About Prostate Cancer
According to the National Cancer Institute, prostate cancer is the second most common type of cancer among men in the United States. Men with certain risk factors are more likely than others to develop the disease. Published data suggests that one of the most important factors in treating prostate cancer is early diagnosis and accurate treatment by experienced doctors.
Before a treatment plan is determined, however, it is important to understand the disease and to research all the options available.
The team at the International Prostate Cancer Foundation has worked hard to create a comprehensive guide on prostate cancer caregiving. Click here to download or visit the download center for other download options.
what causes prostate cancer?
Medical professionals and researchers aren’t completely sure what causes prostate cancer. It’s likely that several different factors come into play, but researchers are still investigating which factors have the greatest impact and how they cause the cancer to develop. At a very basic level, researchers do know that prostate cancer develops as a result of DNA mutations in one or more prostate cells.
These DNA mutations may be:
Inherited. For instance, some people are born with tumor suppressor genes (RNASEL, BRCA1 and BRCA2) that don’t function the way they should. This can allow cancerous cells to develop, grow and eventually form a tumor.
Caused by increased hormone levels. For instance, too many androgens (male hormones, such as testosterone) may program prostate cells to grow at an abnormally high level, and DNA mutations may occur as a result.
Acquired over time. Although the correlation isn’t fully understood, being obese or over the age of 50 are risk factors for prostate cancer. These aren’t proven causes of prostate cancer, but rather can make a person’s DNA more likely to mutate over time.
prevention
Visit the resources section for prevention tips, support groups, and more!
There are many things that men can do to reduce or delay their risk
of developing prostate cancer.
Why is prostate cancer so common in the Western culture
and much less so in Asia, and why when Asian men migrate to western countries? It is believed the major risk factor is diet – foods that produce oxidative damage to DNA.
What can I do to prevent or delay the onset of the disease? There's no sure way to prevent prostate cancer. Study results often conflict with each other and most studies aren't designed to definitively prove if something prevents prostate cancer. As a result, no clear ways to prevent prostate cancer have emerged.
In general, doctors recommend that men with an average risk of prostate cancer make choices that benefit their overall health. Below are some things that have shown some evidence of lowering your prostate cancer risk.
Exercise
Exercise can help you maintain your weight, or it can help you lose weight. Men who exercise may have a reduced risk of prostate cancer. Exercise has many other health benefits and may reduce your risk of heart disease and other cancers. If you are overweight or obese, work on losing weight. You can do this by reducing the number of calories you eat each day and increasing the amount of exercise you do. If you have a healthy weight, work to maintain it by exercising most days of the week and choosing a healthy diet that's rich in fruits, vegetables and whole grains.
If you don't already exercise, make an appointment with your doctor to make sure it's OK for you to get started. When you begin exercising, go slowly. Aim for 30 minutes of exercise most days of the week.
Reduce Fat
Try to keep the amount of fat you eat from red meat and dairy products to a minimum. In some studies, men who ate the highest amount of fat each day had an increased risk of prostate cancer. While this association doesn't prove that excess fat causes prostate cancer, reducing the amount of fat you eat each day has other proven benefits, such as helping you control your weight and helping your heart stay healthy.
To reduce the amount of fat you eat each day, limit fatty foods or choose low-fat varieties. For instance, reduce the amount of fat you add to foods when cooking, select leaner cuts of meat, and choose low-fat or reduced-fat dairy products. In studies, men who ate the most dairy products — such as milk, cheese and yogurt — each day had the highest risk of prostate cancer. But study results have been mixed, and the risk associated with dairy products is thought to be small.
Make Smarter Food Choices
Eat more fish. Evidence from several studies suggest that fish can help protect against prostate cancer because fish have "good fat" such as omega-3 fatty acids. Avoid trans fatty acids (found in margarine).
Try to incorporate tomatoes that are cooked with olive oil,
which has also been shown to be beneficial, along with cruciferous vegetables (like broccoli and cauliflower) into many of your weekly meals.
Eat more fat from plants than from animals. In studies that looked at fat consumption and prostate cancer risk, fats from animals were most likely to be associated with an increased risk of prostate cancer. Animal products that contain fats include meat, lard and butter.
You might consider using plant-based fats instead of animal fats. For instance, cook with olive oil rather than butter. Sprinkle nuts or seeds on your salad rather than cheese.
Soy and green tea are also potential dietary components that may be helpful, as well as broccoli, pomegranate juice, tomatoes and legumes.
What about supplements?
Avoid over-supplementation with megavitamins. Too many vitamins, especially folate, may "fuel the cancer", and while a multivitamin is not likely to be harmful, if you follow a healthy diet with lots of fruits, vegetables, whole grains, fish, and healthy oils you likely do not even need a multivitamin. Watch your calcium intake. Do not take supplemental doses far above the recommended daily allowance. Taking calcium supplements is fine but avoid taking more than 1,500 mg of calcium a day. Always check with your healthcare team before taking anything on your own.
