Prostate Cancer

Symptoms

Early-stage prostate cancer usually doesn’t cause any symptoms. In the later stages of the disease, you may experience:

• Difficulty when starting to urinate
• Decreased force in the stream of urine
• Feeling like you have to urinate constantly or urgently
• Dribbling after urination
• Trouble getting an erection
• Unexplained weight loss
• Fatigue
• Bone pain and fractures (in later stages if the cancer spreads to the bones)

How is prostate cancer detected early?

Prostate cancer screening is recommended in men from 55–79 years old, sometimes earlier depending on risk factors. It consists of a digital rectal exam or DRE and a blood test known as a prostate specific antigen (PSA).

• Your provider should perform a DRE as part of your yearly physical exam. During this exam, the provider gently places their finger in the rectum and feels the back side of the prostate (where the cancer generally occurs). If they feel an irregularity or hard nodule, they will want to run other tests to confirm if it is prostate cancer.
• While PSA is made by all prostate cells, it is higher in men with prostate cancer. If the PSA is high or suddenly increases from normal levels, it may be an early sign of prostate cancer. But there can be other reasons for its increase. Your provider will interpret your PSA results.

Causes of prostate cancer

It’s not known what causes prostate cancer. It develops when normal prostate cells have changes in their DNA, which controls how the cells function. These changes, or mutations, can be inherited from a parent or happen during a person’s lifetime.

Risk factors

• Older age. Most prostate cancers (60%)  occur in men ages 65 and older.
• Race. In the U.S., African-American men and Caribbean men of African ancestry have the highest risk of prostate cancer than any other race. In these men, the disease tends to start at a younger age. They’re also more likely to die from prostate cancer.
• Family History and Race/Ethnicity. Having a father or brother with prostate cancer more than doubles a man’s risk of developing the disease. While age is a significant risk factor for prostate cancer, family history and race/ethnicity also play crucial roles in determining an individual's risk. Men with a family history of prostate cancer have a substantially higher risk of developing the disease. Having a father or brother with prostate cancer more than doubles a man's risk, and the risk increases further if multiple close relatives are affected. Additionally, men with a family history of breast or ovarian cancer may also have an elevated risk due to inherited gene mutations, such as BRCA1 and BRCA2.
• Race and ethnicity are also important factors in prostate cancer risk. African American men face a disproportionately high risk compared to other racial and ethnic groups. They are about 1.7 times more likely to be diagnosed with prostate cancer and 2.1 times more likely to die from the disease than white men. The reasons for these disparities are complex and likely involve a combination of genetic, environmental, and socioeconomic factors.
• It's important for men to be aware of these risk factors and discuss them with their healthcare providers. Those with a family history of prostate cancer or who are of African American descent may benefit from earlier or more frequent screening, potentially starting as early as age 40-45. Understanding individual risk can help inform decisions about prostate cancer screening and early detection strategies.
• Chemical exposure. Prostate cancer has been linked to exposure to Agent Orange, a chemical spray used during the Vietnam War.

Preventative tips

There are no proven ways to completely prevent prostate cancer. The best form of prevention is early detection. Be sure to get a yearly physical, which includes screening tests for prostate cancer.