Prostate cancer – Symptoms, causes & treatment

Prostate cancer is the most common form of cancer among men. The disease usually develops slowly and can remain in the body for many years without showing any clear symptoms. Most cases are detected in the early stages, which allows for effective treatment.

Symptoms of prostate cancer

In its early stages, prostate cancer often causes no symptoms. As the disease progresses, certain changes may occur that could be signs that the cancer has begun to affect the body.

A common symptom is problems with urination. This may include difficulty emptying the bladder completely, a weak urine stream, frequent urination (especially at night), or sudden urges to urinate.
In more advanced cases, pain in the pelvis, hips, or lower back may occur. Blood in the urine or semen can also be present. If the cancer spreads, it may cause fatigue, weight loss, and a general feeling of illness.

Since these symptoms can also be caused by other, less serious conditions—such as an enlarged prostate or urinary tract infection—it’s important to consult a doctor for a medical evaluation.

Causes and risk factors

There are several factors that can increase the risk of developing prostate cancer.

Age
The risk of prostate cancer increases with age. The disease is rare before the age of 50 but becomes increasingly common thereafter. Most cases are diagnosed in men over 65.

Hereditary and genetic factors
If a close relative, such as a father or brother, has had prostate cancer, the risk increases. The risk is even higher if multiple family members have had the disease, especially if diagnosed at a younger age. Certain genetic mutations, such as BRCA2 and HOXB13, have been linked to a higher risk of prostate cancer.

Diet and lifestyle
There are some associations between diet and prostate cancer, although the research is not entirely conclusive. A diet high in red meat, processed foods, and saturated fats may increase the risk, while a healthy diet rich in fruits, vegetables, and fish may offer some protection. Physical inactivity and obesity have also been linked to an increased risk of more aggressive prostate cancer.

How is prostate cancer diagnosed?

Prostate cancer can be detected through various examinations.

A common first step is a PSA test, a blood test that measures the levels of prostate-specific antigen. High PSA levels can be a sign of prostate cancer, but may also result from other conditions like benign prostate enlargement or inflammation.

If PSA levels are elevated, the doctor may perform a digital rectal exam to feel the prostate gland through the rectum for any abnormalities.

If cancer is suspected, a tissue biopsy may be performed, where small samples of prostate tissue are examined under a microscope. In some cases, an MRI scan is also used to get a more detailed image of the prostate.

Treatment of prostate cancer

The choice of treatment depends on how advanced the disease is, as well as the patient's age and overall health.

Active surveillance
For some men with low-risk cancer, active surveillance may be an option. This involves regular PSA tests, checkups, and sometimes biopsies to monitor the disease without starting treatment immediately.

Surgery
In cases of localized prostate cancer, surgery to remove the prostate gland may be an option. The procedure may also include removing nearby lymph nodes.

Radiation therapy
Radiation can be used either as a standalone treatment or after surgery to reduce the risk of recurrence. Radiation may be delivered externally using a radiation machine or internally by placing radioactive seeds in the prostate (brachytherapy).

Hormone therapy
If the cancer has spread, hormone therapy may be used to lower testosterone levels, which slows the tumor's growth. Hormone therapy is often combined with other treatments.

Chemotherapy and targeted therapy
In more advanced cases, chemotherapy may be used to slow the progression of the disease. There are also targeted medications used for certain aggressive forms of prostate cancer.

The importance of prevention and regular checkups

Although prostate cancer often develops slowly, it’s important to be aware of the risk factors and seek medical attention if symptoms occur.

Men with a family history or other risk factors may consider regular PSA testing for early detection. However, PSA screening has both pros and cons, as the test can sometimes lead to unnecessary worry and overdiagnosis.

Living a healthy lifestyle with a balanced diet, regular exercise, and avoiding smoking can also help reduce the risk of developing aggressive prostate cancer.

Sources: 

VISS. Vårdprogram Prostatacancer. VISS. Accessed April 5, 2025. https://viss.nu/kunskapsstod/vardprogram/prostatacancer-inklusive-svf