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Prostate Cancer

Incidence/Mortality for Prostate Cancer

Prostate cancer is the second leading cause of cancer death among American men, second only to lung and bronchus cancer.  About 1 man in 36 will die from prostate cancer.  Data from the Ohio Department of Health indicate that in 2013

  • about 7,700 Ohio men will be diagnosed with invasive prostate cancer
  • about 1,260 Ohio men will die from prostate cancer

The American Cancer Society estimates that in the United States during 2013

  • about 238,590 new cases of prostate cancer will be diagnosed
  • about 29,720 men will die from this cancer

What is Prostate Cancer?

The prostate is a gland that makes the fluid that protects and nourishes sperm cells in semen. It is only found in males and is located below the urinary bladder and in front of the rectum.  The prostate is typically about the size of a walnut but can get much larger particularly as a man gets older.

The prostate has several types of cells but almost all prostate cancers develop from the gland cells.  A cancer that is initiated in gland cells is called an adenocarcinoma.  Other types of cancer can also start in the prostate but these are quite rare.

Some prostate cancer can grow and spread quickly, but most grow slowly.  Several studies based on autopsies reveal that many men who died of other diseases also had prostate cancer that never affected them during their lives.  In many cases, neither the men nor their doctors knew they had prostate cancer.

Causes of Prostate Cancer

The exact cause of prostate cancer is unknown; however, there are known risk factors for prostate cancer.  At the simplest level, prostate cancer is caused by changes in the DNA of the prostate cell.  DNA is the chemical that makes up our genes and has the instructions for nearly everything our cells do.

There are genes that control when our cells grow, divide into new cells, and die.  Certain genes that instruct cells to grow are called oncogenes.  Other genes that slow down cell division, or cause cells to die at the right time are called tumors suppressor genes.  Cancer can be caused by DNA changes (mutations) that turn on oncogenes or turn off tumor suppressor genes.  These DNA mutations can be inherited from a parent or can be acquired during a person’s lifetime.

Risk Factors for Prostate Cancer

A risk factor is any influence that increases the chances of developing a disease such as cancer.  Different cancers have different risk factors.  Some risk factors, like tobacco smoking, can be changed.  Others, like increasing age or family history, cannot be changed.

Risk Factors That Can Be Changed:

  • A diet high in red meat and/or high-fat dairy products;
  • A diet relatively low in fruits and vegetables;
  • Being obese (severely overweight); and,
  • Sexually transmitted infections

Risk Factors That Cannot Be Changed:

  • Increasing age.  Prostate cancer is very rare in men younger than 40, but the risk dramatically changes after age 50.  About 60% of cases are in men over age 65;
  • African-American men and Jamaican men of African ancestry are at greater risk than men of other races;
  • Prostate cancer is more common in North America, Northwestern Europe, Australia, and Caribbean Islands.  It is less common in Asia, Africa, Central America, and South America; and,
  • A family history of prostate cancer increases risk, suggesting that there may be an inherited or genetic risk factor.  A man with a brother or father with prostate cancer has dramatically increased risk.

American Cancer Society Recommendations for Prostate Cancer Screening

Prostate cancer can often be found early (and thus more treatable) by testing the amount of prostate specific antigen (PSA) in a man’s blood.  Another screening test is the digital rectal exam (DRE) in which a doctor puts a gloved finger into the rectum to feel the prostate gland.  Neither test is 100% accurate.  These tests can sometimes have abnormal results when a man does not have prostate cancer (false positive results).  Normal results can occur when a man does have prostate cancer (false negative results).

Tests that are unclear can cause confusion and anxiety.  False positive results can lead some men to have a prostate biopsy with small risks of pain, infection, and bleeding, when they do not have cancer.  False-negative results can give some men a false sense of security even though they actually do have prostate cancer.

The American Cancer Society 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 information about the underlying risks, and potential benefits of prostate cancer screening.  Men should not be screened unless they have received this information.  This discussion should take place at age 50 for men at average risk of prostate cancer and at age 45 for men at high risk.

 

Source:  The information regarding causes, risk factors, and screening was adapted from the American Cancer Society website at www.cancer.org where much more detailed information is available.

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Last Reviewed: 9/16/13