Understanding Prostate Cancer

Prostate cancer is the most common type of non-skin cancer among men. It’s estimated that 1 in 9 men will develop prostate cancer in their lifetime. The good news is that prostate cancer is 100 percent treatable if detected early.

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Home | What is the Prostate? | Understanding | Diagnosing | Treating

What is the prostate?

Located near the bladder, the prostate is a small gland within the male reproductive system. It produces and contains a fluid that makes up part of semen, which is released during ejaculation. The prostate also functions as a muscle-driven switch between urination and ejaculation.

Prostate cancer by the numbers

Data from the National Cancer Institute and the American Cancer Society

U.S. estimates for 2021

248,530 new cases

34,130 deaths

Alabama estimates for 2021

4,020 new cases

480 deaths

Probability of developing*

0-48 years: 0.2%

50-59: 1.8%

60-69: 4.7%

70+: 8.2%

*In the U.S., 2015-2017

5-year relative survival rates**

All stages combined: 98%

Localized: >99%

Regional: >99%

Distant: 30%

**By stage at diagnosis in the U.S., 2010-2016

What are the types of prostate cancer?

Almost all prostate cancers are adenocarcinomas. These cancers develop from the gland cells (the cells that make the prostate fluid that is added to the semen). Other types of cancer that can start in the prostate include:

Small cell carcinomas
Neuroendocrine tumors (other than small cell carcinomas)
Transitional cell carcinomas
Sarcomas

These other types of prostate cancer are rare. If you are told you have prostate cancer, it is almost certain to be an adenocarcinoma. Some prostate cancers grow and spread quickly, but most grow slowly. In fact, autopsy studies show that many older men (and even some younger men) who died of other causes also had prostate cancer that never affected them during their lives. In many cases, neither they nor their doctors even knew they had it.

What are the risk factors for prostate cancer?

Age

Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About 6 in 10 cases of prostate cancer are found in men older than 65.

Race/ethnicity

Prostate cancer develops more often in African-American men and in Caribbean men of African ancestry than in men of other races. And when it does develop in these men, they tend to be younger. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than in non-Hispanic whites. The reasons for these racial and ethnic differences are not clear. Learn more in the USA Health Wellness article "What African American men should know about prostate cancer."

Geography

Prostate cancer is most common in North America, northwestern Europe, Australia, and on Caribbean islands. It is less common in Asia, Africa, Central America, and South America. The reasons for this are not clear. More intensive screening for prostate cancer in some developed countries probably accounts for at least part of this difference, but other factors such as lifestyle differences (diet, etc.) are likely to be important as well. For example, Asian Americans have a lower risk of prostate cancer than white Americans, but their risk is higher than that of men of similar ethnic backgrounds living in Asia.

Family history

Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Still, most prostate cancers occur in men without a family history of it. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. (The risk is higher for men who have a brother with the disease than for those who have a father with it.) The risk is much higher for men with several affected relatives, particularly if their relatives were young when the cancer was found.

Gene changes

Several inherited gene changes (mutations) seem to raise prostate cancer risk, but they probably account for only a small percentage of cases overall. For example:

Inherited mutations of the BRCA1 or BRCA2 genes, which are linked to an increased risk of breast and ovarian cancers in some families, can also increase prostate cancer risk in men (especially mutations in BRCA2).
Men with Lynch syndrome (also known as hereditary non-polyposis colorectal cancer, or HNPCC), a condition caused by inherited gene changes, have an increased risk for a number of cancers, including prostate cancer.

Diet

The exact role of diet in prostate cancer is not clear, but several factors have been studied. Men who eat a lot of dairy products appear to have a slightly higher chance of getting prostate cancer. Some studies have suggested that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing prostate cancer. But most studies have not found such a link with the levels of calcium found in the average diet, and it’s important to note that calcium is known to have other important health benefits.

Obesity

Being obese (very overweight) does not seem to increase the overall risk of getting prostate cancer. Some studies have found that obese men have a lower risk of getting a low-grade (slower growing) form of the disease, but a higher risk of getting more aggressive (faster growing) prostate cancer. The reasons for this are not clear. Some studies also have found that obese men may be at greater risk for having more advanced prostate cancer and of dying from prostate cancer, but not all studies have found this.

Smoking

Most studies have not found a link between smoking and getting prostate cancer. Some research has linked smoking to a possible small increased risk of dying from prostate cancer, but this finding needs to be confirmed by other studies.

Chemical exposures

There is some evidence that firefighters can be exposed to chemicals that may increase their risk of prostate cancer. A few studies have suggested a possible link between exposure to Agent Orange, a chemical used widely during the Vietnam War, and the risk of prostate cancer, although not all studies have found such a link. The National Academy of Medicine considers there to be “limited/suggestive evidence” of a link between Agent Orange exposure and prostate cancer.

Inflammation of the prostate

Some studies have suggested that prostatitis (inflammation of the prostate gland) may be linked to an increased risk of prostate cancer, but other studies have not found such a link. Inflammation is often seen in samples of prostate tissue that also contain cancer. The link between the two is not yet clear, and this is an active area of research.

Sexually transmitted infections

Researchers have looked to see if sexually transmitted infections (like gonorrhea or chlamydia) might increase the risk of prostate cancer, because they can lead to inflammation of the prostate. So far, studies have not agreed, and no firm conclusions have been reached.