What Makes Prostate Cancer Aggressive?

Aggressive Growth of Prostate Cancer

Professional using microscope

Have you ever wondered what makes prostate cancer aggressive?

Some prostate cancers grow quickly, rapidly invade the tissues surrounding the prostate, and spread to other areas of the body. Others don't. 


Prostate cancer develops in the prostate — a small gland that makes seminal fluid. It is one of the most common types of cancer in men. Prostate cancer usually grows over time and in the beginning usually stays within the prostate gland, where it may not cause serious harm.

While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.

Prostate cancer that is caught early has a better chance of successful treatment.


Prostate cancer that is more advanced may cause signs and symptoms such as:


Prostate cancer begins when some cells in the prostate become abnormal. Mutations in the abnormal cells' DNA cause the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can break off and spread (​metastasize) to other parts of the body.

Risk Factors 

Factors that can increase your risk of prostate cancer include:

  • Older age. Your risk of prostate cancer increases as you age.
  • Being black. Black men have a greater risk of prostate cancer than do men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced. It's not clear why this is.
  • Family history of prostate or breast cancer. If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.
  • Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.

Reasons for Aggression 

The most important factor that determines whether a prostate cancer is "aggressive" or not is the degree to which the prostate cancer cells are abnormal. Extremely abnormal prostate cancer cells behave much more aggressively than near-normal cells.

The prostate cancer grade, often quantified using the Gleason scoring system, is a measure of just how abnormal the prostate cancer cells are. The more abnormal the cells, the higher the grade, and, generally, the more aggressive the cancer.

Cancers can also be more aggressive in men who have other health problems or weakened immune systems. In a sense, the body is not strong enough to fully block the growth of the aggressive cancer.


Allsbrook Jr WC, Mangold KA, Yang X, et al. The Gleason grading system: an overview. J Urologic Path 10:141-157, 1999.

Gleason DF. Histology grading of prostate cancer: a perspective. Hum Path 23:273-279, 1992.

Mayo Clinic. Prostate Cancer. http://www.mayoclinic.org/diseases-conditions/prostate-cancer/basics/definition/con-20029597.