6 Things to Know About Prostate Cancer

Prostate Cancer: Causes, Prevention & Symptoms

Prostate cancer is cancer that occurs in the prostate — a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer in men. Usually, prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 41 will die of prostate cancer. About 1 man in 9 will be diagnosed with prostate cancer during his lifetime.

Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 3.1 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

Prostate cancer that is detected early — when it is still confined to the prostate gland — has a better chance of successful treatment.

1. Risk factors

Age. Your risk of prostate cancer increases as you age. About 6 cases in 10 are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age at diagnosis is about 66.

Race. For reasons not yet determined, black men carry a greater risk of prostate cancer than men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced.

Family history. If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.

Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that is more difficult to treat.

Vasectomy. Some studies have suggested that men who have had a vasectomy a slightly increased risk for prostate cancer, but other studies have not found this. Research on this possible link is still under way.

2. Causes

Doctors know that prostate cancer begins when some cells in your prostate become abnormal. Mutations in the abnormal cells’ DNA cause the cells to grow and divide more rapidly than normal cells do. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can also break off and spread (metastasize) to other parts of the body.

3. Prevention

There is no sure way to prevent prostate cancer. Many risk factors such as age, race, and family history cannot be controlled. In general, a healthy lifestyle, including a healthy diet, regular exercise, abstaining from alcohol and tobacco, and minimizing toxic exposures, may decrease your risk.

Other drugs and dietary supplements (Vitamin E, soy, selenium, saw palmetto, isoflavones, 5 alpha-reductase inhibitors, aspirin) that might help lower prostate cancer risk are now being studied. But so far, no drug or supplement has been found to be helpful in studies large enough for experts to recommend them.

4. Symptoms

Prostate cancer may cause no signs or symptoms in its early stages.

Prostate cancer that is more advanced may cause signs and symptoms such as:

• Trouble urinating
• Decreased force in the stream of urine
• Blood in semen
• Discomfort in the pelvic area
• Bone pain
• Erectile dysfunction

Make an appointment with your doctor if you have any signs or symptoms that worry you.

5. Testing

A simple blood tested called a PSA (prostate specific antigen) is the primary method for screening blood cancer. Debate continues regarding the risks and benefits of prostate cancer screening, and medical organizations differ on their recommendations. After this discussion, men who want to be screened should get the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.

• If you are African American or have a family history of prostate cancer, you should have your PSA checked at 45. 
• At age 50, discuss prostate cancer screening with your doctor. 

If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:

• Men who choose to be tested who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years.
• Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.

Because prostate cancer often grows slowly, men without symptoms of prostate cancer who do not have a 10-year life expectancy should not be offered testing since they are not likely to benefit. Overall health status, and not age alone, is important when making decisions about screening.

Even after a decision about testing has been made, the discussion about the pros and cons of testing should be repeated as new information about the benefits and risks of testing becomes available. Further discussions are also needed to consider changes in a man’s health, values, and preferences.

6. Complications

Complications of prostate cancer and its treatments include:

Cancer that spreads (metastasizes). Prostate cancer can spread to nearby organs, such as your bladder, or travel through your bloodstream or lymphatic system to your bones or other organs. Prostate cancer that spreads to the bones can cause pain and broken bones. Once prostate cancer has spread to other areas of the body, it may still respond to treatment and may be controlled, but it is unlikely to be cured.

Incontinence. Both prostate cancer and its treatment can cause urinary incontinence. Treatment for incontinence depends on the type you have; how severe it is and the likelihood it will improve over time. Treatment options may include medications, catheters and surgery.

Erectile dysfunction. Erectile dysfunction can result from prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.