Prostate cancer

Alternative names:

cancer of the prostate

Definition:

A malignant tumor growth within the prostate gland.

Causes, incidence, and risk factors:

Prostate cancer is the most common cancer in US men. It is the third most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over 75 years old. The risk of prostate cancer begins to increase at 50 years of age and is rarely found in men younger that 40. There are an estimated 184,500 new cases per year in the US, 39,000 of which result in death. Autopsy series indicate that approximately 60% of men develop prostate cancer over time, although the overwhelming majority doesn't find out that they have it. The incidence is greatest in black men whose risk is double that of white men of the same age. Increased incidence is also associated with farmers, tire workers, painters, and men exposed to cadmium. The lowest incidence occurs in Japanese men and vegetarians. A family history of prostate cancer does increase the risk slightly, but true hereditary prostate cancer is very rare.

The cause is unknown, although some studies have shown a relationship between high dietary fat intake and increased testosterone levels. This hormonal role has been suggested by observing that eunuchs (men whose testicles have been destroyed or removed) do not develop prostatic cancer, and prostate tumors regress after surgical removal of the testicles (orchiectomy). There is no known association with benign prostatic hyperplasia (BPH).

Prostatic cancer is the third most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over 75 years old. Prostate cancer is rarely found in men younger that 40 years of age. The incidence is greatest in black men over 60 years old. Increased incidence is also associated with farmers, tire workers, painters, and men exposed to cadmium. The lowest incidence occurs in Japanese men and vegetarians.

Prostate cancer can be localized to the prostate, can be advanced locally (extensive disease, but has not spread to a distant site) or there can be distant spread (metastasis). When it spreads, it does so locally through 1) direct extension into the tissue around the prostate or into the seminal vesicles, 2) through the lymph glands to the regional lymph nodes in the pelvis, or 3) through the blood to the bones. There are also certain, very rare instances where it spreads to the liver and lung as well.

Updated Date: 05/08/00

Updated by: Bradley G. Somer, MD, Division of Hematology-Oncology, Hospital University of Pennsylvania, Verimed Health Network