Seattle Prostate Institute

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About Prostate Cancer

Prostate cancer is the most common form of cancer in men

Aside from skin cancer, prostate cancer is the most common form of cancer in men. In fact, each year approximately 300,000 men in the United States are diagnosed with prostate cancer. The exact cause of prostate cancer is unknown. According to the American Cancer Society, an average American man has a one in six chance of being diagnosed with prostate cancer during his lifetime.

Located just below the bladder and in front of the rectum, the prostate is a walnut sized gland that is part of the male reproductive system. The urethra, the tube that urine flows through, runs through the center of the prostate gland. The prostate gland produces prostatic fluid which when mixed with sperm produces semen.

Prostate cancer occurs when portions of the prostate gland develops malignant cells. Most prostate cancer is ‘localized’ which means the cancer remains inside the prostate or the capsule surrounding the prostate. However, it is possible for the cancer to grow to surrounding tissue, or spread more distantly to the lymph nodes or bone or elsewhere. When it has spread beyond the localized area, it is referred to as metastatic prostate cancer.

Risk factors for prostate cancer

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for many cancers. But risk factors don't tell us everything. Many people with one or more risk factors never get cancer, while others with this disease may have had no known risk factors.

Although we don't yet completely understand the causes of prostate cancer, researchers have found several factors that may change the risk of getting it. For some of these factors, the link to prostate cancer risk is not clear, yet.

  • Age: Age is the strongest risk factor for prostate cancer. Prostate cancer is very rare before the age of 40, but the chance of having prostate cancer rises rapidly after age 50. Almost 2 out of 3 prostate cancers are found in men over the age of 65.
  • Race/ethnicity: Prostate cancer occurs more often in African-American men than in men of other races. African-American men are also more likely to be diagnosed at an advanced stage, and are more than twice as likely to die of prostate cancer as white men. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than in non-Hispanic whites. The reasons for these racial and ethnic differences are not clear.
  • Nationality: Prostate cancer is most common in North America, northwestern Europe, Australia, and on Caribbean islands. It is less common in Asia, Africa, Central America, and South America. The reasons for this are not clear. More intensive screening in some developed countries likely accounts for at least part of this difference, but other factors are likely to be important as well. For example, lifestyle differences (diet, etc.) may be important: men of Asian descent living in the United States have a lower risk of prostate cancer than white Americans, but their risk is higher than that of men of similar backgrounds living in Asia.
  • Family history: Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man's risk of developing this disease. (The risk is higher for men with an affected brother than for those with an affected father.) The risk is much higher for men with several affected relatives, particularly if their relatives were young at the time the cancer was found.
  • Genes: Scientists have found several inherited genes that seem to raise prostate cancer risk, but they probably account for only a small number of cases overall. Genetic testing for most of these genes is not yet available. Recently, some common gene variations have been linked to the risk of prostate cancer. Studies to confirm these results are needed to see if testing for the gene variants will be useful in predicting prostate cancer risk. Some inherited genes raise the risk for more than one type of cancer. For example, inherited mutations of the BRCA1 or BRCA2 genes are the reason that breast and ovarian cancers are much more common in some families. Mutations in these genes may also increase prostate cancer risk in some men, but they account for a very small percentage of prostate cancer cases.
  • Diet: The exact role of diet in prostate cancer is not clear, although several different factors have been studied. Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables. Doctors are not sure which of these factors is responsible for raising the risk. Some studies have suggested that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing advanced prostate cancer. Most studies have not found such a link with the levels of calcium found in the average diet, and it's important to note that calcium is known to have other important health benefits.
  • Obesity: Most studies have not found that being obese (having a high amount of extra body fat) is linked with a higher risk of getting prostate cancer. Some studies have found that obese men have a lower risk of getting a low-grade (less dangerous) form of the disease, but a higher risk of getting more aggressive prostate cancer. The reasons for this are not clear. Studies have also found that obese men may be at greater risk for having more advanced prostate cancer and of dying from prostate cancer, but this was not seen in other studies.
  • Exercise: Exercise has not been shown to reduce prostate cancer risk in most studies. But some studies have found that high levels of physical activity, particularly in older men, may lower the risk of advanced prostate cancer. More research in this area is needed.
  • Inflammation of the prostate: Some studies have suggested that prostatitis (inflammation of the prostate gland) may be linked to an increased risk of prostate cancer, but other studies have not found such a link. Inflammation is often seen in samples of prostate tissue that also contain cancer. While the link between the two is not yet clear, this is an active area of research.
  • Infection: Researchers have also looked to see if sexually transmitted infections (like gonorrhea or chlamydia) might increase the risk of prostate cancer, possibly by leading to inflammation of the prostate. So far, studies have not agreed, and no firm conclusions have been reached.
  • Vasectomy: Some earlier studies had suggested that men who had a vasectomy (minor surgery to make men infertile) -- especially those younger than 35 at the time of the procedure -- may have a slightly increased risk for prostate cancer. But most recent studies have not found any increased risk among men who have had this operation. Fear of an increased risk of prostate cancer should not be a reason to avoid a vasectomy.

Source: For more information please visit the American Cancer Society.

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