There are several types of prostate cancer. The most common type is adenocarcinoma, which grows in the tissue of the prostate gland. But other types of cancer can also originate in the prostate.

If you’re male, your prostate is a small gland in your lower abdomen, just under your bladder and surrounding the urethra. This gland produces seminal fluid (semen), a substance containing sperm that exits the urethra during ejaculation. The hormone testosterone regulates the prostate.

When an unusual, malignant growth of cells called a tumor forms in the prostate, it’s called prostate cancer. This cancer can spread to other areas of the body.

Prostate cancer is the most diagnosed cancer in males worldwide.

This article covers the types of prostate cancer.

The different types of prostate cancer are categorized depending on the type of cell in which they originate. The main type is called adenocarcinoma, making up about 95% of all diagnosed prostate cancers.

Less common types include:

  • transitional cell carcinoma
  • squamous cell carcinoma
  • neuroendocrine prostate cancer
  • sarcoma
  • lymphoma

Some types can grow and spread quickly, but most are slow growing.

Adenocarcinomas are by far the most common type of prostate cancer. They develop within the gland cells in the prostate that make the prostate fluid that’s added to semen.

Adenocarcinoma is typically slow growing and less aggressive than other types of cancer, with a high survival rate.

There are two subtypes of prostate adenocarcinoma.

Acinar adenocarcinoma of the prostate

Prostatic acinar adenocarcinoma (PAC) develops from the acinar epithelium, a layer of outer cells that line the prostate gland. People with this subtype tend to live longer and avoid the spread of cancer to other organs more often than the other subtype.

Ductal adenocarcinoma of the prostate

Ductal adenocarcinoma (DAC) is considered to be rare and more aggressive. It develops in the ducts, or tubes, of the prostate gland and is characterized by tall, stacked columns of atypical epithelial cells. It’s known to occur alongside PAC. It’s more difficult to detect in earlier stages.

DAC is more likely to reoccur and spread to distant tissues than PAC. This makes it more dangerous and leads to lower survival rates. Additionally, DAC doesn’t respond as well as PAC to androgen deprivation therapy (ADT), a type of hormone therapy used in treatment.

Despite this type of cancer being rare, it’s still the second most common type of prostate cancer. The following types are even rarer.

Neuroendocrine prostate cancer originates in the prostate’s neuroendocrine cells. These cells receive signals from the nervous system to release hormones.

These cancers are more difficult to detect with a blood test because neuroendocrine cells don’t involve elevated prostate-specific antigen (PSA) levels like other prostate cancers. Neuroendocrine cells don’t make PSA like other cell types.

Neuroendocrine prostate cancer is highly aggressive and quickly spreads to other organs. The World Health Organization (WHO) has identified four subtypes:

  • Small cell carcinoma: The most aggressive type, small cell carcinoma often spreads to other parts of your body, like your bones, and doesn’t respond well to treatment with ADT. The average age at diagnosis is 70 years, according to a 2019 study.
  • Large cell neuroendocrine carcinoma: This subtype type most commonly occurs as a result of ADT for other prostate cancers.
  • Adenocarcinoma with neuroendocrine differentiation: This subtype contains both adenocarcinoma and neuroendocrine tumor components.
  • Well differentiated neuroendocrine tumors: These comprise cells that appear like normal cells but can act aggressively.

Transitional cell carcinoma of the prostate, also called urothelial carcinoma, originates in the cells that line the urethra, the tube that carries urine outside your body.

This type of cancer usually starts in the bladder and spreads into the prostate. This means that if a doctor discovers it in the prostate, it’s usually already spread from somewhere.

Rarely, it can start in the prostate and spread into the bladder and nearby tissues.

Squamous cells are thin, flat cells that make up the outermost layer of various organs. This type of cancer is most common in the skin, but it can also affect your prostate, lungs, mucous membranes, digestive tract, and more.

Squamous cell carcinoma of the prostate begins in cells that cover the prostate. This type of cancer typically spreads faster, particularly to your bones, and is more aggressive than adenocarcinoma.

