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Overall, in the UK about 1 in 12 men develop prostate cancer. Many men worry about getting prostate cancer, sometimes because one of their relatives has developed the illness. This section explains:
The cause of most prostate cancers is not known. But we do know that some things – called risk factors – can increase our chances of developing cancer. Some risk factors are very likely to cause cancer, whereas others will only very slightly increase our likelihood of getting it.
Having a particular risk factor for cancer, or being exposed to one, doesn’t mean that we will definitely get cancer; just as not having it doesn’t mean that we won’t. Smoking is a good example of this. If you smoke, it isn’t certain that you will get lung cancer; just as if you don’t smoke, it’s not certain that you won’t. But smoking will greatly increase your risk of getting lung cancer. Nine out of ten people who develop lung cancer are smokers.
Cancer is very common and nearly 1 in 3 of us will develop it at some time during our lives. This means that most of us will have relatives who have had cancer. Surveys have shown that many people are worried that a history of cancer in their family greatly increases their risk. People often worry that an increased risk of cancer can be inherited, or passed on from one generation to another. In fact less than 1 in 10 cases of cancer (between 5 and 10%) have been shown to be due to a family history of the disease.
Genes carry the biological information that we inherit from our parents. They affect the way our bodies grow, work and look. Changes (mutations) in some genes can increase the risk of developing cancer in family members who inherit the genetic change. However, only a small number of prostate cancers are thought to be due to an inherited altered gene running in the family.
It is thought that your risk of developing prostate cancer is significantly increased if you have:
The risk that the cancers are caused by an inherited gene mutation is greater the more relatives there are on the same side of the family with prostate cancer, the more closely related to you they are, and the younger their age at diagnosis. If you only have one elderly relative who has developed prostate cancer, this does not significantly increase your risk.
If your family seems to show that an inherited gene mutation is possible, and you are worried about developing prostate cancer, you might want to talk to your GP. Your GP will ask you questions about your family history. There are currently no gene tests for prostate cancer available on the NHS. But you can talk to your doctor and arrange to have tests, such as a blood test to check the level of prostate specific antigen (PSA) in your blood and a digital rectal examination (DRE). The PSA level may be raised in a man with prostate cancer, but it may also be raised for other reasons, so it is not a straightforward screening test. However, if you have a strong family history of prostate cancer and you are worried, regular PSA tests may be helpful. You can read more about this test in our section on Understanding the PSA Test. A DRE can detect abnormalities in the way the prostate gland feels.
Research to try to identify gene changes (mutations) that may be inherited and so cause a higher risk of prostate cancer is ongoing, and is being carried out by many groups worldwide. Prostate cancer often seems to cluster in families, but research so far has not identified a specific ‘prostate cancer gene’ that could be the cause in these cases. It is likely that several genes may be involved and the cancer risk may be related to environmental factors too, although these have not yet been identified.
It has been found that for a small number of people, a change (mutation) in the breast cancer genes, BRCA1 and particularly BRCA2, can be linked with prostate cancer. So, if there is a strong history of breast cancer in your family or a BRCA gene mutation has been found in your family, you may want to discuss the risk of prostate cancer with your doctor. Your GP may refer you to your local genetics centre for further advice and possibly gene testing.
It can be a normal reaction to severe illness in the family, or to bereavement, to feel more vulnerable to the same disease. If you can’t stop worrying, you may find it helpful to see a counsellor, who can help you get things back into perspective. You can ask your GP, or call our nurses for details of a local service. You could also call the Cancer Counselling Trust to speak to a counsellor.
Mind, the mental health charity, has published a leaflet called 'How to Stop Worrying'.
Other risk factors in the development of prostate cancer can play a bigger role than family history.
Prostate cancer is mainly a disease of older men and the risk of getting it gets higher as you get older. Prostate cancer is rare in men under 50 and very rare in the under 40s. About one third of men over the age of 50 will have some cancer cells within their prostate, and by the age of 80, about half of all men will have a form of prostate cancer, but this will not affect their daily life and most will die from other causes
Prostate cancer differs from most other cancers in the body, because small areas of cancer within the prostate are very common and may stay dormant (and so be harmless) for many years. However, in some men, the cancer can grow more quickly, and in some cases may spread to other parts of the body, particularly the bones.
Men from certain ethnic groups have a higher chance of developing prostate cancer. For example, African-Caribbean or African-American men are more likely to have this type of cancer than white men.
Asian men are least likely to develop prostate cancer. Some experts think this may be due to traditional diets in Asian countries. However, if men from these areas move to countries where the rates of prostate cancer are higher, and adopt their lifestyle, their chances of getting prostate cancer can increase.
There is some evidence to suggest that diet plays a part in the risk of developing prostate cancer, but this is not completely clear. Current thinking is that a diet high in animal fats may increase the risk of developing the disease. Red meat (beef, lamb and pork) in particular, contains a lot of saturated fat and so does dairy produce (butter, full fat milk, cheese, eggs and cream).
You can’t do anything about risk factors such as your age or race, but there are other risk factors, known as lifestyle risk factors, that you can control. It has been estimated that about half (50%) of all cancers diagnosed in the UK could be avoided if people made changes to their lifestyles. These changes don’t mean that you definitely won’t get cancer – but they make it less likely. So here are some things that you might want to consider:
A healthy diet limits the intake of red meat, animal fat and salt, and includes plenty of fresh fruit and vegetables. It is recommended that everyone should eat at least five portions of fruits and vegetables per day. Drinking plenty of water and fruit juices also helps.
If you are worried about prostate cancer, it would help to cut down on red meat, animal fat and salt in your diet. Eating a healthy diet will also lower your risk of developing other cancers, as well as other illnesses such as heart disease and diabetes.
Some studies have suggested that supplements such as vitamin E and selenium may offer some protection against prostate cancer. Lycopenes that are found in tomatoes and tomato products may also help to protect against prostate cancer. You should check with your GP before taking supplements. You can find the recommended daily dosage, plus more information from Prostate UK.
Smoking is the single biggest cause of cancer that can be avoided. About 1 in 3 cases of cancer (30%) are caused by smoking. It is responsible for around 9 out of 10 (90%) cases of lung cancer, but also plays a role in many other cancers, as well as heart disease and high blood pressure. For help, contact the NHS Smoking Helpline on 0800 169 0 169 or visit www.gosmokefree.co.uk
The European Code Against Cancer recommends that to reduce the risk of developing cancer men should drink no more than two units a day. A unit is half a pint of ordinary strength beer, lager or cider or one small glass (125ml) of wine or a single measure (25ml) of spirits.
Take up some regular exercise. You don’t need to go to the gym – walking, cycling or gardening, a few times a week, can be enough.
This means knowing what is normal for you and what seems a serious change.
Men with early prostate cancer are unlikely to have any symptoms as these usually only occur when the cancer is large. Men over 50 often have enlargement of the prostate that is not due to cancer (benign enlargement). The symptoms of both benign enlargement of the prostate and cancer of the prostate are similar and are listed below; but remember, most enlargements of the prostate are not cancer.
If you have any of the following symptoms, it is important to have them checked by your doctor:
Cancer of the prostate is often a slow-growing cancer and symptoms may not occur for several years. For this reason, you might want to talk to your doctor about having a regular health check, and whether a regular PSA test might be helpful.
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