Other than skin cancer, prostate cancer is the most common cancer in American men. The 2009 American Cancer Society estimates for prostate cancer in the United States predict that about 192,280 new cases of prostate cancer will be diagnosed and that 27,360 men will die of this disease.
About 1 man in 6 will be diagnosed with prostate cancer during his lifetime. More than 2 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 35 will die of prostate cancer. Prostate cancer accounts for about 10% of cancer-related deaths in men. The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. These rates are used to create a standard way of discussing prognosis (outlook).
Prostate cancer is caused by changes in the DNA of a prostate cancer cell. A small percentage (about 5% to 10%) of prostate cancers has been linked to inherited traits and other cancers may also be linked to higher levels of certain hormones. While we do not yet know exactly what causes prostate cancer, we do know that certain risk factors are linked to the disease.
Age: Age is the strongest risk factor for prostate cancer. The chance of getting prostate cancer goes up quickly after a man reaches age 50.
Race: For unknown reasons, prostate cancer is more common among African-American men than among men of other races. 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, and a few other places. It is less common in Asia, Africa, Central and South America.
Family history: Prostate cancer seems to run in some families. 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.
Diet: Men who eat a lot of red meat or high-fat dairy products seem to have a greater chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables. Doctors are not sure which of these factors causes the risk to go up.
Because we don't know the exact cause of prostate cancer, it is not possible to prevent most cases of the disease. But some cases might be prevented.
Diet: While the results of research studies are not yet clear, the ACS suggests eating less red meat and fat and eating more vegetables, fruits, and whole grains. Tomatoes, pink grapefruit, and watermelon are rich in substances called lycopenes. Lycopenes help prevent damage to DNA and may help lower prostate cancer risk. Scientists have found some substances in soybeans that may help to prevent prostate cancer. Research on this is still going on.
Vitamins: Some studies suggest that taking vitamin E daily may lower the risk of prostate cancer. Selenium, a mineral, may also lower risk. On the other hand, vitamin A (beta-carotene) supplements may actually increase prostate cancer risk. Before starting any vitamins or other supplements, you should talk with your doctor. Although many people believe that vitamins are natural and cause no harm, recent research has shown that high doses may be harmful. One study found that men who take more than 7 multivitamin tablets per week may have an increased risk of developing advanced prostate cancer.
Medicine: A study of the drug finasteride (Proscar) found that men taking the drug were less likely to get prostate cancer than men taking a placebo ("sugar pill"). The drug can cause side effects such as lower sex drive and trouble getting an erection. The results of the study will become clearer over the next few years. Other drugs that may help prevent prostate cancer are now being tested in clinical trials.
ACS believes that doctors should discuss the pros and cons of testing with men so each man can decide if testing is right for him. If a man chooses to be tested, the tests should include a PSA blood test and DRE (digital rectal exam) yearly, beginning at age 50, for men at average risk who can be expected to live at least 10 more years.
The PSA Blood Test
PSA (prostate-specific antigen) is a substance made by the prostate gland. Most healthy men have levels under 4 ng/mL (nanograms per milliliter) of blood. The chance of having prostate cancer goes up as the PSA level goes up. If your level is between 4 and 10, you have about a 1 in 4 chance of having prostate cancer. If it is above 10, your chance is over 50%. But some men with a PSA below 4 can also have prostate cancer.
Factors other than cancer can also cause the PSA level to go up, including:
The DRE is less effective than the PSA blood test in finding prostate cancer, but it can sometimes find cancers in men with normal PSA levels. For this reason, ACS guidelines recommend that when prostate cancer screening is done, both the DRE and the PSA should be used.
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