Seek medical treatment for stress, high blood pressure, high cholesterol, and depression. Treating these conditions may save your life and will improve your survivorship with prostate cancer. A yearly rectal examination and PSA test will also go a long way in early detection or diagnosis.
Relax and enjoy life.
Reducing stress in the workplace and home
will improve your survivorship and lead to a longer, happier life.
risk factors
A risk factor is anything that affects your chance of getting a disease. Different cancers have different risk factors. Some risk factors, like smoking or diet, can be changed. Others, like a person’s age or family history, can’t be changed.
Having one or several risk factors, does not mean that you will get the disease. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.
Age
Age is the main risk factor for prostate cancer, and the disease is rare in men younger than 45; only 1 in 10,000 men under age 40 will be diagnosed. However, with advanced screening, men as young as 30 have been diagnosed and treated for prostate cancer. The chance of getting prostate cancer increases sharply as a man gets older. In the United States, more than 65% of all prostate cancers are diagnosed in men over the age of 65.
Family History
A man's risk is higher if his father or brother had prostate cancer. This risk is further increased if the cancer was diagnosed in family members at a younger age (less than 55 years of age) or if it affected three or more family members.
Geography
Prostate cancer is most common in North America, northwestern Europe, Australia, and the 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 probably accounts for at least part of this difference, but other factors such as lifestyle differences, such as diet, are likely to be important as well.
Race
It is more common in African-American men than in Caucasian men. Black men are 1.7 times more likely to be diagnosed with — and 2.1 times more likely to die from — prostate cancer than white men. It is less common in Asian and Native-American men.
Certain Prostate Changes
Men with cells called High-Grade Prostatic Intraepithelial Neoplasia (PIN) may be at increased risk. These prostate cells look abnormal under a microscope.
Inflammation of the Prostate
Some studies have suggested that prostatitis (the inflammation of the prostate gland) may be linked to an increased risk of prostate cancer, but other studies have found no such link. Inflammation is often seen in samples of prostate tissue that also contain cancer. The link between the two is not yet clear and is an active area of research.
Certain Gene Changes
Several inherited gene changes seem to raise prostate cancer risk, but they probably account for only a small percentage of cases overall.
For example:
Inherited mutations of the BRCA1 or BRCA2 genes raise the risk of breast and ovarian cancers in some families. Mutations in these genes (especially in BRCA2) may also increase prostate cancer risk in some men.
Men with Lynch Syndrome (also known as Hereditary Non-Polyposis Colorectal Cancer, or HNPCC), which is a condition caused by inherited gene changes, have an increased risk for several cancers, including prostate cancer.
Diet
The exact role of diet in prostate cancer is not clear, but several factors have been studied. Some studies suggest that men who eat a diet high in animal fat or meat may be at increased risk. In other studies, men who ate the most dairy products — such as milk, cheese and yogurt — each day had the highest risk of prostate cancer.
Overall, study results have been mixed, and the risk associated with dairy products is thought to be small. The fact remains that men who eat a diet rich in fruits and vegetables may have a lower risk.
Lack of Exercise and a Sedentary Lifestyle
Exercise can help you maintain or lose weight. Men who exercise may have a reduced risk of prostate cancer. Exercise has many other health benefits and may reduce your risk of heart disease and other cancers. If you are overweight or obese, work on losing weight.
risk myths
Sexual Activity
High levels of sexual activity or frequent ejaculation have been rumored to increase prostate cancer risk. This is untrue. In fact, studies show that men who reported more frequent ejaculations had a lower risk of developing prostate cancer.
Vasectomy
A vasectomy was originally thought to increase a man's risk, but this has since been disproven.
Medications
Several recent studies have shown a link between aspirin intake
and a reduced risk of prostate cancer by 10-15%. This may result
from different screening practices, through a reduction
of inflammation, or other unknown factors.
Alcohol
There is no link between alcohol and prostate cancer risk.
Vitamin E
Recent studies have NOT shown a benefit to the consumption
of vitamin E in the prevention of prostate cancer.
early diagnosis & screening
Visit the resources section for prevention tips, support groups, and more!
Prostate cancer can often be diagnosed early by testing for Prostate-Specific Antigen (PSA) levels in a man’s blood. Another way to diagnose prostate cancer early is with the digital rectal exam (DRE) in which the doctor puts a gloved, lubricated finger into the rectum to feel the prostate gland.
If the results of either one of these tests are abnormal, further testing is often done to see if a man has prostate cancer. If cancer is found as a result of screening with the PSA test or DRE, it will probably be at an earlier, more treatable stage than if no screening were done.
