Who Is At A Risk For Prostate Cancer
Prostate cancer affects roughly 13% of American men at some point in their lives, with 2%-3% of cases leading to death. Risk factors for prostate cancer include the following:
- Age: As men age, their risk of prostate cancer increases considerably.
- Prostate cancer risk begins to increase sharply after 55 years and peaks at 70 to 74 years, declining slightly thereafter.
- About 60% of prostate cancer is diagnosed in men older than 65 years. That is why it is important to talk with your doctor about prostate-specific antigen screening for prostate cancer as you enter middle age.
- However, there are cases of prostate cancer in men in their 20s and 30s, some of which have been very aggressive.
Am I At Risk Of Prostate Cancer
In the UK, about 1 in 8 men will be diagnosed with prostate cancer in their lifetime. We don’t know exactly what causes prostate cancer but there are some things that may mean you are more likely to get it these are called risk factors.
There are three main risk factors for getting prostate cancer, which are things you can’t change. These are:
- getting older it mainly affects men aged 50 or over
If you have any of these risk factors or if you have any symptoms, speak to your GP. They can talk to you about your risk, and about the tests that are used to diagnose prostate cancer. You can also get in touch with our Specialist Nurses, who can help you understand your risk of prostate cancer.
Specific Type Of Focal Therapy
HIFU : HIFU focuses the energy of sound waves to create heat and destroy cancer cells. Just like a magnifying glass concentrating sun rays to burn a hole in the paper. During the procedure, an ultrasound probe is inserted into the patients rectum while the patient is asleep from anesthesia. Guided by MRI and ultrasound 3D-images, the physician finds the tumor, plus the area to be treated, and delivers the energy aimed at the diseased tissue in the prostate gland. HIFU is a noninvasive precision treatment that spares healthy tissue and lowers the chances of negative side effects associated with radical prostate surgery or radiation, such as impotence, incontinence and bowel function disturbance. UChicago Medicine is the first medical center in the Midwest to offer and perform this procedure with the newest Focal One advanced robotic HIFU technology. This fills a significant treatment void for men with localized prostate cancer who find themselves in between active surveillance and whole gland treatments such as radiation or surgery. The treatment has been used for years in both Europe and Asia.
Urologists Ariel Shalhav, MD, and Scott Eggener, MD, answer questions about new treatment options for prostate cancer, including focal therapy and HIFU, as well as specialized care programs for men diagnosed with advanced prostate cancer or at high risk for the disease.
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Brca1 And Brca2 Genes
Everyone has BRCA1 and BRCA2 genes. They are important genes that stop the cells in our body from growing and dividing out of control. A fault or mutation in the BRCA1 or BRCA2 gene means that the cells can grow out of control. This can lead to cancer.
People who inherit faulty versions of BRCA 2 genes have an increased risk of developing different types of cancer. This includes prostate cancer. A recent study showed that your risk of developing prostate cancer is around 2 times higher than that of the general population if you have a faulty BRCA2 gene.
The risk of developing prostate cancer may also increase with faulty BRCA1 genes. But researchers need more studies to find out for sure.
Veterans & Chemical Exposure
Exposure to chemicals and defoliants can add to prostate cancer risk and severity. Studies have shown Vietnam and Korean War Veterans with exposure to defoliants like Agent Orange have a higher occurrence of prostate cancer. In fact, Veterans are about twice as likely to be diagnosed with prostate cancer than men who have never served in the military. Read more about Veterans and prostate cancer here.
Farmers and other men who work with large amounts of pesticides can be at increased risk and those who are frequently exposed to metal cadmium like welders, battery manufacturers, and rubber workers are abnormally vulnerable to prostate cancer. There is some evidence that firefighters are also at higher risk.
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What Are The Benefits Of Active Surveillance
One of the benefits of active surveillance is that you may be able to avoid treating a cancer that may never be a problem. You also can delay or avoid surgery or radiation and its side effects. The short-term and long-term side effects from having surgery or radiation are serious. They include having trouble getting erections, having urinary problems like not being able to control your bladder, and having bowel problems such as diarrhea or rectal pain.
Another benefit is that you can keep your current quality of life and keep doing the activities you enjoy, at least for a time. Your overall well-being your physical, mental, and sexual health and your relationships are all part of your quality of life.
