Small cell prostate cancer

Small cell prostate cancer is a rare type of prostate cancer. Less than 2 in every 100 prostate cancers (less than 2%) are small cell prostate cancer. They can also be classed as a type of neuroendocrine prostate cancer.

Small cell prostate cancers are very different from the most common type of prostate cancer. They grow more quickly than other types. Most people with small cell prostate cancer have advanced cancer by the time they are diagnosed. This means that the cancer has spread to other parts of the body such as the bones.

Symptoms

The most common symptoms of small cell prostate cancer include:

• difficulty passing urine

• pain

• confusion

You may also have a group of symptoms called paraneoplastic syndrome. This is when you have high levels of certain hormones in the body. Symptoms of paraneoplastic syndrome include:

• pricking, tingling or numbness in your arms, hands, legs and feet 
• muscle cramps
• difficulty walking
• difficulty swallowing
• problems with your memory

Small cell prostate cancer develops from neuroendocrine cells of the prostate. These types of cells don’t make prostate specific antigen (PSA). So the PSA level in men with small cell prostate cancer is often normal, or only slightly higher than normal. This is different from people with more common types of prostate cancer.

Tests for small cell prostate cancer

The tests you have to diagnose small cell prostate cancer are similar to other types of prostate cancer. Tests you might have include:

• bone scan
• CT scan
• MRI scan
• blood tests including a PS blood test
• taking a sample of your prostate gland called a biopsy

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. This is advanced prostate cancer.

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

Chemotherapy uses cytotoxic drugs to destroy cancer cells. You usually have a combination of chemotherapy drugs. Commonly used chemotherapy drugs include:

• etoposide
• cisplatin
• carboplatin
• docetaxel
• doxorubicin

Radiotherapy

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 such as the bones.

Surgery

You may have surgery before or after chemotherapy if your cancer is just within the prostate gland. You usually have a radical prostatectomy. This means taking out the whole of your prostate gland.

Surgery is not usually possible for advanced small cell prostate cancer. 

Hormone therapy

Hormone therapy doesn’t usually 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 of the prostate. 

You might have hormone therapy with chemotherapy.

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. 

Go to Cancer Research UK’s clinical trials database if you are looking for a trial for prostate cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

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.