The prostate is a gland found in biological males, roughly the size of a walnut. It sits just below the bladder and in front of the rectum, and its primary role is associated with sexual reproduction. Prostate cancer will develop in approximately 1 in 8 men during their lifetime. Although it typically progresses slowly and is often manageable when detected early, it remains one of the leading causes of cancer-related death in men. In May 2025, the family of former United States President Joe Biden announced his diagnosis of prostate cancer, prompting renewed public interest in the disease and the importance of early screening.

Prostate cancer occurs when abnormal cells begin to grow uncontrollably within the gland. The disease may remain localized, extend to surrounding tissues, or metastasize to distant parts of the body such as the bones or lymph nodes. While there is no single known cause, potential contributing factors include genetic predisposition, chronic inflammation, hormonal imbalances, psychological stress, depression, autoimmune conditions, prior genitourinary trauma, and possibly repeated prostate biopsies. However, many of these associations are still being researched and are not conclusively established.

The primary screening method is a blood test called the prostate-specific antigen (PSA) test. If PSA levels are elevated, additional tests—such as advanced blood or urine biomarker panels (e.g., PHI, 4Kscore, or PCA3)—may help determine the likelihood of cancer and guide decisions about imaging or biopsy. While the digital rectal exam (DRE) was traditionally part of screening, current guidelines often limit its role to supplementary assessment, particularly when PSA results are abnormal or when urgent evaluation is needed and PSA testing is unavailable.

Screening is generally recommended for men between the ages of 55 and 69. For higher-risk individuals—including Black men, those with a first-degree relative diagnosed before age 65, or those with BRCA1 or BRCA2 mutations—screening may begin as early as age 40-45. Depending on individual risk and baseline PSA levels, repeat screening may occur every one to four years. For most men over age 70, especially those with limited life expectancy, screening is typically not recommended due to the risk of overdiagnosis and overtreatment.

While the diagnosis and management of prostate cancer falls outside the scope of chiropractic care, doctors of chiropractic may play a role in early detection. For example, a male patient over 50 presenting with persistent back pain that is deep, unrelenting, worse at night, and not relieved by movement or posture, particularly in combination with urinary symptoms (e.g., frequency, urgency, weak stream, or hematuria), or bilateral sciatic symptoms or saddle paresthesia, should be referred for medical evaluation. Notably, there are at least nine published cases in the medical literature over the past four decades in which chiropractic examinations contributed to the early diagnosis of prostate cancer.