For men with low-risk localized prostate cancer who choose active surveillance, the chance of their cancer spreading is low. One study that compared active monitoring , surgery, and radiation in men with localized prostate cancer found that the risk of dying was about the same no matter what men chose.footnote 2
Treatment Options For High
While active surveillance and watchful waiting are used in early phase, or low-risk prostate cancer, high-risk disease requires a more proactive treatment approach.
Currently, different treatment modalities are used, usually in combination, to provide optimal treatment and the best possible prognosis.
For patients with localized high-risk prostate cancer, the treatment options include RT, or radical prostatectomy along with pelvic lymph node dissection and androgen deprivation therapy. Usually, the multimodal approach is guided by the individuals case and the input of a team of medical experts.
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What Puts You At Risk For Prostate Cancer And When Should One Be Screened
SummaryAbout one in six men will be diagnosed with prostate cancer during his lifetime. Though scientists are still uncertain about what causes prostate cancer, they do know that some men are at a higher risk of getting the disease than others.
Risks Men Cant Control
Here are three unavoidable risks:
Age: The risk for prostate cancer increases with age. More than 64% of all diagnosed prostate cancers are found in men age 65 and older.
Family history: The risk for prostate cancer doubles if a man has a father or a brother with the disease.
Race: African American men are at greater risk for prostate cancer compared to men from other racial/ethnic groups.
What Men Can Control
There are ways to reduce your risk of prostate cancer, according to Michael Toulan, M.D., Urologist. And beginning at age 50, men should talk with their doctor about being screened.
The United States Preventive Services Task Force recommends against Prostate Specific Antigen screening for all men. Their review of two major trials found evidence that the benefits of screening when men do not have symptoms of prostate cancer likely do not outweigh the risks. Recommendations from other organizations, including the American Cancer Society, differ slightly.
Prostate cancer may cause no symptoms, and possible symptoms are often due to other problems, such as an enlarged prostate. To be safe, though, tell your doctor if you experience any of the following:
- Pain during urination
What Is Prostate Cancer
Prostate cancer starts in the prostate gland and is the most diagnosed cancer in men after skin cancer.
Cancer is a disease that starts in cells, which are the basic components of all body tissue and organs, including the prostate. Normally, cells proliferate, grow, and die on a regular basis. When something goes wrong with this process, the cells do not die as expected and instead develop into a tumor. Tumors can be benign or malignant .
Prostate cancer has the potential to spread to the bone, other organs, and lymphatic system. Prostate cancer that has spread to other parts of the body is known as metastatic prostate cancer. If prostate cancer spreads metastasizes to the bone, the cells in the bone are prostate cancer cells, not bone cancer cells.
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The ProtecT trial has one important weakness: The participants have only been observed for ten years so far. But it would only be possible to draw any reliable conclusions about the pros and cons of the three treatment approaches after 15 or 20 years.
Surgery is the only treatment for which there is currently conclusive long-term data gathered over a period of 23 years. This data comes from a Scandinavian study that compared the surgical removal of the prostate with the watchful waiting approach. But only about one third of the men in this study had low-risk prostate cancer. So its not possible to draw any reliable conclusions about the long-term pros and cons of the current standard treatment options for low-risk prostate cancer.
The ProtecT trial also has another limitation: The check-ups that men had in the active surveillance group were different from the current standard approach in Germany. In the ProtecT trial, the men had a PSA test every 3 months in the first year, and then every 6 to 12 months after that. If the PSA levels were too high or if the men developed symptoms such as problems urinating, they had further tests. In Germany, men who have abnormal PSA test results are also advised to have regular biopsies . This is meant to increase the likelihood of finding out soon enough if the cancer progresses, but it can also be more distressing.
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Prostate Cancer Awareness Month: Why Black Men Face Unacceptable Disparities
Among the other results of the study, ACS found that, geographically, the highest mortality rates for prostate cancer in White men were found in the Western region of the United States.
The researchers analyzed incidence rates for bladder, kidney, prostate, and testicular cancers across the United States from the Surveillance, Epidemiology, and End Results Database at the National Cancer Institute .
Mortality rates were based on the U.S. Cancer Statistics database from the Center for Disease Control and Prevention, and the National Center for Health Statistics .
