Prostate Cancer: Symptoms and Risk Factors

Prostate cancer is an increasingly common disease in the United States. It is second only to skin cancer as the most common cancer in men. It is the second-leading cause of cancer death in men and the most common cause of cancer death in male nonsmokers.

The severity of prostate cancer depends on how quickly it grows. Most cases progress slowly and never become advanced or life threatening. Some, however, advance more quickly and eventually metastasize (spread) to other parts of the body, including the spine, lymph nodes, and lungs.

Symptoms

• The most common symptoms include difficult or painful urination, feelings of having to urinate frequently or being unable to urinate completely, and blood in the urine.
  
• A small number of cases present with symptoms of metastatic disease, such as weight loss, fevers, or back pain.
  
• Many cases do not have any symptoms at all. These cases can go unnoticed, or may be detected during a physical examination or blood testing.

Risk Factors

• Age: The risk of prostate cancer increases rapidly with age. It rarely occurs before age 45, but most men over 80 have evidence of cancerous prostate cells.
  
  Because of its strong association with age, the number of new cases and deaths from prostate cancer is expected to increase as the American population grows older.
  
• Race: African-American men have the highest risk of prostate cancer. They also tend to have a more advanced stage of the disease at diagnosis, compared with whites.
  
• Genetics: Prostate cancer is likely influenced by several genetic factors. Men who have a first-degree relative with prostate cancer have twice the risk of developing the disease themselves. Early onset of prostate cancer in a first-degree family member further increases the risk.
  
  The incidence of prostate cancer is also higher in families with breast cancer and in patients with certain genetic traits, called BRCA1 or BRCA2 gene mutations, which are best known for their contribution to breast cancer.
• Insulin-like growth factor-I (IGF-I): High blood concentrations of IGF-I are associated with prostate cancer and have been correlated with excess body weight and with certain dietary intakes, which are described in Nutritional Considerations below.