Are you at increased risk of prostate cancer?
- Age – the risk of getting prostate cancer increases with age. Prostate cancer is most common in men over 65 but has been diagnosed in men in their 30’s.
- Family history – Your risk is higher if your father, brother, or son had prostate cancer, especially at an early age. There is also evidence of an increased risk if close relatives have had breast cancer.
- Race – Prostate cancer is more common in men of color. African-American men have the highest risk.
- Other factors that may increase risk include:
- Diet high in animal fat and/or low in fruits & vegetables
- A history of inflammation or infection of the prostate
- Exposure to chemicals including Agent Orange
- Biopsy evidence of high-grade prostatic intraepithelial neoplasia (PIN) or atypical small acinar proliferation (ASAP) See: Precancerous Lesions of the Prostate
See our article: For Your Sons, Promoting Awareness within the Family
What are the symptoms of prostate cancer?
There are usually no symptoms for prostate cancer in the earlier stages which supports the importance of screening. As the cancer progresses, urinary symptoms may appear similar to those discussed for BHP and prostatitis in the Prostate Basics section of this Decision Aide.
Can you reduce your risk of prostate cancer?
According to the Prostate Cancer Foundation, “research in the past few years has shown that diet modification might decrease the chances of developing prostate cancer, reduce the likelihood of having a prostate cancer recurrence, or help slow the progression of the disease.” For more information, see the Any Alternatives? section of this Decision Aide.
Medicines called 5-alpha-reductase inhibitors (5-ARI)
The Prostate Cancer Prevention Trial (PCPT) demonstrated that finasteride (Proscar®) reduces the risk of prostate cancer by nearly 25%. The REDUCE trial completed in May 2009 for a similar drug, dutasteride (Avodart®), reported a reduced risk of 23%.
In 2008, ACSO/AUA issued the following guidelines for 5-ARI for PC prevention
- inform the man who is considering a 5-ARI that these agents reduce the incidence of prostate cancer, and be sure to be clear that these agents do not reduce the risk of prostate cancer to zero;
- discuss the elevated rate of high-grade cancer observed in the PCPT and inform men of the potential explanations;
- make it known to men that no information on the long-term effects of 5-ARIs on prostate cancer incidence exists beyond approximately 7 years, and that whether or not a 5-ARI reduces prostate cancer mortality or increases life expectancy remains unknown;
- inform men of possible but reversible sexual adverse effects; and
- inform men of the likely improvement in lower urinary tract symptoms.
See our August 2010 article Chemoprevention of Prostate Cancer