Prostate Cancer

Last Updated: August 16, 2022

Prostate cancer is the second most common cancer in men. It usually grows very slowly and is unlikely to cause serious problems unless it spreads to other parts of the body. Western dietary patterns rich in dairy products seem to increase the risk of prostate cancer.

Prostate Cancer falls under theCancerandMen’s Healthcategories.

What is prostate cancer?

Prostate cancer is a disease in which cells in the prostate gland — a walnut-sized gland in the male reproductive system that resides below the bladder and surrounds the upper part of the urethra (i.e., the tube that carries urine from the bladder) and makes seminal fluid — start to grow out of control.[1] It is the second most common cancer in men worldwide and is most prevalent in men over the age of 65;[2] The majority of prostate cancers grow very slowly and are unlikely to cause serious problems. When the cancer is confined to the prostate, long-term prognosis is excellent, but if the cancer begins to grow quickly and spreads to distant organs, it becomes dangerous, and current therapies cannot cure it.

What are the main signs and symptoms of prostate cancer?

The signs and symptoms of prostate cancer are nonspecific and tend to be more indicative of benign prostatic hyperplasia (i.e., noncancerous enlargement of the prostate) than cancer. They’re mainly related to problems with urinating and include:[1]

  • Decreased urinary stream that’s hard to start, or starts and stops
  • Frequent urination, especially at night
  • Suddenly needing to urinate right away
  • Incomplete bladder emptying
  • Pain or burning while urinating
  • Blood in the urine or semen Although rare in the current era of widespread screening, people with prostate cancer may also present with symptoms of metastatic disease (i.e., the spread of cancer cells to other parts of the body), such as bone pain or fractures.
How is prostate cancer diagnosed?

A doctor can use different tests to screen for prostate cancer, such as a digital (finger) rectal exam, a prostate-specific antigen (PSA, a protein secreted by prostate cells) blood test, and imaging tests (e.g., ultrasound, magnetic resonance imaging).[1] A prostate biopsy is then used to confirm the presence of prostate cancer and determine the severity of the disease.

What are some of the main medical treatments for prostate cancer?

The treatment selected depends on a variety of factors, including age, comorbidities, expected lifespan, the stage (i.e., the size of the tumor and whether the cancer has spread to other parts of the body) and grade (i.e., how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread) of the cancer, and patient preferences.[3] Common treatment options include watchful waiting or active surveillance, surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, and immunotherapy.

Watchful waiting or active surveillance is typically reserved for older men without symptoms and prostate cancer that isn’t likely to grow or with comorbidities that would affect their immediate lifespan.[4] Surgery or radiation therapy are used in the early stages of prostate cancer to try and cure the disease.

Have any supplements been studied for prostate cancer?

Because oxidative stress is implicated in the development of prostate cancer, phenolic compounds and micronutrients with antioxidant effects have mainly been studied for reducing the risk of or treating the disease:[5][6]

How could diet affect prostate cancer?

A Western dietary pattern rich in animal-based protein, dairy products, and refined carbohydrates tends to be associated with an increased risk of prostate cancer, whereas a healthy plant-based dietary pattern (e.g., the Mediterranean diet) tends to be associated with a decreased risk of prostate cancer.[7][8] Concerning specific dietary factors, a notable body of evidence indicates that a high intake of dairy products is associated with an increased risk of prostate cancer,[7] while fairly consistent evidence indicates a high intake of lycopene from tomato products is associated with a decreased risk of prostate cancer.[9][10] Also, obesity increases the risk of advanced prostate cancer, so a hypocaloric diet that facilitates weight loss is often beneficial in this population.

Are there any other treatments for prostate cancer?

Increased physical activity is associated with a decreased risk of prostate cancer and prostate cancer mortality.[7][11] Also, cigarette smoking seems to play a role in the progression of prostate cancer and is associated with an increased risk of prostate cancer mortality.[7][11]

What causes prostate cancer?

