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Small cell prostate cancer

Read about small cell cancer of the prostate gland. 

What is small cell prostate cancer?

Small cell prostate cancer is a very rare type of prostate cancer. Most prostate cancers are acinar adenocarcinomas which develop in the glandular cells of the prostate gland.

Fewer than 2 in 100 prostate cancers (2%) are small cell. The cells look small and round under a microscope. They are also sometimes called oat cell cancers.

About half of the men who have small cell prostate cancers have a mixture of small cells and other cells.

The symptoms of small cell prostate cancer are similar to other types of prostate cancer. They include:

  • difficulty passing urine
  • passing urine more often than usual
  • pain passing urine
  • blood in the urine (this is rare)

Some men with small cell prostate cancer also have paraneoplastic syndrome. This is when you have high levels of particular hormones or other substances in the body which cause symptoms.

The symptoms can include pins and needles, muscle cramps, sickness and changes in your blood.

The blood level of prostate specific antigen (PSA) in men with small cell prostate cancer is often normal, or only slightly higher than normal, even if the cancer has spread.

Men who have adenocarcinoma usually have a high amount of PSA in their blood, especially when their cancer has spread.

Small cell cancers tend to grow more quickly than adenocarcinomas. They are more likely to spread to other parts of the body (metastasise).

The most common part of the body for acinar adenocarcinomas to spread to is the bone. Small cell cancers are more likely to spread to other organs in the body, such as the lungs or liver.

Treatment

Your treatment depends on the stage of your cancer (the size and how far the cancer has spread). Most small cell prostate cancers have spread outside the prostate gland when they are diagnosed.

If the cancer has spread, the aim of treatment is to control the cancer for as long as possible. The treatment also reduces symptoms and gives you as good a quality of life as possible.

The treatment for small cell cancers of the prostate is different from acinar adenocarcinomas. Doctors are more likely to treat small cell prostate cancer with chemotherapy.

Hormone therapy does not often work for this type of prostate cancer.

As the cancer has usually spread, the main treatment is chemotherapy. The aim of chemotherapy is to control the cancer and any symptoms you have.

You may have etoposide with cisplatin. Other drugs used include ifosfamide and doxorubicin.

You may also have radiotherapy. This can help to shrink the tumour in the prostate and so control the cancer. It can also reduce any symptoms you have.

Radiotherapy can also control symptoms if your cancer has spread to other parts of your body.

Hormone therapy tends not to work very well for this type of prostate cancer.

You may have hormone treatment if you have a mixture of small cell and adenocarcinoma and your PSA is higher than normal.

If your tumour is just within the prostate gland, you may have surgery before or after chemotherapy but this is rare. Surgery means taking out the whole of your prostate gland (radical prostatectomy).

Unfortunately surgery is often not possible because the cancer has usually already spread outside the prostate gland when it is diagnosed.

Research into treatment

Small cell cancer of the prostate is rare so it is harder to research than other more common types of prostate cancer.

Small cell cancers can develop in almost any part of the body. The most common place for them to start is the lung.

Research has looked into using some of the newer chemotherapy drugs and targeted cancer drugs for small cell lung cancer.

The research looks promising but it is not clear if these treatments will work in the same way for small cell prostate cancers. We need more research to find out.

Coping

Coping with a rare condition can be difficult, both practically and emotionally. Being well informed about your condition and its treatment can help you to make decisions and cope with what happens.

It can also help to talk to other people who have the same thing. Check out Cancer Chat – Cancer Research UK's discussion forum.

It is a place for anyone affected by cancer to share experiences, stories and information with other people who know what you are going through.

You may also find it helpful to contact the Rare Cancer Alliance or the Rarer Cancers Foundation who offer support and information to people who have rare cancers.

Last reviewed: 
12 Mar 2014
  • Textbook of uncommon cancer (4th Edition). D Raghavan and others. Wiley Blackwell. 2012.

  • Results of a phase II study with doxorubicin, etoposide, and cisplatin in patients with fully characterized small-cell carcinoma of the prostate. CN Papandreou and others. Journal of Clinical Oncology. 2002 Jul 15;20(14):pages 3072-80

  • Small-cell carcinoma of the prostate. CJ Anker and others. J Clin Oncol. 2008 Mar 1;26(7):pages 1168-71

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