Ashley Clay, MSPAS,
PA-C Medcor Provider
Prostate cancer is the second most common cancer in American men—1 man in 9 will be diagnosed during their lifetime with the average age at diagnosis being 66 years of age.1 Most men diagnosed with prostate cancer do survive; according to the National Cancer Institute, 98% of men have survived 5 or more years after being diagnosed with prostate cancer, based on data collected from 2009–2015.2
However, it does remain the second leading cause of cancer deaths in American men (following lung cancer)—1 man in 41 diagnosed with prostate cancer will die from the disease.3
Factors associated with the risk of developing prostate cancer include:4
- Age: Roughly 60% of cases are in men older than 65 years of age.
- Race/ethnicity: Prostate cancer is more common in African-American and Caribbean men.
- Geography: Prostate cancer is more common in North America, northwestern Europe, Australia, and in the Caribbean islands.
- Family history: Your risk is more than doubled if your father or brother has or had prostate cancer.
- Changes to inherited genes: Certain inherited genes that have mutated can increase your risk. This includes the genes linked to an increased risk of breast and ovarian cancers (BRCA1 or BRCA 2 genes).
Other possible contributing factors, which are highly debated, include diets high in red meat and/or calcium, obesity, smoking, chemical exposure, history of prostatitis, sexually transmitted diseases, and those who have underwent a vasectomy.
There is no one method of preventing prostate cancer; however, some lifestyle interventions to consider include:
- Maintaining a healthy body weight, and staying physically active during all life stages.
- Increasing vegetable and fish intake; including tomatoes, green-leafy vegetables, soy beans, and legumes to your diet.
Additionally, vitamin E and selenium supplementation remain controversial for reduction in risk—some studies support their use while others refute the findings.5
Medications known as 5-alpha reductase inhibitors—like Proscar and Avodart—used to treat benign prostatic hyperplasia (BPH) may reduce the risk of prostate cancer. The body produces an enzyme called 5-alpha reductase which is responsible for changing testosterone into dihydotestosterone (DHT)—the main hormone that causes the prostate to grow. These medications work by blocking the production of DHT; however, the FDA has not approved these medications for prevention of prostate cancer.6
Screening Tests for Prostate Cancer
There are two screening tests available for prostate cancer 1) prostate-specific antigen (PSA) blood test and 2) a digital rectal exam (DRE). Due to prostate cancer’s slow growth, its overall low impact on survival, and the potential harms that arise from “false positives” that can be found while screening, routine screening is controversial; patients should engage in an open conversation surrounding the risks and benefits of screening with their healthcare provider.7
The American Cancer Society recommends that discussions about screening should begin at the age of 40 – 45 in those at high risk (e.g., African American and those who have a first-degree relative with prostate cancer).8 The American Urological Association reaffirms the individualized approach for those at higher risk, indicating that discussions should start between the ages of 40 and 54 years.9
Men—if you are having any of the following symptoms,10 discuss these with your health care professional today and be your own advocate:
- Frequent urinating
- Starting or stopping stream
- Weak or dribbling urine flow
- Difficulty having an erection, painful erection, or decreased amount of fluid that is ejaculated
- Blood in urine or semen
- Pressure or pain of the rectum
- Pain/stiffness in lower back, hips, thighs
1 American Cancer Society, “Key Statistics for Prostate Cancer,” https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html
3 “Key Statistics for Prostate Cancer.”
4 American Cancer Society, “Prostate Cancer Risk Factors,” https://www.cancer.org/cancer/prostate-cancer/causes-risks-prevention/risk-factors.html
5 American Cancer Society, “Can Prostate Cancer Be Prevented?” https://www.cancer.org/content/cancer/en/cancer/prostate-cancer/causes-risks-prevention/prevention.html
7 Richard M Hoffman, “Screening for prostate cancer,” UptoDate, updated January 20, 2020.
8 American Cancer Society, “American Cancer Society Recommendations for Prostate Cancer Early Detection,” https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/acs-recommendations.html
9 “Screening for prostate cancer.”
10 Prostate Cancer Foundation, “When to Get Checked for Prostate Cancer,” https://www.pcf.org/patient-resources/family-cancer-risk/get-checked-prostate-cancer/