Chapter 8 Prostate Cancer: Cancer

Content provided by the Faculty of the Harvard Medical School

Chapter 8: Prostate cancer

The prostate is a walnut–sized gland that produces the fluid that mixes with sperm. It is located just below a man's bladder. Prostate cells sometimes begin to grow abnormally and multiply out of control, forming a tumor.

Prostate cancer is diagnosed in approximately 186,000 men annually, with about 28,500 deaths per year. Although treatments are improving, they can be debilitating (causing incontinence and impotence). In its early stages, prostate cancer often has no symptoms, but in its later stages it may produce symptoms resembling those of the benign condition known as prostate enlargement or benign prostate hyperplasia (BPH). These symptoms include frequent or difficult urination, pain or burning when urinating, blood in the urine, and pain or stiffness in the lower back, hips, or upper thighs.

Most of the risks for prostate cancer, such as advancing age or a family history of the disease, are not under your control. But it's helpful to know what they are so that you can be more aware of your own risk profile for this disease, and take the necessary steps — mainly screening — to reduce your chances of dying from it. Risk factors you cannot control include:

Age. Your risk of prostate cancer increases the older you get. Most men who develop prostate cancer are older than 50. More than 80% of all cases of prostate cancer are diagnosed in men older than 65.

Family medical history. Having a father or brother who had prostate cancer doubles your risk of developing the disease yourself. Some types of prostate cancer have been linked to mutated genes that can be inherited, but not enough is known about these genes to offer a screening test such as that available for the breast cancer genes, BRCA1 and BRCA2.

Race/ethnicity. African Americans have a higher risk of developing prostate cancer than other ethnic groups, while Asians have a lower risk. It is not clear why risk should vary across ethnic groups. One possibility is that the difference is linked to the varied diets consumed by different ethic and racial groups. Another theory is that men of different ethnic backgrounds have different levels of hormones and that this may account for observed differences in the incidence of prostate cancer.

Height. If you are tall, you also have an increased risk of prostate cancer (as well as colon cancer and breast cancer in women). It is not clear why. One theory puts a protein known as insulin-like growth factor-1, or IGF- 1 as the main reason. IGF-1 is needed for proper growth in children. This same protein also can stimulate cancer growth in adults. Men with prostate cancer tend to have higher levels of circulating IGF-1.

Last updated:	May 01, 2008