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Pet/mri Accurately Predicts Risk Of Prostate Cancer Recurrence After Prostatectomy
Journal of Nuclear Medicine
In men recently diagnosed with intermediate or high-grade prostate cancer, prostate specific membrane antigen , PET/MRI can successfully determine whether their cancer is likely to return within two years of a prostatectomy. Armed with this information, physicians can identify patients who could benefit from additional treatment and/or frequent surveillance. This research was published in the December issue of the Journal of Nuclear Medicine.
Prostate cancer is known to have very variable behavior and outcomes. While many cases of localized prostate cancer can be treated successfully, some patients experience a rapid progression even after prostatectomy or radiation therapy. Therefore, initial risk stratification is important to determine treatment decisions and subsequent management of prostate cancer patients.
“Clinicians currently use biopsy findings and clinical information, such as prostate-specific antigen levels, to predict if prostate cancer is slow-growing or if it will spread quickly and require aggressive treatments,” said Andrei Iagaru, MD, professor of RadiologyNuclear Medicine and chief of the Division of Nuclear Medicine and Molecular Imaging at Stanford University Medical Center in Stanford, California. “However, functional imaging, such as PET/MRI, is increasingly being considered as a way to identify patients at risk for persistent or recurrent disease.”
More information:Journal of Nuclear MedicineJournal information:
How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren’t noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
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Questions You May Want To Consider Asking Your Doctor Include:
- What type of prostate problem do I have?
- Is more testing needed and what will it tell me?
- If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
- What type of treatment do you recommend for my prostate problem?
- For men like me, has this treatment worked?
- How soon would I need to start treatment and how long would it last?
- Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
- What are the side effects of the medicine?
- Are there other medicines that could interfere with this medication?
- If I need surgery, what are the benefits and risks?
- Would I have any side effects from surgery that could affect my quality of life?
- Are these side effects temporary or permanent?
- How long is recovery time after surgery?
- Will I be able to fully return to normal?
- How will this affect my sex life?
- How often should I visit the doctor to monitor my condition?
Related Resources
Robotic Prostatectomy With Lymph Node Dissection
Robotic prostatectomy is offered by urologists at UCLA as a treatment approach for patients with high risk prostate cancer. It is a minimally invasive treatment with less blood loss and a more rapid overall recovery. Our surgeons at UCLA have extensive experience in treating high risk prostate cancer patients, having completed more than 3,500 robotic prostatectomies since the program began in 2003. We use the newest, cutting edge techniques to remove the cancer while preserving both sexual and urinary function.
In men with high risk prostate cancer, here at UCLA we often perform an extended lymph node dissection. Although PSMA has greatly improved the detection of lymph positive prostate cancer, we still want to ensure that the lymph nodes are thoroughly sampled in high risk cancer. Our surgeons have significant experience performing extensive lymph node dissection robotically.
Surgery techniques for radical prostatectomy include prostate nerve-sparing. Due to our cutting-edge imaging, especially MRI, our surgeons are often able to still perform nerve sparing in high risk patients. We rely heavily on the collaboration with radiologists to help determine where in the prostate the cancer is located. If the nerves are safely away from the prostate cancer then we will still perform nerve-sparing dissection. Some high risk cancers, however, will require more extensive surgery.
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Study: Black Men Face Higher Risk Of Prostate Cancer Than All Other Racial Groups
Black men have an estimated 70 percent to 110 percent higher incidence and mortality rate for prostate cancer than White men in the United States, according to a new study led by the American Cancer Society and published December in the journal European Urology.
The new data is consistent with previous ACS studies that found racially disproportionate cancer death rates overall for Black Americans. Black men have six percent higher cancer incidences but 19 percent higher cancer mortality than White men, which highlights the lower survival rates for Black men.
What Are Prostate Tests And How Is Prostate Cancer Diagnosed
Tests which check for prostate cancer include:
- A digital rectal exam . In this exam, your provider feels your prostate for lumps or anything unusual by inserting a lubricated, gloved finger into your rectum.
- A prostate-specific antigen blood test. A high PSA blood level may be a sign of prostate cancer. But many other things can cause high PSA levels, too.
- Imaging tests. These tests may use ultrasound or MRI to make pictures of your prostate.
If these tests show that you might have prostate cancer, the next step is usually a prostate biopsy. A biopsy is the only way to diagnose prostate cancer.
During a biopsy, a doctor uses a hollow needle to remove some prostate tissue. The tissue is studied under a microscope to look for cancer cells.
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