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NCCN Guidelines for Patients


Prostate Cancer, Version 1.2016


Prostate cancer basics

A disease of cells │Cancer's threat

A disease of cells

Cancer is a disease of cells. Inside of cells are coded

instructions for building new cells and controlling

how cells behave. These instructions are called

genes. Genes are a part of DNA (






cid), which is grouped together into bundles called


See Figure 2

. Prostate cancer

occurs when normal cells begin to grow faster or die

slower. Either pattern causes a tumor to form. Some

prostate cancers occur from abnormal changes,

called mutations, in genes.

Aging, being of African-American descent, and having

family members with prostate cancer have been

linked to a higher chance of getting prostate cancer.

Other related factors include contact with Agent

Orange, obesity, smoking, and poor diet. Not all men

with these conditions get prostate cancer and some

men without these conditions do. Prostate cancer is

common among older men. However, prostate cancer

in older men often doesn’t become a problem.

Almost all prostate cancers are adenocarcinomas.

Adenocarcinomas are cancers that start in cells that

line glands and, in the case of prostate cancer, make

semen. Adenocarcinomas of the prostate are the

focus of this book.

Cancer’s threat

Cancer cells don’t behave like normal cells in three

key ways. First, prostate cancer cells grow more

quickly and live longer than normal cells. Normal cells

grow and then divide to form new cells when needed.

They also die when old or damaged as shown in

Figure 3

. In contrast, cancer cells make new cells

that aren’t needed and don’t die quickly when old or

damaged. Over time, cancer cells form a mass called

the primary tumor.

The second way cancer cells differ from normal cells

is that they can grow into (invade) other tissues. If not

treated, the primary tumor can grow large and take

over most of the prostate. It can also grow beyond

the prostatic capsule and invade nearby tissues. This

growth is called extracapsular extension.

Third, unlike normal cells, cancer cells can leave the

prostate. This process is called metastasis. In this

process, cancer cells break away from the tumor and

merge with blood or lymph. Lymph is a clear fluid that

gives cells water and food and contains germ-fighting

blood cells. Then, the cancer cells travel in blood or

lymph through vessels to other sites. In other sites,

the cancer cells may form secondary tumors, replace

many normal cells, and cause major health problems.

Most men with prostate cancer will not die of this

disease. However, prostate cancer is the second most

common cause of death from cancer in men. Most

prostate cancers grow slowly but some grow and

spread quickly. Doctors describe these latter cancers

as “aggressive.” Why some prostate cancers grow

fast is unknown and is being studied by researchers.