early. Cancer cells are small but multiply rapidly, and PSA levels may not rise.
- Squamous cell carcinoma: develops in the squamous cells lining the gland. It typically does not raise PSA levels, which may hinder early diagnosis.
- Urothelial carcinoma: a rare type that develops in cells lining the urethra and bladder and can involve the prostate.
- Sarcoma and sarcomatoid carcinoma: extremely rare types that arise in the connective or muscular tissue of the prostate and are often aggressive.
Which tests diagnose prostate cancer?
Detecting the tumor early is crucial for effective management. There are several prostate exams that help identify the disease and assess whether the tumor is benign or malignant, as well as whether it has spread.
Key tests for prostate cancer include:
- PSA test (Prostate-Specific Antigen): a blood test that measures PSA, a protein produced by the prostate. Elevated levels may indicate cancer but also other conditions such as infections or benign prostatic hyperplasia (BPH).
- Digital rectal exam: the doctor inserts a lubricated finger into the rectum to feel the prostate and check for hard or irregular areas.
- Prostate biopsy: if prior tests are abnormal, small tissue samples are taken to confirm cancer cells.
- MRI and transrectal ultrasound: these imaging tests show the location and extent of the tumor.
- CT scan and bone scintigraphy: used to check for spread to lymph nodes or bones in metastatic cases.
How long does prostate cancer take to manifest?
On average, the development time of prostate cancer is around four years. In many cases, it is detected during routine exams before causing symptoms.
Older men, especially those over 65, are more frequently diagnosed due to the time required for the cancer to develop.
Can the tumor be prevented?
Preventive actions for prostate cancer generally involve adopting a healthy lifestyle:
- Eat a balanced diet;
- Exercise regularly;
- Maintain a healthy weight and avoid obesity;
- Avoid alcohol, smoking, and illicit drugs.
You should also keep your men’s health checkups up to date.
It is recommended that men see a urologist annually and, from age 40, undergo preventive screening. Early diagnosis helps broaden treatment options and may reduce the need for invasive approaches.
Related: 14 foods good for the prostate to support your health
When is prostate cancer considered severe?
Prostate cancer is considered severe when it reaches more advanced stages—especially when it spreads to other organs such as bones, liver, and lungs.
At this point, the tumor is no longer confined to the prostate, and management becomes more complex. The focus often shifts to controlling the disease and relieving symptoms.
Signs that prostate cancer may be advanced include:
- Pain when urinating
- Blood in the urine
- Pain in the lower back or bones
- Unintentional weight loss
- Excessive fatigue
These symptoms often appear when the tumor is more developed, reinforcing the importance of early diagnosis of prostate cancer.
What are the chances of curing prostate cancer?
The chance of cure depends mainly on the stage at diagnosis and the treatment chosen. When the cancer is confined to the prostate or has spread only to nearby areas, outcomes are generally favorable.
For men diagnosed with localized or regional disease, the five-year survival rate is close to 100%, according to INCA data.
However, rates are lower in metastatic cases.
Treatments can still help control the cancer and contribute to quality of life.
Does prostate cancer hurt?
Prostate cancer can cause pain in more advanced stages, especially if it spreads to bones or other parts of the body. Men may feel pain when urinating, or discomfort in the lower back, hips, or bones.
In the early stages, however, prostate cancer rarely causes pain or any other symptoms. Routine exams are important to detect the disease before it progresses.
If left untreated, what can prostate cancer cause?
If untreated, prostate cancer can spread to other parts of the body, causing metastasis.
In such cases, management becomes more difficult, and the focus shifts to symptom control and quality of life. Bone metastasis, for example, can cause intense pain and fractures.
Untreated disease may also lead to complications such as kidney failure if the tumor obstructs urine flow.
Quality of life can be directly affected by pain, urinary difficulties, and generalized weakness.
What are the indicated treatments?
Treatment depends on the stage of prostate cancer, overall health, and patient preferences. Several options are available, each with different durations and approaches.
- Radiotherapy: uses radiation to destroy cancer cells. Two types exist: external beam radiotherapy and brachytherapy (radioactive seed implants in the prostate).
- Hormone therapy: reduces male hormones that fuel cancer growth.
- Chemotherapy: uses drugs to kill cancer cells; indicated for advanced or metastatic disease unresponsive to hormone therapy.
- Immunotherapy: boosts the immune system to fight cancer.
- Radical prostatectomy: surgery that removes the gland.
Related: Prostate massage: what it is and potential benefits
How is post-treatment monitoring done?
Follow-up after treatment is essential to check for recurrence and manage side effects.
The PSA test should be performed regularly to monitor prostate-specific antigen levels.
Follow-up visits with the urologist are important to assess new symptoms or concerns. Digital rectal exams may be included.
In the first years after treatment, PSA tests and visits are typically scheduled every three to six months. If stable, frequency may be reduced to once a year after five years.
Prostate cancer can be prevented in part with healthy habits and treated according to medical guidance. Do not neglect your health.
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Frequently asked questions
Does it only affect older men?
No. Prostate cancer can also be diagnosed in younger individuals. Incidence in this group has been increasing.
A recent study published in Scientific Reports (2025) showed a consistent rise among men aged 15–49 between 1990 and 2021 in 204 countries.
Do Black people have a higher risk?
Yes. Individuals of African descent have higher odds compared with those of European ancestry.
A U.S. study published in 2024 in JAMA Network Open reported 11% greater disease progression among Black men than white men.
Does the disease affect sexual life?
Yes. Prostate cancer can impact sexual health in different ways. Diagnosis-related stress may contribute to low libido and/or erectile dysfunction.
Is a high PSA a sign of prostate cancer?
High PSA can be due to prostate cancer but also to benign conditions such as benign prostatic hyperplasia.
Therefore, the digital rectal exam and an individualized risk assessment (age, family history, race, comorbidities) are also important.
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