The precise causes of prostate cancer are unclear, but they involve changes in the DNA of a normal prostate cell, which are either inherited or acquired throughout life. Several genes have been linked to prostate cancer (e.g., TMPRSS2-ERG, SPOP, FOXA1, BRCA1, BRCA2).[12] Additionally, the risk of prostate cancer is approximately doubled in men who are Black or have a first-degree relative with prostate cancer compared to the general population.[4] Acquired gene mutations are the result of errors in the DNA replication process, which occur at random or via the influence of other factors (e.g., diet, hormone levels, exposure to cancer-causing chemicals).[13]

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References
  1. ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
  2. ^Mattiuzzi C, Lippi GCurrent Cancer Epidemiology.J Epidemiol Glob Health.(2019-12)
  3. ^American Cancer SocietyTreating Prostate Cancer
  4. ^Leslie SW, Soon-Sutton TL, Sajjad H, Siref LEProstate CancerStatPearls.(2022-07)
  5. ^PDQ Integrative, Alternative, and Complementary Therapies Editorial BoardProstate Cancer, Nutrition, and Dietary Supplements (PDQ®): Health Professional Version
  6. ^Maria G Grammatikopoulou, Konstantinos Gkiouras, Stefanos Τ Papageorgiou, Ioannis Myrogiannis, Ioannis Mykoniatis, Theodora Papamitsou, Dimitrios P Bogdanos, Dimitrios G GoulisDietary Factors and Supplements Influencing Prostate Specific-Antigen (PSA) Concentrations in Men with Prostate Cancer and Increased Cancer Risk: An Evidence Analysis Review Based on Randomized Controlled TrialsNutrients.(2020 Sep 29)
  7. ^Wilson KM, Mucci LADiet and Lifestyle in Prostate Cancer.Adv Exp Med Biol.(2019)
  8. ^Lin PH, Aronson W, Freedland SJAn update of research evidence on nutrition and prostate cancer.Urol Oncol.(2019-06)
  9. ^Rowles JL, Ranard KM, Applegate CC, Jeon S, An R, Erdman JWProcessed and raw tomato consumption and risk of prostate cancer: a systematic review and dose-response meta-analysis.Prostate Cancer Prostatic Dis.(2018-09)
  10. ^Rowles JL, Ranard KM, Smith JW, An R, Erdman JWIncreased dietary and circulating lycopene are associated with reduced prostate cancer risk: a systematic review and meta-analysis.Prostate Cancer Prostatic Dis.(2017-12)
  11. ^Peisch SF, Van Blarigan EL, Chan JM, Stampfer MJ, Kenfield SAProstate cancer progression and mortality: a review of diet and lifestyle factors.World J Urol.(2017-Jun)
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  13. ^American Cancer SocietyWhat Causes Prostate Cancer?
  14. ^Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine EProstate-specific antigen as a serum marker for adenocarcinoma of the prostate.N Engl J Med.(1987-Oct-08)
  15. ^David MK, Leslie SWProstate Specific AntigenStatPearls.(2022-04)
  16. ^Thompson IM, Ankerst DP, Chi C, Lucia MS, Goodman PJ, Crowley JJ, Parnes HL, Coltman CAOperating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower.JAMA.(2005-Jul-06)
  17. ^Ilic D, Djulbegovic M, Jung JH, Hwang EC, Zhou Q, Cleves A, Agoritsas T, Dahm PProstate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis.BMJ.(2018-Sep-05)
  18. ^Kilpeläinen TP, Tammela TL, Roobol M, Hugosson J, Ciatto S, Nelen V, Moss S, Määttänen L, Auvinen AFalse-positive screening results in the European randomized study of screening for prostate cancer.Eur J Cancer.(2011-Dec)
  19. ^, Grossman DC, Curry SJ, Owens DK, Bibbins-Domingo K, Caughey AB, Davidson KW, Doubeni CA, Ebell M, Epling JW, Kemper AR, Krist AH, Kubik M, Landefeld CS, Mangione CM, Silverstein M, Simon MA, Siu AL, Tseng CWScreening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.JAMA.(2018-05-08)
  20. ^American Cancer Society(2022-01-18)
  21. ^American Cancer SocietyRadiation Therapy For Prostate Cancer(2022-03-24)
