Prostate cancer is the most common cancer among men. It starts in the prostate gland, which is located below the bladder and in front of the rectum. A healthy prostate gland makes fluid that nourishes sperm cells in semen.
Wilmot Cancer Institute, in partnership with UR Medicine’s Department of Urology, is the leader in prostate cancer care in the region and is actively conducting research to improve care. Our surgeons perform the most prostatectomies, for example, and our clinical research team is studying ways to reduce treatment toxicities for men.
Prostate cancer types
Almost all prostate cancer is adenocarcinoma. Rarely other types of cancer such as sarcomas, neuroendocrine tumors, and transitional cell carcinomas start in the prostate gland. This document will refer only to adenocarcinoma.
Prostate cancer facts
More than 220,000 new cases are diagnosed annually in the U.S., giving men approximately a one in five chance of developing it in their lifetime. Nearly three million men are living with prostate cancer. It can be a serious disease but often prostate cancers grow slowly; many men diagnosed with prostate cancer do not die from it. When detected and treated early, five-year survival rates are nearly 100 percent.
Causes and risk factors
Sometimes prostate cancer starts as a pre-cancerous condition, when the cells in the prostate gland begin to look different. It’s not completely understood what causes prostate cancer but several factors can increase a man's risk of getting it. Age is a leading factor. Prostate cancer is rare in men younger than 40. About six in 10 cases are diagnosed in men older than 65. Other risk factors include:
Race/ethnicity: African-American men and Caribbean men of African ancestry are more likely to get prostate cancer — and more likely to die from the disease.
Family history: Men with a father, brother, son, or several extended relatives with prostate cancer have a higher risk. The highest risk seems to be men with a brother who has the disease, according to the American Cancer Society.
Hormones: The male sex hormone testosterone is essential for the body and to maintain male sex characteristics. But too much testosterone might cause the prostate gland to enlarge, which contributes to risk.
Geography: The disease is more common in North America, parts of Europe, Australia, and on the Caribbean Islands.
Inherited gene changes: Examples include the BRCA1 and BRCA2 genes, which also raise the risk of breast cancer, and Lynch Syndrome, which also raises the risk of colon cancer. DNA mutations that are acquired during a man's lifetime can also increase the risk of prostate cancer. These might result from exposure to radiation or having high levels of insulin-like growth factor in the blood.
Diet: The exact role isn't clear, but men who consume a high amount of dairy foods and red meat and who eat fewer vegetables and fruits tend to be at greater risk. A possible reason: These men may have a low level of folate (from foods like leafy greens, beans and oranges) in their bodies.
Vitamin E: Taking vitamin E increases the risk of prostate cancer.
Obesity: Some studies show that obesity also boosts the risk of developing a high-grade form of prostate cancer and dying from the disease.
There is no sure way to prevent prostate cancer. Risk factors such as age, race, and family history are out of our control. But several controllable prevention strategies are recommended: staying physically active, eating a heart-healthy diet, and maintaining a healthy weight. Getting enough folate through foods is important.
Taking certain vitamins and minerals has been studied to prevent prostate cancer. Neither vitamin E nor selenium has proven to be effective. Lycopene has also been studied, but the results are mixed. Multivitamins have been studied and, in fact, taking multivitamins more than seven times a week can increase the risk of advanced prostate cancer. In general, supplements come with risks and benefits, and it's important to talk to your doctor before taking them.
Some drugs might help reduce the risk of prostate cancer. For example, finasteride and dutasteride are used to treat non-cancerous growth of the prostate. Research shows, however, that although taking the drugs result in fewer prostate cancers, when prostate cancer did develop it tended to be more aggressive. Those drugs reduce the levels of male sex hormones in the body and cause side effects such as erectile dysfunction, loss of sex drive, and enlarged breasts. Studies also suggest that aspirin might help to reduce the risk of prostate cancer, but more research is needed.