Prostate Cancer

What is it?

Prostate cancer is cancer that begins in the prostate gland (which is present in people assigned male at birth unless surgically removed). Most prostate cancers are slow growing and diagnosed in those who are older than 65. When found early before the cancer has spread beyond the prostate, the five-year survival rate is close to 100%.

Early Detection = Better Outcomes®, so it’s important to get screened, reduce your risk, and talk with your health care provider about your health history.

Multi-ethnic group of middle aged men playing basketball.

Get screened

Screening is done with a prostate-specific antigen (PSA) blood test. A digital rectal exam (DRE) may also be done as part of screening. If you have a prostate gland, follow these screening guidelines:*

*Source: American Cancer Society

Ages 45-69: If you have a significant family history

If you have a strong family history of prostate cancer, begin screening with a PSA test at age 45. You should be screened every year until age 69.

Having a strong family history means:

You have a close relative (parent, child or sibling) who had prostate cancer before age 65
You have more than one close relative (parent, child or sibling) who was diagnosed with prostate cancer at any age.

If you are not Black and have just one close relative (parent, child or sibling) who was diagnosed with prostate cancer at age 65 or older, you should get screened every two years from ages 45-69.

Ages 45-69: If you are Black

If you are Black, begin screening with a PSA test at age 45. You should be screened every year until age 69. This applies regardless of whether or not you have a family history of prostate cancer.

Ages 50-69: If you're at average risk

Start getting screened at age 50 if you are at average risk of prostate cancer. You should be screened with a PSA test every two years until age 69.

Ages 70-74: Individual decision

Continuing screening at ages 70-74 is an individual decision, as the balance of benefits and harms remains uncertain. Talk to your healthcare provider for help deciding if you should be screened.

Screening is not recommended for those ages 75 and older. Some people in this age group who are very healthy may want to continue screening; you should discuss this with a healthcare provider.

If you are age 80 or older, you should not get screened.

Additional screening: If you have an elevated PSA

If you have an elevated PSA level, you should undergo repeat PSA testing between two weeks and three months.

If you have a confirmed elevated PSA level, you can get testing with magnetic resonance imaging (MRI) and/or a validated biomarker test to help determine whether you need a prostate biopsy.

What is considered an elevated PSA level?

Ages 45-69: 3.0 ng/mL or higher

Ages 70-74: 6.5 ng/mL or higher

Insurance coverage

Under federal law, private insurers and Medicaid are required to cover services that have an “A” or “B” grade by the U.S. Preventive Services Task Force (USPSTF). Some insurers may choose to cover services for additional groups. Medicare coverage for preventive services is limited to tests for which Congress has explicitly authorized coverage.

Guidelines from the USPSTF give a “C” grade for PSA testing for men ages 55 to 69 and a “D” grade for men 70 and older. They advise a shared-decision making process between patient and provider. The American Cancer Society recommends beginning screening at age 45 or 50, depending on risk factors.

Always check with your insurance provider to find out if you’ll be covered for routine prostate cancer screening.

Know your risk

If you have a prostate gland, you are at increased risk for prostate cancer if you:

Are age 50 or older.
Are overweight or medically classified as obese.
Use tobacco products, including cigarettes, or used them in the past.
Are Black.
Have BRCA1 or BRCA2 mutations or Lynch syndrome.
Have a personal or family history of prostate cancer.

Reduce your risk

You may reduce your risk for prostate cancer through these lifestyle-related risk modifications:

Avoid all forms of tobacco.

Know your family health history.

A family history of prostate cancer may mean you need to get screened earlier or more frequently than those of average risk. If you have a strong family history of prostate cancer (or if you are Black), you should be screened annually beginning at age 45 until age 65. If you have just one close relative diagnosed with prostate cancer at 65 or older, you should be screened every two years beginning at age 45 until age 65.

Maintain a healthy weight.

Get screened for prostate cancer based on guidelines and your personal risk factors.

Signs & symptoms

There are usually no symptoms in the early stages of prostate cancer. Some symptoms could also be caused by other health problems, including an enlarged prostate or benign prostate hyperplasia (BPH). Talk with your health care provider if you experience:

Urinary problems, such as having trouble starting or stopping urine flow, having a weak or interrupted urine flow, or feeling pain or a burning sensation while urinating.
A need to urinate more frequently, particularly at night.
Blood in the urine.
Painful or difficult erection.
Pain in the lower back, pelvis or upper thighs.

Treatment options

Treatment depends on the type and grade of tumor cells, stage of the cancer and your other medical conditions.

Active surveillance

Some prostate cancers grow very slowly and do not require immediate treatment. In these cases, you and your health care provider may decide on “active surveillance” (sometimes called “watchful waiting”) with regular follow-ups, usually every three to six months. This option should be open to reassessment, as your condition or concerns may change.

Surgery

Prostate cancer surgery typically includes removal of the prostate (prostatectomy) along with the seminal vesicles and sometimes the surrounding lymph nodes.

Radiation

This treatment uses high doses of radiation to kill cancer cells and shrink tumors. It may be used alone or in combination with another therapy before or after surgery.

Hormone therapy

This treatment is used to block the hormones that cause cells, including cancer cells, to grow. It may be used alone or in combination with another therapy before or after surgery.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It is usually used to treat more advanced prostate cancer and can be given along with hormone therapy or by itself.

Immunotherapy

This type of cancer treatment helps your immune system better respond to the cancer to detect and destroy abnormal cells. It is usually used to treat more advanced prostate cancer.

Focal therapy

This minimally invasive treatment uses methods like extreme cold or heat to destroy the abnormal cells when surgery or radiation is not possible.

“What I had was an awareness”: Allan Houston on early detection and a family fight against prostate cancer

The two-time NBA All-Star and Olympic gold medalist watched his father fight and survive cancer—and then faced the very same diagnosis 13 years later.

Learn More