The prostate and the lymph nodes

The prostate is a small gland situated close to the urethra. The lymphatic system helps protect us from disease. If prostate cancer cells spread to the lymph nodes, they usually go to the nodes close to the prostate.

The prostate

The prostate is a small gland about the size of a walnut. It is divided into 2 lobes and surrounded by an outer layer called the capsule. The prostate gets bigger as you get older.

The prostate is below the bladder, surrounding the first part of a tube called the urethra. The urethra carries urine (pee) from the bladder to the penis. The urethra also carries semen, which is the fluid that carries sperm. Just behind the prostate is the back passage (rectum). There are also lymph nodes near the prostate. These are sometimes called lymph glands.

The prostate contains muscle tissue and glandular tissue. Glandular tissue makes and releases substances in the body.

The prostate

The illustration shows the lower body from the side. It shows the penis, bladder, testicle, seminal vesicle, rectum and prostate. — Image: The illustration shows the body from the side from the lower abdomen to the top of the thigh. The penis hangs down outside the front of the body. Behind the penis, a small solid oval organ hangs below the body in a pocket of skin. This is the testicle in the scrotum. The illustration shows the organs within the pelvis. This includes the bladder, a hollow organ towards the front of the body. Just below the bladder is a small, rounded organ. This is the prostate. A thin tube goes from the lower end of the bladder, through the prostate and the centre of the penis, and opens at the end of the penis. This is the urethra. Within the prostate, another tube branches off the urethra. This tube connects to a small irregularly shaped gland and then goes over the bladder down to the testicle. The gland is the seminal vesicle. Behind the bladder and prostate is a tube-shaped organ. This is the lowest part of the bowel, called the rectum. A narrow opening called the anus connects the bowel to outside the body. Behind the rectum is a line of bones following the curve of the back. This is the spine.

Prostate cancer

What does the prostate do?

The prostate produces a fluid that mixes with sperm from the testicles to make semen. This fluid is stored in 2 tube-shaped glands called the seminal vesicles. These are positioned just behind the bladder. During sex, the muscle tissue helps force (ejaculate) prostate fluid and sperm into the urethra.

The sex hormone testosterone controls how the prostate works. Testosterone is mainly made by the testicles. It is responsible for things like your sex drive, getting an erection and muscle development.

The prostate also makes a protein called prostate-specific antigen (PSA). This helps make semen more watery. Some PSA leaks into the blood and can be measured in a blood test. This is called a PSA test. Doctors use it to help diagnose different prostate problems, including prostate cancer.

If you are a trans woman

People who have a prostate include men, transgender (trans) women and people assigned male at birth. If you are a trans woman and have had genital gender affirming surgery as part of your transition, you will still have a prostate. It is important to talk to your GP or nurse if you are worried about prostate cancer or have symptoms.

Prostate Cancer UK has detailed information about trans women and prostate cancer.

The LGBT Foundation can also give you confidential advice and support. You can also talk to one of our cancer support specialists.

The lymphatic system

The lymphatic system is part of the body’s immune system. This is the system that protects us from infection and disease. It is made up of fine tubes called lymphatic vessels. These tubes connect to groups of small lymph nodes throughout the body. Fluid drains from the tissues of the body into the lymphatic vessels. The fluid travels through the vessels and nodes, then into the bloodstream.

Pelvic lymph nodes

The illustration shows the lower body from the front. It shows the penis, bladder, scrotum, and prostate. It shows the lymph nodes around the bladder. — Image: The diagram shows an outline of the lower tummy area from the waist to the top of the legs. It shows 2 tubes called the ureters, which go into the top of the bladder on either side. The bladder is an oval-shaped, hollow organ and is in the lower tummy area.

What are lymph nodes?

Lymph nodes are sometimes called lymph glands. They filter germs (bacteria), disease and waste products from the fluid as it passes through. When you have an infection, some lymph nodes may swell as they fight the infection.

Lymph nodes and prostate cancer

If prostate cancer cells spread to the lymph nodes, they usually go to the nodes close to the prostate. You may have a scan to check if the cancer has spread to these nodes.

In early prostate cancer, the cells have not spread to the lymph nodes.

In locally advanced prostate cancer may have spread to the lymph nodes that are close to the prostate.

In advanced prostate cancer, there are usually cancer cells in the lymph nodes close to the prostate and in lymph nodes further away.

References

Below is a sample of the sources used in our prostate cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk

National Institute for Health and Care Excellence (NICE). Prostate cancer: diagnosis and management. NICE Guideline [NG131]. Published: 09 May 2019. Last updated: 15 December 2021. Available from: www.nice.org.uk/guidance/ng131 [accessed March 2024].

Castro E, Fizazi K, Heidenreich A, Ost P, Parker C, Procopio G, et al. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2020; 31(9): 1119–1134. Available from: www.annalsofoncology.org/article/S0923-7534(20)39898-7/fulltext [accessed March 2024].

Cancer Information Development team

Author

Dr Ursula McGovern

Reviewer

Consultant Medical Oncologist & Honorary Associate Professor

University College Hospitals, London

Date reviewed

Reviewed: 01 October 2025

Next review: 01 October 2028

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

use plain English
explain medical words
use short sentences
use illustrations to explain text
structure the information clearly
make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.