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What Is Prostate Cancer?

Prostate cancer occurs when cells in the prostate gland develop changes in their DNA, causing the cells to multiply rapidly. These abnormal cells form a tumor that can destroy normal body tissues and structures. The prostate is a small, walnut-sized gland located behind the base of the penis and below the bladder. The prostate produces seminal fluid, the liquid in semen that protects, nourishes, and helps transport sperm.

Prostate cancer is among the most diagnosed cancers in men. About one in every eight men will be diagnosed with prostate cancer during their lifetime. According to the American Cancer Society, more than 248,500 new cases of prostate cancer are diagnosed in the U.S. each year, resulting in about 34,000 deaths.

In Colorado, there are approximately 3,900 new cases of prostate cancer each year.

Prostate Cancer Prognosis and Survival Rates

Prostate cancer is a serious disease, but most men with prostate cancer do not die from it. Despite this, due to the sheer volume of cases, prostate cancer is the second leading cause of cancer death in men in the United States, behind only lung cancer.

Prostate cancer prognosis depends on the type of cancer and the stage at which it is diagnosed. It is usually curable when detected and treated early.

An Engineer Tackles the Problem of Prostate Cancer as a Patient and Financial Donor

The five-year survival rate for patients with both localized prostate cancer (where the cancer is still confined to the prostate gland) and regional prostate cancer (where the cancer has spread outside the prostate to nearby structures or lymph nodes) is nearly 100%. About 90% of prostate cancers are local or regional.

The survival rate drops drastically as the cancer spreads beyond the immediate area of the prostate. The five-year survival rate for patients with distant prostate cancer, where the cancer has spread to distant parts of the body, is 31%. This accounts for about 10% of all diagnoses.

Prostate cancer and its treatments may result in complications. Two of the most common are urinary incontinence and erectile dysfunction. Prostate cancer that spreads (metastasizes) can result in damage to organs, and cancer that spreads to the bones can cause pain and broken bones.

Why Come to the CU Cancer Center for Prostate Cancer

As the only National Cancer Institute Designated Comprehensive Cancer Center in Colorado and one of only four in the Rocky Mountain region, University of Colorado Cancer Center has doctors who provide cutting-edge, patient-centered prostate cancer care and researchers focused on diagnostic and treatment innovations.

→ Improving Patient Outcomes in Prostate Cancer

The CU Cancer Center also offers a multidisciplinary clinic for prostate cancer patients. Care begins with a preparatory telephone visit with our nurse practitioner, review of pathology and any imaging, and visits with medical oncologists, radiation oncologists, or surgeons based on the needs of the patient. We can often do this entire review in a single day.

There are numerous prostate cancer clinical trials being conducted by CU Cancer Center members at any time. These trials offer patients options to traditional prostate cancer treatment and can result in remission or increased life spans.

Our clinical partnership with UCHealth has produced survival rates higher than the state average for all stages of prostate cancer.

Prostate Cancer Graph

Number of Patients Diagnosed – UCHealth 1,946 – State of Colorado 11,895
Number of Patients Surviving – UCHealth 1,726 – State of Colorado 9,885
*n<30, 5 Year Survival – (Date of diagnosis 1/1/2010–12/31/2014)

Types of Prostate Cancer

Different types of prostate cells can become cancerous, and the type of cell affected determines the type of prostate cancer. They are categorized by looking at the cells under a microscope. Doctors use this information to understand the expected growth pattern and speed, as well as which treatments may work best.

Adenocarcinoma is the most common type of prostate cancer, accounting for almost all diagnoses. Adenocarcinoma forms in the gland cells of the prostate — the cells that make the prostate fluid that is added to the semen.

Other types of prostate cancer are extremely rare, but they can include neuroendocrine tumors, small cell carcinomas, transitional cell carcinomas, and sarcomas. These rare variants tend to be more aggressive than adenocarcinomas.

Pre-cancerous Conditions That Can Lead to Prostate Cancer

Some cases of prostate cancer may begin as pre-cancerous conditions. Two possible pre-cancerous conditions of the prostate are prostatic intraepithelial neoplasia (PIN), in which there are changes in how the prostate gland cells look when seen with a microscope, and proliferative inflammatory atrophy (PIA), in which prostate cells look smaller than normal and there are signs of inflammation in the area.

Although they can be precursors to prostate cancer, many men with PIN and PIA will never develop prostate cancer. However, these men should be followed closely with lab tests, prostate MRI scans, or other biomarkers to help detect cancer.

Risk Factors for Prostate Cancer

Prostate cancer has multiple risk factors: behaviors or conditions that increase a person’s chances of getting a disease, such as cancer. 

Age: The risk of prostate cancer increases with age. The majority of prostate cancer diagnoses occur in men over 50 years old, and more than 80% of prostate cancers are diagnosed in men 65 or older. The average age at diagnosis is about 66.

Race and ethnicity: For reasons not yet understood, Black men have a greater risk of developing prostate cancer than do men of other races and ethnicities. When diagnosed, Black men are also more likely to die from prostate cancer.

Geography: Prostate cancer diagnoses are more common in North America, northwestern Europe, Australia, and the Caribbean than in other parts of the world. Although increased screening in some developed countries may account for part of this difference, other factors such as diet and exercise may also be contributors.

Family history and genetics: Prostate cancer that runs in families makes up about 20% of all diagnoses. This is due to a combination of shared genes and shared environmental or lifestyle factors. Having a father or brother with the disease more than doubles a man’s risk of being diagnosed with prostate cancer, and the risk is even higher for men with several affected relatives. However, most prostate cancers occur in men without a family history of it.

Several inherited gene mutations seem to increase prostate cancer risk, but they account for only about 5% of cases overall. These include hereditary breast and ovarian cancer (HBOC) syndrome, which is associated with mutations to the BRCA1 and/or BRCA2 genes, and Lynch syndrome, also known as hereditary non-polyposis colorectal cancer, or HNPCC.

History of prostate cancer: Men who have already had prostate cancer have a greater risk of developing it again.

Agent Orange exposure: Some studies have suggested a potential link between exposure to Agent Orange, a chemical used extensively during the Vietnam War, and an increased risk of prostate cancer.

Diet: The role of diet in prostate cancer is unclear, but some research suggests that eating a diet that is high in fat, especially animal fat and dairy products, may increase the risk of developing prostate cancer. Other studies have indicated that men who consume a lot of calcium may also be at greater risk. However, most studies have not found such a link with the levels of calcium found in the average diet. Normal calcium intake is still important for other body functions like bone health.

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Information reviewed by Paul Maroni, MD, in August 2022.