When a man goes to a doctor for a prostate exam and is told he has prostate nodules, is this a cause for concern, and does it indicate prostate cancer?
The finding of a prostate nodule can be determined by the doctor palpating the prostate gland, which is comparable to the size and shape of a walnut. The prostate gland is an integral part of the male reproductive system and is located beneath the bladder and sits in front of the rectum. A man’s prostate produces semen, helping carry sperm made by the testicles through the penis during ejaculation.
When a doctor palpates the prostate gland by examining the prostate through a digital rectal exam, a prostate nodule will feel like a firm bump or area of hardness under the surface of the prostate. The site is raised and feels similar to the hand knuckle. Prostate nodules are considered abnormal growth.
The terms “nodules” and “tumors” may be used interchangeably, and both mean the same thing – abnormal growth of cells found on the prostate.
Causes of prostate nodules
The discovery of a nodule found on the prostate can mean many things other than cancer, with several reasons why a man might develop one. Here are some possible reasons for what a prostate nodule may indicate:
All prostate cancers will start as a nodule or abnormal growth but not all nodules or abnormal growths found on the prostate are automatically prostate cancer.
When prostate gland cells grow uncontrollably and spread into nearby tissue and organs, the growth is malignant or cancerous. Conversely, nodules determined to be benign or noncancerous do not spread.
Other than skin cancer, prostate cancer ranks second as the most common cancer diagnosed in men in the United States. It is estimated in 2023, more than 288,300 new cases of prostate cancer and 34,700 deaths will be attributable to this disease.
A benign or noncancerous nodule may be a sign of prostatitis. Prostatitis occurs when the prostate gland becomes inflamed and is often caused by a bacterial infection. Around half of all men are affected by prostatitis at some point, but it does not increase the risk of other prostate diseases.
Sometimes a nodule can be called a prostate stone, similar to a kidney stone that can be felt under the surface. What seems like a nodule is a tiny formation of calcified minerals, with the prostate stone being harmless. It is believed these stones are formed either by secretions from the prostate thickening or when pus and other debris fuses during an infection.
A man with prostate stones may have similar symptoms of chronic prostatitis. In addition, the presence of prostate stones can lead to prostate inflammation, which can stop urine from exiting the body and lead to a bacterial infection.
Men with an enlarged prostate, also known as benign prostatic hyperplasia or BPH, can have nodules on their prostate, which often lead to the symptoms of this condition. BPH is when the prostate grows more prominent than usual but does not increase a man’s risk for prostate cancer.
Other possible causes of nodules found on the prostate include an infarct, an area of dead tissue caused by a loss in blood supply. Abnormalities in the rectum, such as hemorrhoids, could also lead to prostate nodules.
Diagnosing a prostate nodule
Many men will often not be aware of having a prostate nodule as they are not likely to cause symptoms in the beginning. But if they enlarge, there can be signs and symptoms of a prostate issue. Since prostate cancer can be present without symptoms, all men should get regular prostate exams.
There are several ways to diagnose a prostate nodule which include the following:
If a doctor discovers a nodule, they will order a PSA test. PSA is a type of protein made by prostate cells. A simple blood test can measure the PSA in the bloodstream. Even though elevated levels may indicate prostate cancer, PSA levels can be high for several reasons, such as BPH.
A biopsy will be done if a doctor finds the nodule suspicious. During a biopsy, several tiny prostate tissue samples will be removed, then studied in a lab for signs of cancer cells.
Depending on findings and if the nodule is cancerous or benign will determine the treatment. If it is cancerous, prostate cancer treatments might include surgery, radiation, or active surveillance.
If the nodule is benign but is caused by prostatitis or a prostate stone, it will often be treated using antibiotics or other medications.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.