Prostate cancer is a cancer that begins in the prostate. The most common type of prostate cancer is called adenocarcinoma. There are more rare types of prostate cancer but most cases, > 95%, are adenocarcinomas. Adenocarcinomas of the prostate begin in the gland cells of the prostate.

The average man in the United States has a risk for prostate cancer of approximately 15.9% to age 80. Most cases are diagnosed after the age of 50. Eighty percent of cases are diagnosed in men after the age of 65. It is unknown why, but black men have a higher risk for prostate cancer than men of other races. The risk is not only higher for prostate cancer in general but also for prostate cancer diagnosed at an earlier age and a more aggressive (faster growing) prostate cancer. Mutations, or harmful changes, in some genes are associated with an increased risk for prostate cancer.

General Risk Factors

Exposure to Agent Orange (a chemical used during the Vietnam War)

As with the vast majority of cancers, there is no confirmed way to completely prevent the development of prostate cancer. A diet high in fruits, vegetable, beans, and peas may decrease the risk for prostate cancer in men. This is a healthy diet for anyone, regardless of prostate cancer risk. It can also reduce blood pressure and the risk of heart disease.

Symptoms and Screening Methods

Early prostate cancers often have no symptoms.  Symptoms of more advanced prostate cancer can include frequent urination, interrupted or weak urine flow or straining to empty the bladder, blood in the urine or semen, pain during urination,  pain in the back, hips, or other areas of the body if the cancer has spread to the bonesIt is important to remember that these symptoms are frequently caused by noncancerous conditions as wellso further evaluation would be needed to confirm a diagnosis 

A blood test to measure the level of prostate-specific antigen (PSA) can be used to screen for prostate cancer. PSA is made by the prostate gland cells and can be found in the blood. PSA levels can be higher than normal in the blood if a man has prostate cancer. However, there are many other things, outside of prostate cancer, that can also cause a higher PSA level. A digital rectal exam (DRE) is another way to screen for prostate cancer. During this test, a healthcare provider inserts a gloved finger into the rectum to feel for any abnormalities on the prostate that could be suggestive of cancer. Currently, the National Comprehensive Cancer Network (NCCN) recommends that men at average risk for prostate cancer discuss the benefits and limitations of screening for prostate cancer with their healthcare provider beginning at age 45 to decide on a plan for screening. Men at a higher risk for prostate cancer due to race, family history, or a genetic risk factors known to be associated with an increased risk for prostate cancer should have this discussion and screening earliergenerally between the ages of 40 and 45, depending on their risk factors 

If screening with PSA or DRE suggests the possibility of prostate cancer, a healthcare provider will need to perform other tests to make a diagnosis or rule out prostate cancer. These other tests may include a biopsy (tissue sample), transrectal ultrasound, and other imaging exams. 

Screening Methods for Prostate Cancer (NCNN)
Screening Method Age to Begin Frequency
Prostate-specific antigen test (PSA) Discuss the benefits and limitations of this screening with a health care provider at age 45 To be determined by a health care provider
Digital rectal exam Discuss the benefits and limitations of this screening with a health care provider at age 45 To be determined by a health care provider

Healthcare providers may recommend these screening methods more strongly for some patients or may recommend that patients have a discussion of these screening methods earlier than age 45 based on a patient’s medical history,  family history of prostate cancer or ancestry.  

If prostate cancer is diagnosed following any of the tests previously mentioned, treatment will depend on the stage of the cancer (how far the cancer has grown or spread). Treatment can include some combination of surgery, chemotherapy, radiation, vaccine therapy, and hormone therapy. Some prostate cancers can grow and spread quickly, but many grow slowly. If a prostate cancer is believed to be slow growing, active surveillance may be considered.  Active surveillance is closely following the prostate cancer using the exams and screening tests previously discussed.  If the cancer continues to grow, then treatment will be provided Learn more about prostate cancer treatments here.

Avoid the following

A family history of prostate cancer

General Population
10.9%
11
Familial Risk
26.8% to age 80 with one affected first-degree relative. Risk could be higher depending on family history.
27
Hereditary Risk
Up to 52%
52