What causes prostate cancer

What are the common risk factors to develop prostate cancer?

The exact risk factors are still unknown, but research suggests a combination of different risks, including genetic ones, can contribute to its development.

Age: as men age, the higher the risk. The disease is most commonly diagnosed in men over the age of 65.

According to the National Cancer Institute and other respectable urological institutions, family history is another key contributing factor. Men with a close relative with prostate cancer are more likely to develop the disease themselves. This suggests that there may be a genetic component to prostate cancer.

Ethnic differences form one of the top three risk factors. African-American men are more likely to develop the disease than men of other races. This may be due to a combination of genetic and environmental factors.

Lifestyle factors like diet and exercise play a role as well. A diet high in saturated fat and red meat is not recommended, while a diet rich in fruits, vegetables, and whole grains is preferred. Regular physical activity and a healthy diet help to maintain a healthy weight, which is crucial.

Obesity and prostate cancer: is there a link? Is this true?

Yes, research has suggested that there may be a link. Obesity is defined as having a body mass index (BMI) of 30 or higher, a known risk factor for several other types of cancer.

Studies have found that men with a higher BMI may have an increased chance of developing advanced prostate cancer and have a higher prostate cancer-specific mortality rate. The reasons for this are not fully understood. Still, it is thought that obesity may contribute to the development of prostate cancer by increasing levels of insulin and other hormones that promote the growth of cancer cells.

Obesity can make diagnosing and treating the disease more difficult. Big men may have higher PSA levels, making it harder to detect early-stage prostate cancer. They may also be at an increased risk of complications following surgery or other treatments.

It is well known that obesity can limit treatment options due to the higher complication rate associated with specific treatments. It is well known that men with leaner body weights tend to do better when they receive treatment than obese men. A healthy diet is vital.

My father had prostate cancer. Am I at a higher risk?

Your chance of developing prostate cancer is higher than that of someone without a relative history. This is because genetics and shared environmental factors can increase the likelihood of prostate cancer development.

According to the American Cancer Society (ACS) and Cancer Research UK, if your father had prostate cancer, your risk is about twice that of someone without such a history. This chance increases if your father was diagnosed at a young age or if multiple family members had the disease.

It is important to note that having a history of prostate cancer running in the family does not mean that you will develop the disease, nor does it mean that you will develop a more aggressive form of cancer. However, it does mean that you should be more vigilant about screening for the disease. Early screening picks up the disease in its early stages, allowing various cancer treatment options.

The ACS recommends that men with direct relatives diagnosed with prostate cancer should start screening for the disease at age 45, as their overall risk is higher. Early detection makes a difference. This may involve a prostate-specific antigen (PSA) blood test, a digital rectal exam, or both.

My father and brother have prostate cancer. What are my risks?

According to the ACS, if you have a father or brother with prostate cancer, your probability of developing the disease is about two to three times higher. If multiple family members are affected or if the family members were diagnosed at a young age the risk increases.

Are black men at an increased risk of prostate cancer?

Studies have shown that black men are more susceptible than men of other racial or ethnic backgrounds.

The ACS, European Association of Urology (EAU), and National Institute for Health and Care Excellence (NICE) concur that black men are more at risk of developing prostate cancer than any other racial or ethnic group. They are also more likely to be diagnosed with prostate cancer earlier and have more aggressive forms of the disease.

Studies have consistently shown that men of African ancestry have a higher chance of suffering from prostate cancer than men of other racial or ethnic backgrounds.

According to the ACS, black men prostate cancer is quite common cancer compared to any racial or ethnic group in the United States. They are also more likely to be diagnosed earlier and have more aggressive forms of the disease.

If I am black, what are my chances of developing prostate cancer in my lifetime?

20% of black men develop prostate cancer, compared to a 12.5% chance for white men.

The lifetime chance of this disease is:

1 in 6 for all men

1 in 5 Black men

1 in 8 white men

Are Asian men less likely to suffer from prostate cancer?

Studies have suggested that Asian men, including those of East and Southeast Asian ancestry, have a lower chance than men of other racial and ethnic backgrounds.

The reasons for this are unclear but may be related to genetic, environmental, and lifestyle factors.

Does a history of maternal breast cancer increase the risk of prostate cancer?

Yes, there is a link. The gene mutation and environmental factors contributing to this are not yet fully understood, but research suggests some gene mutations responsible for breast cancer are involved.

A family history of breast cancer's risk of prostate cancer increases to 21%.

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What does familial prostate cancer mean?

Familial prostate cancer refers to cases where the prostate disease is clustered in a family, but there is no clear inheritance pattern.

Typically defined as having at least two first-degree relatives (e.g., a father, brother, or son) with a history of prostate cancer. Some definitions may include more distant relatives, such as second-degree relatives (e.g., uncle, grandfather, nephew).

What does hereditary prostate cancer mean?

These cases of prostate cancer are due to inherited genetic mutations. The risk of developing prostate cancer is passed down through families in a predictable pattern based on the specific genetic mutation involved.

