skip-to-content-text
skip-navigation-text

Prostate Cancer

Prostate cancer is one of the most common cancers in the male population. Despite its high incidence, thanks to advances in early detection and treatments, the mortality rate continues to decline.

In Italy it is the most commonly diagnosed cancer in men (19.8% of all cancers diagnosed in the male population). In 2023, about 41,000 new diagnoses were estimated (source: I numeri del cancro in Italia 2023, AIOM-AIRTUM).

Looking for Prostate Cancer Care?

Related services:

Services for the prevention, diagnosis, and treatment of prostate cancer are available at:

On this page

What Is Prostate Cancer?

The prostate is an organ of the reproductive system that helps produce sperm; About the size of a walnut, it is placed under the base of the bladder anterior to the rectum. Prostate cancer occurs when cells in the gland grow uncontrollably, leading to the formation of a malignant tumor.

Back to top

What Are the Symptoms of Prostate Cancer?

In the early stages, prostate cancer usually proceeds silently, without manifesting any noticeable symptoms. However, as the disease progresses, the following symptoms may occur:

  • Blood in semen or urine.
  • Erectile dysfunction.
  • Urination problems (frequent urination/need, slow flow).
  • Pain in the hip, spine or ribs.
  • Numbness of feet and legs.
  • Loss of bowel or bladder control.

The appearance of such signs requires immediate attention and the advice of a health professional. Early recognition of these symptoms can significantly contribute to early intervention and effective management of the disease.

Risk factors for prostate cancer

Several factors can increase your risk of developing prostate cancer, including:

  • Obesity – Excess body fat increases the risk of various cancers, including prostate cancer, due to hormonal imbalances and inflammation.
  • Age – The risk of developing prostate cancer increases significantly with advancing age. In particular, most cases occur in individuals over the age of 55, being rare under the age of 40.
  • Familiarity – The presence of prostate cancer cases among first-degree relatives may increase individual risk. The genetic and familial component is therefore considered a significant factor.

How to reduce the risk of prostate cancer

A change in lifestyle habits can reduce the risk of developing this disease.

Some tips to prevent chronic diseases

  • Limit consumption of red meat – A food rich in saturated fat and calories.
  • Eat seasonal fruit and vegetables regularly – Tomatoes, broccoli, blueberries and cauliflower contain nutrients that can help slow the spread of cancer.
  • Consume 'good fats' – Olive oil, fish, nuts and avocados all contain omega-3 fats. Avoid partially hydrogenated fats, which are contained in many packaged foods.
  • Avoid smoking – Smoking has been linked to various cancers, including prostate cancer. Quitting smoking can significantly improve overall health and reduce the risk of many diseases, including cancer. Good news: ten years without smoking brings the risk factor down to that of a non-smoker of the same age.
  • Limit alcohol consumption – High alcohol consumption weakens the immune system and exposes you to the risk of many diseases, including cancer.
  • Incorporate exercise into your daily routine – If the gym is too much of a commitment or boring, or sticking to a strict exercise routine is difficult, a simple walk or bike ride can get your heart rate up and reduce stress. Look for small tricks to move more throughout the day, such as parking the car further away from the office, walking to the supermarket, taking the stairs instead of taking the lift.
  • Try yoga to reduce stress – A risk factor for several diseases, including prostate cancer. Yoga therapy increases blood flow and relieves stress. It also increases flexibility and muscle tone.
  • Improve sleep quality – The ideal amount of sleep is between 7 and 9 hours per night for an adult person. Turning off the phone or dimming the lights are just a few measures that can help you develop a night-time routine for optimal rest.

Incorporating these practices into your daily lifestyle can help maintain optimal prostate health and reduce your risk of developing prostate cancer. It is important to consult your doctor for a personalized assessment and receive specific advice based on your condition and lifestyle.

Back to top

How Do You Diagnose Prostate Cancer?

Screenings can help find prostate cancer at an early stage when it is easier to treat. Prostate cancer can often be found early using one or both of the following tests.

  • Prostate-specific antigen (PSA) test – Prostate-specific antigen (PSA) is a protein produced by the cells of the prostate gland. It is found mostly in semen, but a small amount is in the blood as well. A blood test measures the level of PSA circulating in the blood. A higher PSA level usually means a higher chance of having prostate cancer. Men over age 50 with very low PSA levels may need to be tested every 2 years. If your PSA is higher, the doctor may recommend more frequent testing.
  • Digital rectal exam (DRE) – During a DRE, your health care provider gently inserts a gloved forefinger into the rectum to feel the prostate gland for enlargement or other abnormalities, such as a lump.

