Prostate Cancer Awareness: Warning Signs, Causes and Treatment Options

20 May 2025

Posted in

Prostate cancer is a major health concern for men, yet many remain unaware of its warning signs, causes and treatments. In this blog, we speak with Tyler Gutschenritter, M.D., a radiation oncologist at INTEGRIS Health Cancer Institute, to help you enhance your understanding of prostate cancer and promote early detection.

Prostate cancer basics

At a glance: Prostate cancer is one of the most common types of cancer among men, with 13 percent of men developing it at some point in their life, according to the CDC. Despite its prevalence, prostate cancer is a slow-growing cancer and is usually successfully treated when detected early.

The prostate is a small, walnut-sized gland located below the bladder and in front of the rectum.

This gland plays an important role in the male reproductive system by producing seminal fluid, a component of semen that nourishes and transports sperm during ejaculation.
When a man ejaculates, the prostate helps push out fluid and sperm through the urethra (tube that carries urine and semen).

With prostate cancer, genetic mutations and hormonal changes – the hormones testosterone and dihydrotestosterone (DHT) bind to androgen receptors in prostate cells – lead to excessive cell growth and tumor formation.

As these cancerous cells continue to grow and divide, they form a mass or tumor within the prostate gland.
Over time, if left untreated, the tumor can grow beyond the prostate and invade surrounding tissues.
Prostate cancer cells can also break away from the primary tumor and spread to other parts of the body (bones, lymph nodes and other organs) through the lymphatic system or bloodstream, a process known as metastasis.

A majority of prostate cancer cases are diagnosed in males over the age of 65.

African American men are at a significantly higher risk of developing prostate cancer compared to men of other races.
People with a family history of the disease are also more susceptible.

Because of this, average-risk men typically begin prostate cancer screening at age 50.

The prostate-specific antigen (PSA) blood test and the digital rectal exam (DRE) are the two ways to screen for prostate cancer.
The PSA test measures the level of PSA in the blood, which can be elevated in men with prostate cancer, while the DRE allows a doctor to physically examine the prostate for abnormalities.

“Screening for prostate cancer with PSA is a simple blood test that allows patients to detect prostate cancer early and have the best opportunity to receive the treatment that is tailored to their personal preferences,” Gutschenritter says. “I greatly enjoy helping prostate cancer patients find the treatment that best suits their goals.”

What causes prostate cancer?

The facts: Prostate cancer occurs due to a combination of genetic, environmental and lifestyle factors that contribute to the transformation of normal prostate cells into cancerous ones.

The process of prostate cancer begins with genetic mutations in the DNA of prostate cells.

These mutations can be inherited or acquired over a person's lifetime.
Family history significantly increases prostate cancer risk, particularly for those with close relatives affected.
BRCA1 and BRCA2 gene mutations are linked to higher risk.

Environmental and lifestyle factors also play a role.

Consuming a diet high in red and processed meats, high in saturated fat and low in fruits and vegetables may increase the risk of prostate cancer.
A sedentary lifestyle is linked to a higher risk of prostate cancer.
Being overweight or obese is associated with an increased risk of aggressive prostate cancer.
Exposure to certain chemicals, such as those found in pesticides, herbicides and industrial products, can elevate the risk of prostate cancer.
Smoking is linked to a higher risk of prostate cancer, particularly aggressive forms of cancer.
Excessive alcohol consumption may increase prostate cancer risk.

As men age, prostate cancer becomes more likely due to a higher chance of hormonal changes, hormonal fluctuations and the inability to efficiently perform cellular repair.

The mutations can disrupt normal cell growth and repair processes, increasing the risk of cancerous changes in prostate cells.
Likewise, hormone levels promote conditions favorable for cancer development by influencing prostate cell growth.
The immune system and cellular repair mechanisms tend to become less efficient with age, allowing abnormal cells to grow out of control.

Five warning signs of prostate cancer

Why it matters: Prostate cancer often shows no symptoms until advanced stages, as it develops slowly. Symptoms like urination or ejaculation issues can also result from aging or other health problems, not necessarily cancer. Experiencing these symptoms should prompt a visit to a urologist for evaluation.

