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Small cell prostate cancer

Small cell prostate cancer is a rare type of prostate cancer. Around 1 in every 100 prostate cancers (1%) are small cell prostate cancer. They can also be classed as a type of neuroendocrine cancer.

Small cell prostate cancers are very different from the most common type of prostate cancer. They grow more quickly than other types. Most men have a cacner that has spread to other parts of the body such as the bones at diagnosis (advanced cancer).

Symptoms

Symptoms of small cell prostate cancer are similar to other types of prostate cancer. Many men with this type of prostate cancer already have spread to other parts of their body at diagnosis. So, when they go to their doctor they are more likely to have:

  • bone pain
  • difficulty passing urine
  • blood in the urine

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

Symptoms of paraneoplastic syndrome may include:

  • pricking, tingling or numbness in your arms, hands, legs and feet 
  • muscle cramps
  • feeling sick
  • changes in your blood

The prostate specific antigen (PSA) level in men with small cell prostate cancer is often normal, or only slightly higher than normal, even if the cancer has spread. This is different from people who have adenocarcinoma prostate cancer, which is the most common type.

Treatment

Treatment for small cell prostate cancer is different from other types of prostate cancer. Most small cell prostate cancers have spread to other parts of the body by the time they are diagnosed. The aim of treatment is to control the cancer for as long as possible. Treatment can also reduce your symptoms and help you feel better. 

The main treatment for small cell prostate cancer is chemotherapy.

Chemotherapy uses cytotoxic drugs to destroy cancer cells. The aim of chemotherapy is to control the cancer and reduce your symptoms.

You usually have a combination of chemotherapy drugs. Commonly used chemotherapy drugs include:

  • etoposide
  • cisplatin
  • ifosfamide 
  • doxorubicin

You may also have radiotherapy during or after chemotherapy. Radiotherapy uses high energy waves similar to x-rays to destroy prostate cancer cells. This can help to shrink the cancer and help you to feel better.

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

Hormone therapy tends not to work very well for this type of prostate cancer. But you might have hormone therapy if your doctors think that you have a mixture of small cell prostate cancer and adenocarcinoma. 

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

Most small cell prostate cancers have spread outside the prostate gland when they are diagnosed, so surgery is often not possible. 

Research and clinical trials

Doctors are always trying to improve the diagnosis and treatment of cancer. But small cell prostate cancer is very rare, so it is harder to research than other more common types of prostate cancer.

Researchers are looking into immunotherapy for small cell prostate cancer. This is early stage research and it's not clear whether these treatments will work well for small cell prostate cancer. 

Coping with small cell prostate cancer

Coping with a rare condition can be difficult, both practically and emotionally. Being well informed about the cancer 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 condition.

You can visit 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 who offer support and information to people who have rare cancers.

Last reviewed: 
03 Feb 2020
  • Small cell carcinoma of the prostate 
    R Nadal and others 
    Nature Reviews Urology, 2014. Vol 11, Issue 4, Pages 213-219

  • The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part B: Prostate and Bladder Tumours.
    P Humphrey and others
    European Association of Urology, 2016

  • Poorly Differentiated Small-Cell-Type Neuroendocrine Carcinoma of the Prostate: A Case Report and Literature Review
    K Kumara and others
    Case Reports in Oncology, 2018. Vol 11, Pages 676–681

  • Small-cell neuroendocrine cancer of the prostate: an atypical presentation of a common disease
    D Alves and others
    BMJ Case Reports, 2016. 

  • Neuroendocrine (Small-Cell) Carcinomas: Why They Teach Us Essential Lessons About Prostate Cancer
    A Aparicio and others
    Oncology, 2014. Vol 34, Number 1

Information and help