For those with a higher risk, a family risk assessment is recommended. A qualified health care professional will evaluate your risk of having a hereditary cancer. They will then help you determine preventive steps and how frequently you should be monitored.

If the result of a PSA or DRE test is abnormal, your doctor will perform a biopsy. This is the only way to confirm that you have prostate cancer. Biopsies are done as an outpatient procedure in a doctor’s office or other facility.

Prostate biopsy

Prostate biopsy is the only method that can confirm with certainty the presence of prostate cancer. This examination involves taking small tissue samples from the prostate gland, which are then analyzed under a microscope.

The need for a biopsy may arise from several signs, such as the detection of a lump during rectal exploration, an increase in PSA (Prostate Specific Antigen) levels in the blood, or the presence of suspicious lesions observed by MRI.

How is the biopsy performed?

The biopsy is usually performed under trans-rectal ultrasound guidance. Samples are taken using a trans-perineal or trans-rectal approach, with local anesthesia or sedation.

Recently, an innovative technique called fusion prostate biopsy has been introduced, which combines magnetic resonance imaging (MRI) with ultrasound images. This technology allows for the creation of a three-dimensional reconstruction of the prostate, significantly improving diagnostic accuracy and optimizing patient management.

Back to top

How Do You Treat Prostate Cancer?

But the good news is that prostate cancer is highly treatable when caught early. In addition, new techniques are shortening the treatment time and minimizing side effects.

But it remains important to know your risks, know the symptoms, get regular screenings, and understand your treatment options.

Latest prostate cancer treatments

Today there are many treatments for localized prostate cancer. The type of treatment you receive will depend on your risk level, your age, and any other health problems. Your doctor will take time to clearly explain your cancer, your options for treatment, and possible side effects.

Active surveillance

Because prostate cancer usually grows slowly, some men, especially those who are older or have other health problems, may never be treated for it. Instead, their doctors may recommend active surveillance, otherwise known as “watchful waiting.” If the tumor grows or changes, your doctor may recommend treatment.

Radiation treatment

Radiotherapy is one of the most common treatments, alongside surgery, for eliminating residual cancer cells and preventing the spread of cancer. By using high-intensity energy beams, radiotherapy destroys cancer cells.

Modern radiotherapy techniques allow for treating the tumor with millimeter precision. Thanks to advanced imaging technologies, radiotherapists can deliver radiation in a targeted manner, minimizing damage to healthy tissues. In many cases, thanks to these advanced techniques, treatment can be completed in just 5 sessions, instead of the traditional 8 weeks.

Nerve-sparing prostatectomy

The most frequent surgical procedure to treat prostate cancer is radical prostatectomy, an operation to remove the prostate gland and some tissue around it. The surgeons who treat prostate cancer are experts at using minimally invasive robotic surgery to remove the cancer, while safeguarding the surrounding nerves that govern urinary and sexual function.

Hormone therapy

This works by blocking testosterone production or stopping testosterone from interacting with the tumor cells. This reduces the tumor size or slows its growth. While hormone therapy may help control prostate cancer, it does not cure it.

Immunotherapy

These cutting-edge treatments are designed to help a patient’s own immune system to fight the cancer.

Clinical trials

Research and clinical trials lead to better care for cancer patients. At any time, UPMC Hillman Cancer Centers worldwide are involved in hundreds of clinical trials offering the latest, most innovative treatments. These studies examine new treatments, devices, and medicines for a variety of cancer types and conditions. Different treatments have different side effects. Your doctor will talk to you about your options based on the level of disease and your overall health.

New treatments offer good odds for recovery and cure

Most men with prostate cancer have an excellent prognosis. And with the development of new tools and protocols, they have options for treatment that are faster and have fewer side effects. So, take some time to talk to your doctor about your prostate health. Get your recommended screenings. And if you have any symptoms as described above, seek care right away. It could save your life.

Therapeutic Option: Focal Therapy by Irreversible Electroporation (IRE)

Focal therapy is a minimally invasive approach that uses a multichannel diode laser to specifically destroy cancer cells. This treatment is based on MRI images that identify suspicious areas, which are later confirmed by biopsy.

Ultra-thin needles are used to reach and treat the affected areas directly, applying the laser to create necrosis of the diseased tissue. This procedure arrests tumor growth, reducing the risk of disease progression, without affecting the surrounding tissues.

A key advantage of focal therapy is its precision, which preserves delicate structures such as nerves responsible for sexual function. resorbed and replaced naturally by scar tissue.

Back to top

Reviewed October 2024.