What is Prostate Cancer?

Prostate cancer is a form of cancer that affects the prostate, a gland in the male reproductive system. Like other types of cancer, it is caused by cells which begin to divide abnormally. 

At what age is prostate cancer usually diagnosed?

The average age of diagnosis is 66 years old. Prostate cancer affects roughly 3.2 million American men, and 12.5% will be diagnosed at some point during their lifetime, making it the most common non-skin cancer in men. 

What are some symptoms of prostate cancer?

Typical symptoms of prostate cancer include frequent and difficult urination, pain in and around the groin, and pain in adjacent parts of the body such as the pelvis and hips.  

How does genetics influence prostate cancer risk?

Genetics are implicated in the development of prostate cancer, the heritability of which is estimated to be between 52% to 63% based on an analysis of almost 50,000 twin pairs drawn from the Nordic Twin Study of Cancer.

Prostate cancer is very common and about 80% of men diagnosed with prostate cancer will live at least five years after their diagnosis. Many cases of prostate cancer do not require active treatment, but some may require medical treatment by an oncologist, surgery, and/or radiotherapy.

Screening for prostate cancer is controversial. While it may reduce death from prostate cancer, about 1000 men must be screened, some of which subsequently undergo biopsy, and then treatment, for one man to benefit. This results in about 25 cases of erectile dysfunction, along with other complications.

Is there anything I can do?

Lifestyle

There is no high-quality evidence that any lifestyle interventions can reduce the risk of developing prostate cancer. Certain kinds of diets, such as low-fat and high-soy diets, are associated with lower risk of prostate cancer, but there are no controlled trials demonstrating a benefit to dietary change to reduce prostate cancer risk. 

Medication

Many prostate cancers appear to be driven by androgens, which are male hormones. Treatment of prostate cancer often involves varying forms of androgen deprivation, in addition to surgery, radiation, and other treatments. 

For that reason, prostate cancer prevention trials using finasteride and dutasteride, which selectively inhibit the synthesis of a specific androgen, DHT, have been conducted. Both appear to reduce the relative risk of prostate cancer by around 20%, though there is some controversy over whether high-grade prostate cancer may become more common.

Labs/Imaging

As mentioned above, screening for prostate cancer is controversial. 

If screening is performed, it is generally through measuring the levels of prostate-specific antigen in the blood, and sometimes through a digital rectal exam (DRE). Especially high levels (>10 ng/mL) raise the risk for prostate cancer, and may prompt doctors to get a prostate biopsy or repeat the PSA test. 

The American Cancer Society recommends that patients and their physicians should discuss prostate cancer screening after age 50 for normal-risk men, after age 45 for high-risk men, and after age 40 for very high-risk men. The discussion should explain the risks and benefits of prostate cancer screening.

There are a variety of imaging technologies that can be used to diagnose and/or stage prostate cancer. None are used for screening and are generally used only after an abnormal PSA test or the presence of symptoms.

Embryo Prioritization

As explained in the prostate cancer whitepaper, genetics plays an important role in determining the risk of prostate cancer. Using Orchid’s embryo scoring, you can prioritize the embryo with the lowest genetic risk for prostate cancer and reduce their risk.  

Takeaways

1. Prostate cancer screening is controversial, but should be discussed with a doctor who is aware of a patient’s particular risk profile.

Learning More

1. Podcast episode between Dr. Ted Shaeffer and Dr. Peter Attia

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