  22. ^National Cancer InstituteSide Effects of Cancer Treatment
  23. ^American Cancer SocietyHormone Therapy for Prostate Cancer(2021-09-23)
  24. ^American Cancer SocietyChemotherapy for Prostate Cancer(2019-08-01)
  25. ^PDQ Adult Treatment Editorial BoardProstate Cancer Treatment (PDQ®): Patient Version
  26. ^American Cancer SocietyImmunotherapy for Prostate Cancer(2019-08-01)
  27. ^Ørsted DD, Bojesen SEThe link between benign prostatic hyperplasia and prostate cancer.Nat Rev Urol.(2013-Jan)
  28. ^Miah S, Catto JBPH and prostate cancer risk.Indian J Urol.(2014-Apr)
  29. ^Dai X, Fang X, Ma Y, Xianyu JBenign Prostatic Hyperplasia and the Risk of Prostate Cancer and Bladder Cancer: A Meta-Analysis of Observational Studies.Medicine (Baltimore).(2016-May)
  30. ^Zhang L, Wang Y, Qin Z, Gao X, Xing Q, Li R, Wang W, Song N, Zhang WCorrelation between Prostatitis, Benign Prostatic Hyperplasia and Prostate Cancer: A systematic review and Meta-analysis.J Cancer.(2020)
  31. ^Bostwick DG, Cooner WH, Denis L, Jones GW, Scardino PT, Murphy GPThe association of benign prostatic hyperplasia and cancer of the prostate.Cancer.(1992-Jul-01)
Examine Database References
  1. Prostate Cancer Risk - C J Paller, X Ye, P J Wozniak, B K Gillespie, P R Sieber, R H Greengold, B R Stockton, B L Hertzman, M D Efros, R P Roper, H R Liker, M A CarducciA randomized phase II study of pomegranate extract for men with rising PSA following initial therapy for localized prostate cancerProstate Cancer Prostatic Dis.(2013 Mar)
  2. Prostate Cancer Risk - Pantuck AJ, Leppert JT, Zomorodian N, Aronson W, Hong J, Barnard RJ, Seeram N, Liker H, Wang H, Elashoff R, Heber D, Aviram M, Ignarro L, Belldegrun APhase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancerClin Cancer Res.(2006 Jul 1)
  3. Prostate Cancer Risk - Heinonen OP, Albanes D, Virtamo J, Taylor PR, Huttunen JK, Hartman AM, Haapakoski J, Malila N, Rautalahti M, Ripatti S, Mäenpää H, Teerenhovi L, Koss L, Virolainen M, Edwards BKProstate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trialJ Natl Cancer Inst.(1998 Mar 18)
  4. Prostate Cancer Risk - Lippman SM, Klein EA, Goodman PJ, Lucia MS, Thompson IM, Ford LG, Parnes HL, Minasian LM, Gaziano JM, Hartline JA, Parsons JK, Bearden JD 3rd, Crawford ED, Goodman GE, Claudio J, Winquist E, Cook ED, Karp DD, Walther P, Lieber MM, Kristal AR, Darke AK, Arnold KB, Ganz PA, Santella RM, Albanes D, Taylor PR, Probstfield JL, Jagpal TJ, Crowley JJ, Meyskens FL Jr, Baker LH, Coltman CA JrEffect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT)JAMA.(2009 Jan 7)
  5. Prostate Cancer Risk - Klein EA, Thompson IM Jr, Tangen CM, Crowley JJ, Lucia MS, Goodman PJ, Minasian LM, Ford LG, Parnes HL, Gaziano JM, Karp DD, Lieber MM, Walther PJ, Klotz L, Parsons JK, Chin JL, Darke AK, Lippman SM, Goodman GE, Meyskens FL Jr, Baker LHVitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT)JAMA.(2011 Oct 12)
  6. Prostate Cancer Risk - Choi YH, Han DH, Kim SW, Kim MJ, Sung HH, Jeon HG, Jeong BC, Seo SI, Jeon SS, Lee HM, Choi HYA randomized, double-blind, placebo-controlled trial to evaluate the role of curcumin in prostate cancer patients with intermittent androgen deprivationProstate.(2019 May)
  7. Prostate Cancer Risk - Hurst R, Hooper L, Norat T, Lau R, Aune D, Greenwood DC, Vieira R, Collings R, Harvey LJ, Sterne JA, Beynon R, Savovic J, Fairweather-Tait SJSelenium and prostate cancer: systematic review and meta-analysisAm J Clin Nutr.(2012 Jul)
  8. Prostate Specific Antigen - lker Durak, PhD, Erdal Yılmaz, MD, Erdinç Devrim, MD, Hakkı Perk, MD, Murat Kaçmaz, MDConsumption of aqueous garlic extract leads to significant improvement in patients with benign prostate hyperplasia and prostate cancerNutrition Research.()