Understanding the Formation and Spread of Prostate Cancer: What Every Man Should Know

By Dr. David Samadi

Cancer, including prostate cancer, can feel like an enigma—many men diagnosed with the disease have questions about how it forms and spreads. It can be to your advantage to understand the mechanics behind prostate which can be vital to be better prepared for decision-making and deciding your care. 

If you or someone you know has been diagnosed with prostate cancer, asking your urologist to explain the differences between localized and metastatic disease, as well as where cancer cells can spread, is a valuable step toward taking control of your health.

Prostate Cancer: A Common Diagnosis

Prostate cancer is a commonly cancer diagnosed in American men. In fact, it’s the second leading cause of cancer-related deaths in men. Over the course of a man’s lifetime, approximately 1 in 8 will hear the words, “You have prostate cancer.” Knowledge is power; understanding prostate cancer and knowing that earlier detection can lead to better treatment outcomes is vital.

The Role of the Prostate Gland

The walnut-sized prostate is a small but essential gland found only in men. It is situated beneath the bladder and in front of the rectum and surrounds the urethra—the tube that carries urine out of the body. This gland has a starring role in the continuation of the human race as it produces prostate fluid, a vital component of semen.

How Does Prostate Cancer Develop?

Prostate cancer begins when abnormal cells grow uncontrollably within the prostate, forming a tumor. Based on its progression, prostate cancer falls into three categories:

• Localized Prostate Cancer
• Locally Advanced Prostate Cancer
• Metastatic Prostate Cancer

Let’s examine each stage in detail.

Localized Prostate Cancer

Localized prostate cancer means that the cancerous cells are confined within the prostate gland and have not spread to other parts of the body. Often, this stage is asymptomatic or presents mild symptoms such as:

• Difficulty urinating (weak stream, pain, or difficulty starting/stopping)
• Pain in the lower back
• Discomfort during ejaculation
• Blood in urine

Adenocarcinoma, a cancer that develops in the fluid-producing cells of the prostate, is the most common form of localized prostate cancer.

Locally Advanced Prostate Cancer

When cancer cells break beyond the prostate gland and metastasize into nearby tissues, such as the seminal vesicles or the prostate capsule, it is classified as locally advanced prostate cancer. Although the cancer has spread, it remains relatively close to the prostate and has not yet reached distant organs.

For men diagnosed with a localized and locally advanced prostate cancer, treatment options typically include:

• Active surveillance (for slow-growing cases)
• Surgery (prostatectomy)
• Radiation therapy, sometimes combined with hormone therapy

Metastatic Prostate Cancer

Metastatic prostate cancer occurs when cancer cells have escaped and spread beyond the prostate to distant body areas, such as the lymph nodes, bones, liver, lungs, or brain. These cancer cells make their way beyond the prostate by traveling through the bloodstream or lymphatic system, allowing them to establish new tumors in other areas.

Once prostate cancer reaches the lymph nodes, it is more likely to spread to additional organs. The most common site of metastasis is the bones, accounting for 85-95% of cases. Regardless of where prostate cancer spreads, it is still considered prostate cancer because the original cancer cells originate from the prostate.

Treatment Options for Metastatic Prostate Cancer

While metastatic prostate cancer is more challenging to treat, several options can help manage the disease and improve quality of life:

• Hormone Therapy: Reduces the production of male sex hormones that fuel cancer growth
• Chemotherapy: Targets and destroys rapidly dividing cancer cells
• Radiation Therapy: Shrinks tumors and kills metastasized cancer cells
• Immunotherapy: Enhances the immune system’s ability to fight cancer cells

The Importance of Early Detection

Men should remain vigilant for symptoms of prostate cancer and always ask questions about any concerns with their healthcare provider. When detected early, prostate cancer has an exceptionally high survival rate of 97-98%.

A prostate-specific antigen (PSA) test is a critical tool for early detection. Men should establish a baseline PSA level at age 40 and continue regular screenings thereafter. Early diagnosis provides the best opportunity for successful treatment and long-term survival.

By staying informed and proactive about prostate health, men can take meaningful steps to detect and manage prostate cancer effectively. If you have concerns, consult a urologist to discuss your risk factors and screening options.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, and Prostate Cancer, Now What? A Practical Guide to Treatment, Diagnosis, and Recovery, both available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.