Adenocarcinoma is the most common type of prostate cancer. If you or someone you love has recently been diagnosed with adenocarcinoma of the prostate, it can be helpful to learn more about your condition. Understanding your type of cancer can help you have better conversations with your healthcare team and make informed decisions about your medical care.

1. Most Prostate Cancers Are Adenocarcinomas

Between 95 percent and 99 percent of prostate cancers are adenocarcinomas. Most prostate cancers develop in the glands that line your prostate and produce fluid. This fluid later combines with sperm to make semen.

Although adenocarcinoma is the most common type of prostate cancer, there are other types as well. Rarer types of prostate cancer include:

• Small cell carcinoma — This cancer develops in the round cells within the prostate and accounts for 1 percent of prostate cancers. It’s aggressive and spreads fast.
• Neuroendocrine tumors — These tumors develop in the nerves and glands that make and release hormones.
• Transitional cell cancer — This type of cancer starts in the urethra or the bladder and spreads to the prostate gland. About 5 percent of prostate cancer is this type.
• Prostate sarcoma — Prostate sarcoma develops in the muscles, nerves, and other soft tissue surrounding the prostate but outside of the gland itself.
• Squamous cell carcinoma — This cancer makes up less than 1 percent of all prostate cancers and develops in flat cells covering the gland. It’s aggressive.
• Adenoid cystic carcinoma, or basal cell carcinoma — This type of cancer develops in basal cells, which shape the acini and the ducts in the prostate. It’s a very rare type.
• Lymphoma — Lymphoma develops in the lymphatic system and lymph nodes. It may affect the prostate but only very rarely starts there.

2. There Are Subtypes of Adenocarcinoma

Adenocarcinoma in the prostate can be further broken down into two categories: acinar and ductal. Acinar adenocarcinoma develops in acini cells, which line the glands that secrete fluid in the prostate. This is by far the most common type of adenocarcinoma in the prostate. In fact, acinar adenocarcinoma is the only kind of prostate cancer that’s considered common.

There are different subtypes of prostate adenocarcinoma. Ductal adenocarcinoma is considered more aggressive than acinar adenocarcinoma.

There are at least four subtypes of acinar adenocarcinoma. These subtypes are based on details about how the cancer cells look when examined under the microscope. Knowing the subtype can help your cancer care team know which treatments to recommend.

Ductal adenocarcinoma develops in the cells that line both the ducts and the tubes inside the prostate. Ductal adenocarcinoma can be harder to detect than acinar adenocarcinoma because it doesn’t raise levels of prostate-specific antigen (PSA), the protein measured in prostate cancer screening.

3. Diagnosing Adenocarcinoma Requires a Biopsy

While blood tests measure your PSA level and a digital rectal exam may be part of screening for prostate cancer, you’ll need a prostate biopsy to confirm a diagnosis. A biopsy also helps determine exactly what kind of cancer you have. For a prostate biopsy, a doctor will take a sample of the tumor and send it to a pathology lab to be examined.

Healthcare staff at the lab will look at the cells from your biopsy under a microscope. They’ll examine how the cells look and respond to tests. Results of testing will allow for an accurate, detailed diagnosis. Your oncologist can explain the results of your pathology report.

4. Adenocarcinoma Can Occur in Other Parts of the Body

Adenocarcinomas don’t just occur in the prostate. They can happen anywhere in the body where gland cells line the inside of organs. In addition to the prostate, adenocarcinoma can occur in the:

• Breasts
• Lungs
• Colon
• Rectum
• Stomach
• Esophagus
• Pancreas

Developing an adenocarcinoma in your prostate doesn’t mean that you’ll develop adenocarcinomas in other areas. While prostate cancer can spread to other areas, one adenocarcinoma doesn’t mean you’re at risk for more.

5. Family History Can Raise the Risk for Adenocarcinoma

If you have a close family relative who has had adenocarcinoma, you may be more likely to develop adenocarcinoma yourself. Close relatives include your grandparents, parents, and siblings. Researchers don’t know exactly how much family history raises your chance of this cancer, but it’s a risk factor to consider when you’re thinking about adenocarcinoma. If you’ve been diagnosed with prostate adenocarcinoma, you may want to discuss your diagnosis with close relatives so they can make informed decisions about their own health.

6. You Can Have Adenocarcinoma Along With Other Types of Prostate Cancer

Some people develop more than one type of prostate cancer at the same time, and these combinations often involve adenocarcinoma. For instance, any of the more rare prostate cancer types can occur with adenocarcinoma. There’s a subtype of prostate cancer called adenosquamous carcinoma in which cells of adenocarcinoma and squamous cell carcinoma are found together.

Apart from the prostate, adenocarcinomas can develop in the lungs, breasts, colon, pancreas, and other organs.

It’s possible to have both types of adenocarcinoma at the same time. Ductal adenocarcinoma often develops alongside acinar adenocarcinoma. If more than half of the features of your cancer match acinar adenocarcinoma, your doctor may consider it to be that type of cancer.

7. Adenocarcinoma Can Be Slow Growing or Aggressive

Acinar adenocarcinoma usually grows more slowly and is considered less aggressive than ductal adenocarcinoma. This means that people with acinar adenocarcinoma are less likely to have their cancer spread, or metastasize. They also have better survival rates.

Ductal adenocarcinoma tends to be more aggressive. This means that it’s more likely to come back after treatment or spread to other parts of the body. Overall prognosis is often worse.

Outside of adenocarcinoma, squamous cell carcinoma is known for growing quickly. Small cell carcinoma, however, is the fastest growing type of prostate cancer. Many people don’t find small cell carcinoma until it has spread beyond the prostate to other organs or to the bones.

8. Different Types of Adenocarcinoma May Need Different Treatments

You and your urologist or oncologist will develop a treatment plan based on a number of factors. These factors will likely include the type of cancer you have, the grade of your cancer, and what stage it is. Your goals and preferences are also important to consider. Different treatment options are recommended in different situations. For instance, some hormone therapies may not work on the ductal subtype.

Adenocarcinomas make up between 95 percent and 99 percent of prostate cancers.

Other treatment options for both adenocarcinomas and other kinds of prostate cancer may include:

• Radical prostatectomy or prostatectomy (surgery to remove all or part of your prostate)
• Radiation therapy
• Chemotherapy
• Immunotherapy
• Targeted therapy

Your oncology team may also combine more than one of these prostate cancer treatments to better address specific kinds of cancer.

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