A member of the Seattle Cancer Care Alliance Network

What to Expect With Prostate Cancer

The prostate is a small, walnut-sized gland that helps produce semen to protect and carry sperm. The prostate sits just below the bladder; the urethra (a tube that carries urine to the penis) passes through it.

As men age, their risk increases for developing prostate problems, either cancerous or benign (non-cancerous).

Benign prostatic hyperplasia (BPH), also known as an enlarged prostate, occurs when normal prostate cells grow too fast. If the prostate gland is enlarged, it can make urinating difficult. Most men over age 50 have some symptoms of BPH.

Prostate cancer produces malignant cells that not only multiply faster than normal cells, but also can spread beyond the prostate. The cancer can make the prostate expand, putting pressure on the urethra and making urination difficult. Prostate cancer most often is a slow growing cancer.

At Kaiser Permanente medical offices, we care for our prostate cancer patients using the latest medical knowledge and advanced technology. Your care team at Kaiser Permanente will help you understand what to expect and discuss your treatment options. They will provide care and support during your diagnosis, any treatment needed, and ongoing care.

Image of the prostate

Developing a Treatment Plan

At Kaiser Permanente, we develop the right treatment plan together with you. We encourage you to bring a family member or friend to your appointments to take notes and help ask questions.

Prostate cancer is diagnosed both by grading — based on how abnormal the prostate cells are — and staging — based on how far the cancer has spread. Treatment recommendations take into consideration a man’s age, lifestyle, and how serious the cancer is.

Grading and staging: Once the grade of your cancer has been determined, your doctor might order additional tests to determine its stage — the size of the tumor, how fast it’s growing, and whether cancer cells have spread (metastasized) to other areas of the body.

Both grading and staging help your doctor plan the right treatment for you. It can also help in finding a clinical trial that you might be able to participate in.

Some patients — once they’ve received the initial diagnosis and staging — want to get a second opinion for more information about their diagnosis or treatment options. 

Prostate Cancer Treatment

Your treatment plan will depend on the stage and type of cancer (fast or slow growing), your age, PSA level (prostate-specific antigen in your blood), and health and lifestyle factors.

At Kaiser Permanente, we keep up with the rapid changes and improvements in cancer treatment. We offer surgery that’s less invasive, chemotherapy that’s easier to tolerate, and radiation targeted to the cancer growth. We review the latest research findings to make sure our treatments are the most effective.

Your doctor will let you know about the benefits and possible risks of various treatments.

Watchful waiting: Most men who have prostate cancer have a low grade, less aggressive cancer. In those cases, the doctor might recommend watchful waiting (active surveillance). In watchful waiting, you won’t undergo immediate treatment, such as surgery or radiation.

Instead, your doctor will carefully monitor the prostate with regular medical exams and follow-up tests, which might include blood tests, biopsies and rectal exams. These tests will occur about every three to six months and will help the doctor find out whether the cancer is growing and how quickly.

Other treatments: For higher grade, more aggressive cancer, treatment could include surgery, hormone therapy, radiation therapy, and chemotherapy. Side effects depend on the treatment, including type of drugs and radiation dose.

Side effects for chemotherapy and radiation may include nausea, vomiting, constipation, diarrhea, pain, and skin irritation. Side effects from hormone therapy may include osteoporosis and possibly hot flashes. Some treatments also cause problems with sexual function.
Planning ahead: Once you and your doctor have decided on a treatment plan, you can prepare for how treatment might affect your daily life.
Your care team will let you know how to manage the side effects common for your type of treatment. A nutritionist can help you plan foods to have on hand. If you’re likely to lose your hair during treatment, you might want to get a hat or possibly a hair piece.

Adjusting your priorities and schedule in advance can help ease stress before treatment begins. You may want to contact friends or family members to see if they’re available to help with rides or household needs.

After Treatment

Your doctor will continue monitoring your health, watching for any changes in your prostate. Monitoring will include regular exams and blood tests, and discussing side effects or symptoms.

Erectile dysfunction — when you’re unable to get or keep an erection — is a common side effect of prostate cancer treatment. This often improves within a few years after treatment. Talk to your doctor if this is an ongoing problem, as there are treatment options to help.

Making certain lifestyle changes, such as following a healthy diet, may help the health of your prostate. Keeping up with your follow-up plan for care helps make sure that your body continues to heal.

Many people who have had cancer describe themselves as survivors. You’ve gone through a journey of tests, diagnosis, and treatment, handled side effects, and possibly made major lifestyle changes. Through all of that you’ve continued to manage life and move forward.

You may want to honor the courage in yourself, the connection you make to others, and your ability to survive the challenges you’ve faced with cancer. We honor your journey as well.