Also called soft tissue sarcoma, sarcomas are cancers that originate from soft tissues, such as the:

  • muscles
  • nerves
  • blood vessels
  • fibrous tissue
  • fat
  • joint lining
  • lower levels of the skin

They can develop anywhere on your body, including the prostate. There are several types, including:

  • leiomyosarcoma, which is aggressive and can spread elsewhere on the body
  • rhabdomyosarcoma, which is also aggressive and most common in children

Lymphoma is cancer of the lymph nodes.

According to a 2022 study, it only affects the prostate in around 0.1% of newly diagnosed lymphomas. Due to its rarity, it’s difficult to differentiate between this type and other types. More research into this condition is needed.

Some prostate cancers might begin as a precancerous condition, which a doctor might discover with a prostate biopsy. There are two known types:

  • Prostatic intraepithelial neoplasia (PIN): When seen under a microscope, prostate cells don’t look normal or healthy, but they also don’t appear to be attacking other parts of the prostate like cancerous cells do. There are two types of PIN:
    • low grade PIN if the patterns of cells appear close to normal
    • high grade PIN if the patterns of cells look more atypical (this type may increase the risk of developing prostate cancer)
  • Proliferative inflammatory atrophy (PIA): Under a microscope, prostate cells appear smaller than normal, and there are signs of inflammation. Medical researchers are still trying to determine if PIA can lead to PIN or prostate cancer.

Because prostate cancer is a risk for all people with a prostate, you should speak with a doctor about your risk at your annual checkups. They may recommend screening depending on your personal risk factors or family history.

Additionally, contact a doctor if you have any symptoms you think might be due to prostate cancer.

Prostate cancer symptoms

Symptoms of prostate cancer vary among people. In the early stages, you may not experience any symptoms. As the cancer progresses, however, you may experience:

  • difficulty urinating
  • weak or disrupted urine flow
  • frequent urination, especially at night
  • difficulty completely emptying your bladder
  • pain or a burning sensation during urination
  • blood in your urine or semen
  • painful ejaculation
  • erectile dysfunction
  • persistent pain in your back, hips, pelvis, arms, or legs
  • fatigue
  • changes in bowel habits
  • unexplained weight loss
  • swelling or fluid in your legs

Doctors discover most prostate cancers during routine screenings, since the cancer may not cause any symptoms in the early stages. Screening tests include:

Even with a positive screening, a biopsy will be needed for a doctor to make a definitive diagnosis.

A prostate biopsy is a procedure in which a health professional removes small samples of the prostate and looks at them under a microscope. This inspection will help them identify the type of prostate cancer you have, as well as its stage and grade, which determines treatment.

For most prostate cancers, the outlook is usually favorable when a doctor discovers and treats the cancer early, before it’s spread to other organs.

Survival rates decrease for untreated prostate cancer and for cancer that’s spread to other organs.

Some types, such as neuroendocrine prostate cancer, have worse outlooks. This is usually due to a late stage diagnosis and lack of effective treatment. About half of people with neuroendocrine cancer live less than 1 year.

The following are some frequently asked questions about the different types of prostate cancer.

Small cell carcinoma is the most aggressive type of neuroendocrine prostate cancer.

According to one 2019 study with 260 participants with this type of cancer, researchers reported a 42.1% survival rate at 1 year following diagnosis, a 22.1% survival rate at 2 years, and a 12.5% survival rate at 5 years.

Since small cell prostate cancers are often in the advanced stages at diagnosis, they may not be curable. However, treatment can help prevent further progression while extending the overall survival rate.

Other types of aggressive prostate cancer include squamous cell carcinoma and DAC.

According to a 2021 review of studies, the chances of surviving acinar adenocarcinoma 5 years after surgery were 87.9%. This type of prostate cancer, which is by far the most common, is typically slow growing and the easiest to detect in routine blood test screenings.

Although there are many types of prostate cancer, the vast majority of diagnoses are for acinar adenocarcinoma, which is treatable and has a favorable outlook when a doctor detects it early.

Speak with a doctor if you’d like to get screened for prostate cancer or want to know about your risk.