Prostate

C61WHO Vol. 8

Male Reproductive System

Key facts

New cases per year (US)

About 333,830 estimated for 2026 — 15.8% of all new US cancer cases (SEER)

5-year relative survival

98.2% overall; ~100% localized/regional, 40.1% distant (SEER, 2016–2022)

Main risk factors

Older age, Black race, family history of prostate cancer (NCI)

Screening

PSA blood test and digital rectal exam; no standard routine screening program — an individual decision (NCI)

Typical age

Median age at diagnosis: 68 years; mostly older men (SEER, 2019–2023)

Lifetime risk (US men)

13.2% — about 1 in 8 men (SEER)

Prostate cancer develops in the tissue of the prostate — a gland of the male reproductive system located below the bladder, in front of the rectum, which produces part of the seminal fluid. In its early stage it often causes no symptoms; over time, trouble starting urination, frequent urination (especially at night), difficulty emptying the bladder completely, or a weak, interrupted urine stream may appear. Detection rests on a blood PSA (prostate-specific antigen) test and a digital rectal exam, and the diagnosis is confirmed by biopsy; MRI and PSMA PET scans serve as supporting tools. The cancer's aggressiveness is graded with the Gleason score (6–10, from low- to high-grade) and the corresponding Grade Groups. The disease mainly affects older men — the median age at diagnosis is 68 years, and about one in eight men in the US will be diagnosed with it during their lifetime.

Prognosis

Prognosis in prostate cancer depends strongly on the stage at diagnosis, as well as on the cancer's grade (Gleason score / Grade Group), PSA level, the patient's age and overall health. According to US SEER data (patients diagnosed 2016–2022), 5-year relative survival is 98.2% for all stages combined — around 100% when the cancer is confined to the prostate or has spread only regionally, and 40.1% when distant metastases are present; as the NCI notes, most men diagnosed with prostate cancer do not die of it. Some prostate cancers never cause symptoms or become life-threatening. These figures are population statistics describing large groups of patients diagnosed in past years — they do not predict the course of the disease in any individual person.

🔬 Histological Types

📚 Latest Research

2026-09-09

Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation for Localized Prostate Cancer: A GRADE-Assessed Systematic Review and Meta-Analysis.

Nadeem A, et al

A systematic review and meta-analysis of 13 studies encompassing 650 patients found that MRI-guided transurethral ultrasound ablation (TULSA) for localized prostate cancer achieved 100% technical success with major complications (grade ≥ 3) in only 2% of cases. Urinary continence was preserved in 97% of treatment-naive patients compared to just 47% in the salvage setting (p < 0.0001), and PSA levels fell by a mean of 5.02 ng/mL — representing an 85% reduction from baseline. Biochemical recurrence was observed in 13% of patients, clinically significant cancer on follow-up biopsy in 22%, and 14% required salvage treatment progression, though oncologic certainty remains very low due to high heterogeneity and a maximum follow-up of only 36 months. The authors conclude that current evidence supports TULSA for carefully selected treatment-naive prostate cancer patients, pending long-term comparative data.

Cardiovascular and interventional radiology

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2026-09-09

PSMA-PET Tumor Volume Stratifies Nonmetastatic Castration-resistant Prostate Cancer.

Civan C, et al

A large international study of 514 men with nonmetastatic castration-resistant prostate cancer (nmCRPC) found that PSMA-PET imaging detected metastatic disease in 66% of patients previously classified as nonmetastatic by conventional imaging, revealing that tumor volume and the presence of distant metastases are powerful predictors of survival. Patients with high tumor volume (above the optimal cutoff of 7.8 ml) had a 2.47 times greater risk of death (95% CI 2.22–2.71, p < 0.001) compared to those with low-volume disease, while those with any distant metastases on PSMA-PET had a hazard ratio of 1.74 (95% CI 1.49–2.00, p < 0.001) for shorter overall survival. The findings, drawn from the multinational PROMISE-PET Registry covering 2013–2022 with a median follow-up of 4.4 years, strongly support incorporating PSMA-PET staging and tumor volume measurements into future nmCRPC risk stratification frameworks.

European urology focus

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2026-09-09

Dosimetric and robustness comparison of single- and double-arc volumetric-modulated arc therapy incorporating avoidance structures for prostate cancer with simulated bilateral hip prostheses.

Kato T, et al

Double-arc (DA) volumetric-modulated arc therapy (VMAT) demonstrated marginally superior dosimetric performance and plan robustness compared to single-arc (SA) VMAT for prostate cancer patients with bilateral hip prostheses, though absolute clinical differences were small. In a retrospective analysis of 15 prostate cancer cases with simulated titanium-equivalent hip prostheses, DA plans achieved statistically better planning target volume and rectal dose parameters, and CTV D98% differences between SA and DA under posterior and inferior position corrections remained ≤0.6 Gy. Both techniques showed reduced CTV coverage at a 10-mm anterior shift, with mean decreases of 1.7% for SA and 1.6% for DA. SA plans remain a viable clinical alternative given their theoretically shorter delivery times, provided that strict patient preparation protocols and careful management of anterior internal errors are maintained.

Medical dosimetry : official journal of the American Association of Medical Dosimetrists

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