Difficulty urinating may present itself as trouble starting or maintaining a steady stream of urine.

This occurs because the tumor might press against the urethra, obstructing urine flow.

Frequent urination, particularly during the night, is another common symptom.

This can result from pressure on the bladder or urethra, leading to frequent urges.

Blood in urine or semen should never be ignored.

The presence of blood may result from the tumor disrupting normal blood vessels or tissues.

Pain while urinating may develop due to the prostate's anatomical position surrounding the urethra and surrounding nerves and muscles.

A tumor can press against or obstruct the urethra, causing discomfort or pain during urination.
The prostate is in close proximity to many nerves (pudendal nerve, pelvic nerve and hypogastric nerve) and muscles (pelvic floor muscles, detrusor muscle and sphincter muscles) involved in urinary function, and these can also be impacted by a tumor.

Sexual issues, such as erectile dysfunction or painful ejaculation, may arise.

Erectile dysfunction can occur if prostate cancer affects nerves or blood vessels involved in achieving an erection.
Painful ejaculation may arise if the prostate tissue becomes inflamed or cancerous, disrupting normal function.

More reading: For a more in depth look at the signs and symptoms of prostate cancer, read our blog on the most common warning signs.

Prostate cancer treatment

The bottom line: Treatment options for prostate cancer vary based on several factors, including the cancer's stage, the patient's age, overall health and personal preferences. Common treatments include surgery, radiation therapy, hormone therapy, chemotherapy and active surveillance.

Prostate cancer surgery, also called a radical prostatectomy, involves the removal of the prostate gland and some surrounding tissue.

A surgical oncologist typically recommends the surgery for localized prostate cancer.
The surgery can be performed open or laparoscopically, with the latter being more common nowadays due to a smaller incision and shorter recovery time.
Common side effects can include incontinence and erectile dysfunction.

Radiation therapy treats prostate cancer both in early stages before spreading and in advanced stages when it affects nearby tissues.

Brachytherapy, or internal radiation, treats localized prostate cancer by implanting radioactive seeds in the prostate to kill cancer cells.
External beam radiation therapy is used to treat localized and advanced prostate cancer by delivering high energy X-rays or protons from a machine that can precisely target the cancer.
Common side effects can include more frequent urination and bowel movements.
Both radiation and surgery can be excellent curative treatments for prostate cancer, and the optimal treatment for each patient depends on stage, health conditions and personal preferences.

“As a radiation oncologist, I am able to offer multiple types of radiation treatments for prostate cancer,” Gutschenritter says. “I am also able to perform procedures such as placing fiducial markers and a rectal hydrogel spacer to help make treatment more precise and minimize the effects of prostate radiation.”

Hormone therapy focuses on suppressing androgens in your body.

The main options include orchiectomy (surgery to remove the testicles) and medications such as luteinizing hormone-releasing hormone (LHRH) agonists.
This treatment is for recurrent or advanced prostate cancer not curable by surgery or radiation.

Chemotherapy uses drugs to kill or stop the growth of cancer cells.

Common drugs include docetaxel and cabazitaxel, which target and destroy cancer cells throughout the body.
Chemo is typically recommended for advanced or hormone-resistant prostate cancer.

Immunotherapy uses medications to enhance the immune system to fight cancer.

One treatment, Sipuleucel-T, involves extracting white blood cells, exposing them to a prostate cancer protein in a lab and reinfusing them to stimulate an immune response against cancer cells.
Immunotherapy is used for advanced prostate cancer unresponsive to hormone therapy with minimal symptoms.

Active surveillance involves closely monitoring the cancer without immediate treatment.

Doctors recommend this path for men with no symptoms or slow-growing, small tumors.
It involves frequent doctor visits, PSA tests and biopsies.

Next steps: If you're concerned about prostate health or notice any symptoms, consult with your primary care doctor or a urologist for further examination.