The short answer
Almost all prostate cancers are adenocarcinomas, which start in the gland cells. Rare subtypes, like small cell (neuroendocrine) carcinoma and transitional cell carcinoma, behave differently and need different treatment.
Nearly all prostate cancers are adenocarcinomas, starting in the gland cells.
Rare subtypes include small cell (neuroendocrine) carcinoma, transitional cell carcinoma, and sarcoma.
Rare subtypes often grow and spread differently and need different treatment approaches.
The Gleason score, which grades adenocarcinoma, is a separate measure from the cancer's type.
Choose how you want to understand this
The full explanation.
The simple version
Almost all prostate cancers are one type. It is called adenocarcinoma. A small number are rarer subtypes. Those behave differently and need different treatment.
The common type
Adenocarcinoma starts in the gland cells of the prostate. Those cells make some of the fluid in semen. If you are told you have prostate cancer, it is very likely this type.
Rare subtypes
A small share of prostate cancers are other, rarer types:
- Small cell (neuroendocrine) carcinoma. A more aggressive subtype. It can appear after hormone-blocking drugs stop working, and it does not respond to them the way adenocarcinoma does.
- Other neuroendocrine or large cell carcinoma. Also uncommon. These act differently from typical adenocarcinoma.
- Transitional cell (urothelial) carcinoma. This starts in cells like those that line the bladder. It sometimes spreads into the prostate from the bladder.
- Sarcoma. A rare cancer that starts in the supporting tissue of the prostate.
In short: nearly all cases are adenocarcinoma. The rare subtypes need their own approach.
Why type matters for treatment
Standard treatments, including hormone therapy, are built around how adenocarcinoma grows. Hormone therapy works by lowering testosterone or blocking its effect. Rare subtypes like small cell carcinoma often do not respond the same way, so the plan is different for them. That is why a biopsy and pathology review confirm the exact type, rather than assuming it is adenocarcinoma.
Type vs. grade
It is easy to mix up type and grade. Type is the kind of cell the cancer is made of. Grade describes how abnormal those cells look under a microscope. For adenocarcinoma, grade is most often reported as a Gleason score. Type, grade, and stage together shape your treatment plan.
Sources
Words to know
Tap any term to see what it means.
Common questions
What type of prostate cancer do most people have?
The large majority of prostate cancers are adenocarcinomas. If you are told you have prostate cancer, it is very likely to be this type.
What is neuroendocrine (small cell) prostate cancer?
This is a rare, more aggressive subtype that does not behave like typical adenocarcinoma and often does not respond to the same hormone-based treatments. It sometimes develops after long-term treatment for standard adenocarcinoma.
Is the Gleason score a type of prostate cancer?
No. The Gleason score is a grading system that describes how abnormal adenocarcinoma cells look under a microscope. It is separate from, but related to, the type of cancer.
Why does the type matter if most cases are the same type?
Because the rare subtypes, though uncommon, often need different treatment. A pathologist confirming the exact type is an important part of diagnosis, even though adenocarcinoma is expected in nearly all cases.
Questions to ask your doctor
Being prepared helps you get the most out of your appointments. Save or print these questions.
Tap a question to save it to your list (kept on this device).
Speak With Trained Specialists & Human Navigators
Cancer Explained provides educational guidance, but does not replace trained specialists, social workers, or your medical team.
Talk to a trained cancer information specialist
Free, confidential assistance from NCI Cancer Information Service via phone, chat, or email.
Contact your oncology team
Locate after-hours contact numbers, portal messages, or urgent triage phone lines.
Find a patient navigator
Get one-on-one help with appointments, logistics, translation, and care coordination.
Find a genetic counselor
Discuss inherited mutation risk, family history, and genetic testing options.
Find an oncology social worker
Access emotional counseling, family support groups, and mental health resources.
Find a financial navigator
Locate copay assistance foundations, grant programs, and lodging/travel support.
Find a clinical-trial specialist
Search matching studies and speak with NCI trial information specialists.
Get urgent help
Immediate emergency guidance for fever (>100.4°F during chemo), severe pain, or shortness of breath.
Help Us Improve This Guide
Did this explanation answer your question and help you determine your next step?
Know someone who needs this?
Plenty of people are looking for something like this and do not know where to start. If this would help a friend or someone you love, send it on — we have written an opening line so you do not have to stare at an empty message. You can change every word of it.
Your message is written and sent in your own email or messaging app — we never see who you send it to, and nothing is added to any list.
Plain-language explanation of the published sources cited on this page. AI-assisted, source-checked, not clinician-reviewed.
Last updated: 2026-08-11Next planned review: 2027-08-03
How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status — Source checked. This page was written with AI assistance and checked line by line against the sources listed on it. That confirms the sources support what the page says. It is not a medical review, and it does not confirm the page is complete or right for your situation.
General education — varies by person. Answers genuinely differ between people. This page explains what commonly varies and points you to your care team for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and checked line by line against the sources listed on it. That confirms the sources support what the page says. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
Read more about our editorial process, our use of AI, and our corrections policy.
Spotted a problem? Report an error — a factual mistake, broken or outdated source, confusing wording, or anything that seems unsafe. Please do not include names, medical record numbers, dates of birth, addresses, or other identifying medical information in your report.
After using this page, do you understand what to do next?
Anonymous — we only record the answer, never who gave it.
Related articles
Still have questions?
Educational answers, plain language
Free to print and share