Prostate Cancer Prevention and Early Detection

Medically Reviewed By William C. Lloyd III, MD, FACS
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Prostate cancer is a common cancer in men. It develops in a man’s prostate gland, which produces a component of semen. Prostate cancer can be a serious disease in some men. However, many men have slow-growing prostate cancers that do not affect their health greatly. These men have a high survival rate. They often do not die from the disease, but from another cause.

The prostate sits below the bladder and the urethra (which carries urine and semen in men) runs through it. Often, there are no symptoms early in prostate cancer. When symptoms develop, they frequently affect urination and ejaculation. This can include blood in the semen or urine, difficulty urinating, weak urine stream, or stopping and starting during urination. These and other symptoms can also be present with noncancerous conditions, such as enlarged prostate (benign prostatic hyperplasia, or BPH).

Fortunately, prostate cancer screening tests find many prostate cancers before symptoms appear. About 80% of prostate cancers are in the early stages at diagnosis. Early detection of prostate cancer has led to better survival, with nearly 100% of men still living five years after diagnosis. Even when prostate cancer has spread locally to adjacent tissues, the five-year survival remains at almost 100%. This makes early detection an important part of fighting prostate cancer.

What are the risk factors for prostate cancer?

Knowing the factors that increase the risk of developing prostate cancer help identify men who are at high risk. Risk factors for prostate cancer include:

  • African American race

  • Age over 65. More than half of prostate cancer cases occur in older men.

  • Family history of prostate cancer

  • Genetic mutations and other alterations including having the BRCA1 and BRCA2 gene mutations

Lifestyle factors may also play a role in the risk of prostate cancer. Smoking is the one of the main ones. Heavy smokers may have double the risk of prostate cancer compared to nonsmokers. They are also more likely to die of the disease. The good news is your risk returns to that of a nonsmoker after 10 years of not smoking. If you struggle with this habit, talk with your doctor about quitting. Don’t be discouraged if you have a setback. Quitting can take time and trials of different approaches.

Other lifestyle factors have a less clear link. Unhealthy eating habits may increase the risk of prostate cancer. Lack of exercise and obesity may contribute to poor outcomes in men with prostate cancer. Researchers can’t say for sure whether these things play a role, but evidence suggests a trend.

Reducing your risk of prostate cancer

In general, cancer risk reduction involves changing risk factors under your control. Usually, this means lifestyle factors are the main way to influence your risk. For prostate cancer, stopping smoking is an important way to protect yourself. Other healthy habits may also help including:

  • Eating a heart-healthy diet with plenty of fruits and vegetables and foods low in refined sugars and animal fats

  • Getting regular physical exercise most days of the week. More vigorous activity may be more beneficial for prostate cancer prevention.

  • Maintaining a healthy body weight

However, many of the risk factors for prostate cancer are out of your control; it can happen by chance in men without known risk factors. Because of this uncertainty, researchers have studied ways to prevent the disease with medicines.
The main focus of this research has been 5-alpha reductase inhibitors. Men commonly take these drugs to treat BPH, so scientists wondered if they could help prevent prostate cancer. The results seem to show men taking these drugs may have a lower risk or develop the disease slower. But the drugs didn’t seem to make a difference for survival. They can also cause sexual problems and other side effects. Because it isn’t clear if they work and they can cause problems, the inhibitors are not a standard preventive strategy. More research is necessary.

Every man should discuss his risk of prostate cancer with his doctor. Find out if your lifestyle habits increase your risk. Ask your doctor about medicines for prostate cancer prevention to see if they are right for you. All of this information can help you make informed decisions about your health.

Early detection of prostate cancer

Early detection is an important part of managing prostate cancer. Screening exams are the main tools doctors have for finding prostate cancer early. Screening tests look for—and often find—prostate cancer in people who do not have symptoms yet.

What are prostate exams and how are prostate exams done?

The two main prostate cancer screening tests are:

  • Digital rectal exam (DRE) is a prostate exam that involves your doctor inserting a gloved and lubricated finger into your rectum. Your doctor can feel your prostate through the wall of your rectum for abnormalities. A DRE can be uncomfortable and awkward. Thankfully, the exam is brief and your doctor will help you with tips to ease the process.

  • Prostate-specific antigen (PSA) test is a prostate cancer test that involves a blood sample. A high PSA test result may be a sign of cancer, but it can also be high in other conditions, such as BPH. If your level is high, your doctor may want to repeat it before ordering more tests.

What is the age range for prostate exams?

Guidelines on prostate cancer screening vary. According to the American Cancer Society, all men deserve to make an informed decision about their health. They recommend talking with your doctor about your risk of prostate cancer and the pros and cons of screening exams. This conversation should take place at age 40 for any man who has more than one first-degree relative who had prostate cancer before age 65. African American men and those with one first-degree relative with prostate cancer before age 65 should talk with their doctors at age 45.

Men of average risk—no first-degree family history and not African American—could consider screening at age 50. The American Urological Association also encourages men to talk with their doctors about screening.

If a prostate exam reveals something suspicious, your doctor may order diagnostic testing. This will help confirm or rule out prostate cancer. Diagnosing prostate cancer may include:

  • Transrectal ultrasound (TRUS) to get images of the prostate and measure its size

  • Prostate biopsy to take tissue samples from the prostate. This is the only way to know for sure whether cancer is present.

  • Imaging exams if there is a high likelihood the cancer has spread beyond the prostate

Your doctor will use all this information to make a complete diagnosis, including the stage and grade of the cancer. The stage tells your doctor about the extent of cancer in the body. Lower stages tend to have a better outlook than higher stages. Cancer grade describes the aggressiveness of the cancer. High grades are more likely to grow and spread. This complete diagnosis helps your doctor plan the most effective treatment.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 11
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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