If your doctor tells you that your prostate exam revealed a nodule on your prostate, your first thought may be that it’s a sign of cancer. But a nodule or other changes to your prostate don’t necessarily mean you have cancer. Keep reading to learn more about prostate nodules.
A nodule is a lump or area of hardness under the surface of the prostate. In some cases, a prostate stone, which is similar to a kidney stone, can be felt under the surface. It may seem like a nodule, but it’s really a tiny formation of calcified minerals. A stone is usually harmless. A true prostate nodule is an abnormal growth of cells that may or may not be cancerous.
Nodule vs. tumor
You may hear the terms “nodules” and “tumors” used interchangeably. For the most part, they mean the same thing: an abnormal growth of cells.
A “nodule” is typically used to describe a very small mass of cells, while “tumor” generally refers to a larger growth. Doctors also tend to use tumor when describing a cancerous growth, though the phrase “benign tumor” is also used sometimes. If you’re ever unsure about a phrase your doctor uses, stop and ask for clarification.
Benign vs. malignant
A malignant prostate nodule is cancerous. That means that cells in a malignant nodule or tumor can spread into nearby tissue and organs.
A benign nodule is noncancerous, meaning the cells don’t spread.
It’s not always clear why abnormal cells multiply and form nodules and tumors. A benign or noncancerous prostate nodule could form because of an infection or as a reaction to inflammation in the body. It may also be a sign of benign prostatic hyperplasia (BPH), which is an enlarged prostate. BPH does not increase your risk of cancer. A malignant or cancerous nodule is a sign of prostate cancer.
A prostate nodule isn’t likely to cause you any symptoms at first. If you develop BPH, you may have difficulty urinating or ejaculating. Cancer can be present without symptoms, so regular prostate exams are important.
If your doctor finds a nodule, they will probably order a prostate-specific antigen (PSA) test. PSA is a type of protein made by prostate cells. A simple blood test can measure the PSA in your bloodstream. High levels suggest cancer may be present, but PSA levels may be elevated for many reasons. You may have a condition known as benign prostatic hyperplasia (BPH), which simply means you have an enlarged prostate. Also, some people’s prostates tend to produce more PSA than others’.
If your levels are higher than normal, your doctor may schedule another test to compare the results. A rapid increase in PSA levels suggests cancer. If the levels remain about the same, you may be advised to go through a “watchful waiting” period. During that period, your doctor will check your prostate annually and look out for any symptoms or changes in your health.
If a nodule or enlargement of your prostate seems suspicious to your doctor, they may advise a prostate biopsy. During a biopsy, the doctor removes several tiny samples of prostate tissue, which are studied in a lab for signs of cancer cells.
Doctors often grapple with false positives when screening for prostate cancer. It’s important to ask your doctor about the possibility of a false positive result. Prostate cancer treatments can cause incontinence and impotence. If necessary, seek a second opinion. Do not rush into a battery of tests or treatments until you feel you have the best medical advice possible.
A nodule or enlargement of the prostate is usually not a sign of cancer. If the nodule turns out to be cancer, know that prostate cancer is very treatable, especially if caught early. There are about 180,000 new cases of prostate cancer reported in the United States each year, according to the National Cancer Institute, with about 26,000 deaths annually. Survival rates are also quite high with prostate cancer.
Prostate cancer tends to be a slow-growing cancer, so even if you are diagnosed, a period of watchful waiting may be your best bet.
Does a large nodule or having multiple nodules increase the likelihood that the nodules are cancerous?
Not necessarily, but there is no direct study of this topic in the literature. A nodule may be part of a tumor where the majority is beneath the surface. The size and number of nodules is not clearly associated with risk of cancer in the prostate.Dr. Ricky Chen, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.