Typically defined as having a strong family history of the disease, with at least three close relatives (e.g., a father, brother, or son) or two close relatives diagnosed before age 55,

The risk of prostate cancer in men with a hereditary predisposition can be much higher than in the general population.

It is known that genetic changes in the BRCA1 and BRCA2 genes, as well as genes like HOXB13, ATM, CHEK2, and DNA mismatch repair genes, can make the chance of getting hereditary prostate cancer higher.

Genetic testing can identify these mutations, which can help identify men at increased risk and guide screening and treatment decisions.

Genetics increase prostate cancer risk.

Genetics play a significant role. Specific inherited gene alterations can increase the risk of developing the disease. If multiple family members are diagnosed with prostate gland cancer, it, suggests the presence of these genetic mutations in the family.

The most significant mutations are in the BRCA1 and BRCA2 genes. Alteration in these genes predisposes to several types of cancer, including breast and ovarian cancer in women and prostate cancer in men. Studies have found that men with BRCA1 or BRCA2 with inherited mutations have an increased risk of prostate cancer, and they tend to develop the disease early on in life and have a more aggressive form of the disease.

Other faulty genes that may increase the risk include those in the HOXB13, ATM, CHEK2, and MSR1 genes. These mutations are less common than BRCA1 and BRCA2, but they may increase the chance of developing the disease.

It is important to note that faulty genes associated with prostate gland disease do not mean an individual will develop it. This simply means that their chance of developing the disease is increased. Other risk factors, as discussed, do play a role.

If an individual has multiple family members who have prostate cancer or other certain cancers (like bowel or breast cancer) or a known gene mutation associated with the disease, they may be referred for genetic counselling and testing. This can help determine the individual's disease development probability and inform appropriate screening and prevention strategies.  

When should I be referred for genetic testing?

NICE states that individuals with a substantial relative history of prostate cancer should be referred for genetic testing if:

• They have a first-degree relative (father or brother) who was diagnosed with prostate cancer at 60 years of age or younger.
• They have two or more first-degree relatives (father or brother) diagnosed with prostate cancer at any age.

In addition, genetic testing may also be considered for individuals who have close relatives diagnosed with other types of cancer, such as breast or ovarian cancer, or for individuals diagnosed with aggressive prostate cancer or early onset.

How do the BRCA1 and BRCA2 genes play a role?

The BRCA1 and BRCA2 genes prevent cancer by repairing damaged DNA. However, if these genes become mutated or altered, they may not be able to properly repair DNA damage, leading to an increased risk of cancer.

While BRCA1 and BRCA2 mutations are most commonly linked to breast and ovarian cancer in women, they can also raise the risk of prostate cancer in men.

Men with BRCA1 or BRCA2 mutations have a higher chance of developing a more aggressive form of prostate cancer. Additionally, men tend to be younger at diagnosis than men without mutations.

It's important to note that not all individuals with these mutations will develop prostate disease.

Can a lack of sex cause prostate cancer?

There is no definitive evidence to suggest that a lack of sex can increase the risk of prostate cancer.

It has been suggested that frequent ejaculation may help to clear the prostate gland of potentially harmful substances and reduce the risk of prostate cancer.

How many times do I need to ejaculate to lower my risk of getting prostate cancer?

There is no consensus on the specific number of ejaculations per month that lowers the risk of getting prostate cancer.

One study published in the Journal of the American Medical Association in 2016 found that men who reported ejaculating at least 21 times per month during their 20s had a lower risk of prostate cancer occurrence later in life than men who ejaculated 4–7 times per month.

However, more research is needed to confirm this association and determine the optimal frequency of ejaculation for prostate health.

It's important to note that sexual activity and ejaculation should not be seen as a way to prevent or treat prostate cancer. Other factors, such as age, relative history, and genetic mutations, are known to play a more significant role in prostate cancer risk.

Does undergoing a vasectomy cause prostate cancer?

No clear evidence suggests that undergoing a vasectomy increases the risk of prostate cancer. The American Urological Association and the ACS both stated that no evidence links vasectomy to prostate cancer risk. Men should not be discouraged from undergoing a vasectomy if they wish to undergo such treatment.

Can heavy drinking cause prostate cancer?

Heavy alcohol consumption may slightly increase the risk of prostate cancer. However, the relationship between alcohol consumption and prostate cancer is poorly understood, and the evidence is not solid.

Does inflammation of the prostate cause prostate cancer?

Inflammation of the prostate is known as prostatitis. Persistent inflammation may contribute to the development of prostate cancer by damaging DNA and increasing cell proliferation. The exact role of this relationship is not fully understood.

There is no clear consensus on whether inflammation of the prostate directly causes prostate cancer. While some studies have suggested a link, others don't.

Reflection from a prostate cancer expert.

More prospective studies are needed to identify those men at greater risk of getting prostate cancer and learn how to prevent prostate cancer. Identifying more prostate cancer risk factors will help diagnose men at a younger age and lower the number of men dying from prostate cancer.