Neither the PSA test nor the DRE is 100% accurate. Doctors are studying if early detection tests will lower the risk of death from prostate cancer. The most recent results from 2 large studies were conflicting and didn’t offer clear answers.
Early results from a study done in the United States found that annual screening with PSA and DRE did detect more prostate cancers than in men not screened, but this screening did not lower the death rate from prostate cancer.
A European study did find a lower risk of death from prostate cancer with PSA screening (done about once every 4 years), but the researchers estimated that about 1,050 men would need to be screened (and 37 treated) to prevent one death from prostate cancer.
Prostate cancer is often a slow-growing cancer, so the effects of screening in these studies may become clearer in the coming years. Both studies are being continued to see if longer follow-up will give clearer results. Several other large studies of prostate cancer screening are currently going on as well.
There is no question that screening can help find many prostate cancers early, and the International Prostate Cancer Foundation recommends both the PSA and DRE.
Should I Be Screened?
The International Prostate Cancer Foundation recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting all the facts about the uncertainties, risks, and potential benefits of prostate cancer screening.
It's important for each man to talk with his doctor about whether screening is right for him. There are many factors to consider, including age and health. If you’re young and develop prostate cancer, it may shorten your life if it’s not caught early. Those in the medical community who advocate regular screening believe that finding and treating prostate cancer early offers men more treatment options with potentially fewer side effects. Ultimately, decisions about screening should be individualized based on a man's level of risk, overall health, and life expectancy, as well as his desire for eventual treatment if he is diagnosed with prostate cancer.
The International Prostate Cancer Foundation recommends that men should determine their risk factors for prostate cancer by the age of 40. Talk to your doctor about the potential benefits, uncertainties and risks of prostate cancer screening based upon the following criteria:
Age 40 — very high risk. Men with more than one first-degree relative — father, brother or son — diagnosed with prostate cancer before age 65.
Age 45 — high risk. Men of African- American descent and/or those who have one first-degree relative diagnosed with prostate cancer before age 65.
Age 50 — average risk. All men over the age of 50.
Prostate cancer screening should include both the PSA and DRE tests, and should only be offered to men with more than a 10-year life expectancy. These recommendations are adopted based upon the guidance of our IPCF expert panel along with consideration of American Cancer Society recommendations and the American Urological Association (AUA) guidelines.
When to Start Screening . . .
The right time to start screening is generally based on individual risk, with age 40 being a reasonable time to start screening for those at highest risk (genetic predispositions or strong family histories of prostate cancer at a young age). For otherwise healthy men at high risk (positive family history or African-American men), starting at age 40-45 is reasonable.
Guidelines differ for men of average risk. Some recommend an baseline PSA and DRE at age 40, and others recommend starting at age 50. In general, all men should create a proactive prostate health plan with their doctor that is right for them based on their lifestyle and family history.
If no prostate cancer is found during screening, the time between future screenings depends on the results of the PSA blood test:
Men 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.
Where Can I Find Free Prostate Cancer Screening?
Local hospitals and local prostate cancer support groups usually either offer screening or have a list of places you can go for screening. Visit the resources section for prevention tips, support groups, and more!
You can find a useful resource for making these decisions at the
U.S. Centers for Disease Control and Prevention site.
ongoing research
How could you benefit from the International Prostate
Cancer Foundation's (IPCF) research program?
Approximately 268,490 men were newly diagnosed with prostate cancer in 2022 in the United States alone, and an estimated 34,500 men will die. Despite advances associated with modern medicine, improvements in prostate-cancer-related mortality have been marginal at best and mortality has, as a matter fact, increased among African-American obese patients. This data suggest that new lines of research are needed to provide improved understanding of the molecular alterations associated with the currently poor prognosis of prostate tumors. This understanding is expected to subsequently enable optimal delivery of current state-of-the-art care and to identify completely novel therapeutic treatment strategies. Delivery of personalized medicine through biomarker-guided clinical intervention, as well as through the discovery of novel therapeutics, is needed to decrease the significant morbidity and mortality, as well as the economic burden associated with prostate cancer.
Systematic sequencing of protein-coding genes has led to the identification of novel mutated genes involved in several cancer types, especially in prostate cancer. Significantly, the advent of next-generation sequencing makes these types of analysis highly feasible in prostate cancer biology and oncology. In addition, these methodologies allow for the complete assembly of prostate cancer genomes, including the identification of gene fusions as well as mutations within regulatory regions of genes. Next-generation sequencing also allows identification of genetic signatures that, when combined with clinical correlates, are expected to be of significant value in prostate cancer diagnosis and prognosis.
Artificial Intelligence (AI) applications in urologic procedures
We are currently working on studies using AI to facilitate and predict pathological outcomes, such as positive surgical margins and cancer recurrence.
New Biomarkers
Besides the current biomarkers and genetic tests in the market, we are working on new urinary markers to improve prostate cancer detection rates and surgical follow-up.