Prostate cancer occurs when abnormal cells in the prostate gland—a small organ located below the bladder in men—start to grow uncontrollably, forming a tumor. Most prostate cancers are adenocarcinomas, which originate in the gland’s lining cells.
How Common is Prostate Cancer?
Prostate cancer is the most frequently diagnosed non-skin cancer among men in the United States. In 2024, around 299,000 new cases are expected, with over 35,000 deaths. It affects about 1 in 9 men in their lifetime and is the second leading cause of cancer-related deaths in men nationwide.
Who is Most at Risk?
Age is the biggest risk factor—most men are diagnosed after age 65, with a median age at diagnosis of 67. Black men face a higher risk, with incidence nearly twice as high and mortality more than double compared to white men. Family history and inherited gene mutations, especially in DNA repair genes like BRCA2, significantly increase your chances of developing prostate cancer.
What Causes Prostate Cancer?
Several factors influence risk. Non-modifiable risks include age, genetics, and race, while lifestyle choices also matter. Diets high in red and processed meats cooked at high temperatures (see “How Charred Meats Lead to Cancer”), obesity, and low physical activity can boost your risk. Chronic inflammation inside the prostate might also play a part, along with certain environmental exposures.
How Can You Reduce the Risk?
Living a healthy lifestyle can help. Regular exercise (can decrease risk by up to 51%), maintaining a healthy weight, and eating plenty of vegetables (a diet high in fiber) while limiting red and processed meats (can decrease risk by up to 12% of all prostate cancers, and up to 36% of advanced prostate cancer) are beneficial. Avoid smoking and limit alcohol intake. While no method guarantees prevention, these habits can lower your chances of developing aggressive prostate cancer by up to 40%, according to the American Cancer Society.
How Does Prostate Cancer Develop?
The disease begins when normal prostate cells acquire genetic mutations, or changes in their DNA, that allow them to grow unchecked. Testosterone and other androgens initially fuel this growth, which is why many treatments focus on hormone regulation. Eventually, prostate cancer can grow without the fuel of testosterone, becoming castrate-resistant. When it spreads, prostate cancer has a propensity to metastasize, or spread, to bones as well as lymph nodes, the lungs, and liver.
What Are the Symptoms?
In early stages, prostate cancer usually causes no noticeable symptoms. Some men experience mild urinary issues, like frequent nighttime awakenings to urinate, trouble starting to urinate, or a weak urinary stream, often related to benign enlargement rather than cancer. Advanced disease may cause bone pain, unexplained weight loss, fatigue, blood in urine or semen, and swelling in the legs, especially if the cancer has spread.
Key Points
Most prostate cancers grow slowly and might never cause problems, but some can be aggressive and life-threatening. Early detection through screening tests like PSA blood tests may help identify prostate cancer at a curable stage.
The NCCN (National Comprehensive Cancer Network) recommends screening as early as age 40 if you are high risk, such as having close relatives with prostate cancer. Other agencies in the United States, including the U.S. Preventive Services Task Force, American Urological Association, and American Cancer Society, recommend discussing screening with your doctor between ages 50 and 55 and continuing up to age 70.
If you have risk factors such as being older than 50, a family history of prostate cancer (especially in first- or multiple second-degree relatives), or are African American, it is reasonable to discuss screening with your primary care provider—such as an internal medicine or family physician—to catch prostate cancer early, while it is still curable.
Sources
- https://www.nejm.org/doi/full/10.1056/NEJMcp2209151
- https://pubmed.ncbi.nlm.nih.gov/25281467
- https://pubmed.ncbi.nlm.nih.gov/32546840
- https://pubmed.ncbi.nlm.nih.gov/19808637
- https://pubmed.ncbi.nlm.nih.gov/38489391
- https://pubmed.ncbi.nlm.nih.gov/37202314
- https://pubmed.ncbi.nlm.nih.gov/31802111
- https://pubmed.ncbi.nlm.nih.gov/38865417
- https://jamanetwork.com/journals/jama/fullarticle/2831269