In 2025, prostate cancer is expected to be the leading cancer diagnosis among men, with an estimated 299,010 new cases1. This makes it the second most common cancer diagnosis overall, following breast cancer. Prostate cancer accounts for about 15 percent of all new cancer cases in the United States.
One out of every eight men will get prostate cancer. And one out of every 40 men will die from prostate cancer. However, when caught early, prostate cancer is highly curable.
Early detection can start with understanding the disease, knowing your risks by using a prostate cancer risk calculator, and planning for prostate cancer screenings before you have symptoms.
Where Is the Prostate and What Does It Do?
The prostate is part of the male reproductive system. It is a small, donut-shaped gland deep in your pelvis between your bladder and urethra2. It secretes an enzyme called prostate-specific antigen (PSA)3. During ejaculation, PSA aids in sperm motility (ability to move) by liquifying the semen. PSA has long been regarded as an indicator of prostate health4.
What Is Prostate Cancer?
Cancer occurs when abnormal or mutated cells begin to multiply at an uncontrolled rate. This is called proliferation. As the cells grow, they clump together, eventually forming a tumor.
Most types of prostate cancer grow slowly, while some more aggressive types accumulate faster. It’s not clear what exactly triggers prostate cancer5. However, we know some symptoms and diagnostic methods.
Prostate Cancer Symptoms
The presence of symptoms and their severity vary between prostate cancer patients.
Some symptoms of prostate problems are6:
- Erectile dysfunction
- Problems with urination
- Bloody urine and semen
- Painful ejaculation
- Inability to ejaculate
- Persistent pain (back, hip, pelvis, or rectum)
Diagnosis of Prostate Cancer
A healthcare professional may suspect prostate disease if you have some or all of the following:
- Abnormal DRE
- Elevated PSA levels
- Clinical symptoms showing possible signs of prostate cancer (like those listed in the section above)
- Suspicious results from a prostate risk calculator
You may be given a referral to urology and require further testing, such as an MRI or prostate biopsy. Often, doctors won’t order an MRI until after the biopsy, which is unfortunate since an MRI could prevent an unnecessary negative biopsy.
Doctors use results from clinical tests to diagnose and stage prostate cancer. Staging assigns a value to the cancer, which helps determine treatments and provide context regarding prognosis.
One tool doctors use is the Gleason Score7. After a prostate biopsy, a pathologist or cytotechnologist will look at the tissue under a microscope. They observe the biopsied cells for differences and similarities to normal cells. Cancer cells that look more like normal tissue get lower Gleason Scores.
What Are Prostate Cancer Risk Factors?
Age is a common risk factor for prostate cancer8. The disease is less common in men under 50. The rate increases after men reach 60.
Lifestyle factors such as diet, lack of physical activity, smoking, and exposure to harmful substances may play a role in getting prostate cancer.
Ethnicity plays a role in the risk of prostate cancer as well. In the United States, the risk is almost two times higher in black men than in white men. Black men who get prostate cancer earlier are more likely to have more aggressive cancer, or high-grade prostate cancer, when diagnosed and tend to suffer poorer outcomes.
Prostate cancer has a higher rate of occurrence in the United States, Australia, Northern Europe, Canada, and Mexico. Men from low-incidence countries like India who move to high-risk areas in North America experience a convergence of prostate cancer risk, as their risk increases to match the local population in just two years9.
Having a close family member with a history of prostate cancer increases your risk as well. This incidence is thought to be due to a shared environment and shared genes. Patients with a family history of prostate cancer account for about a fifth of all cases10.
Prostate Cancer Risk Calculators
Prostate cancer risk calculators, also called nomograms, use prediction models for risk assessment or risk estimates. Doctors use prostate cancer nomograms from screening through prostatectomy, chemotherapy, and radiation.
Some were designed for patients to use. Their version, created by researchers at Kaiser Permanente, helps patients and their doctors better understand the risk of getting prostate cancer11. The goal is to have more informed decision-making regarding screenings.
Another, the SWOP prostate cancer risk calculator, is actually multiple nomograms (six for doctors and two for patients)12.
Available online or as an iPhone or Android app, these prostate cancer risk calculators allow patients with no medical knowledge to safely assess their risks for getting prostate cancer based on various data points.
- Prostate Cancer Risk Calculator #1 is for patients who do not have a PSA result13.
- Prostate Cancer Risk Calculator #2 is for patients with a recent PSA.
Disclaimer: No prostate cancer risk calculator is 100% accurate. Your results are meant to be shared with your doctor, so they will help interpret your results and possibly refer you to a urology specialist for further testing at a medical center or to a radiology center for a scan.
PSA and Prostate Screening Methods
Prostate cancer detection methods have traditionally comprised a digital rectal exam DRE and prostate-specific antigen PSA testing. Today, a magnetic resonance imaging (MRI) scan with IV contrast may be able to detect and exclude high-risk prostate cancer reliably.
Currently, the United States Preventive Services Task Force (USPSTF) recommends that men aged 55 to 69 and their primary healthcare provider decide about screening for prostate cancer14.
If you’re having symptoms of prostate dysfunction, your healthcare provider may want you to do a blood test to measure your free PSA. This will tell them the amount of PSA currently circulating in your bloodstream.
The European Randomized Study of Screening for Prostate Cancer (ERSPC) found a 21% reduction in prostate cancer mortality by measuring PSA levels15.
But an elevated level doesn’t always mean you have cancer. Other conditions, such as benign prostatic hyperplasia (BHA), can raise your PSA to as much as 2.5 times the normal value16.
Some studies suggest that urinary tract infections, prostate stimulation, and inflammation may cause elevated PSA tests17
Other Types of Prostate Screening Methods
Elevated PSA levels may help your doctor decide when to recommend a prostate MRI. Prostate MRIs with IV contrast can also be a part of your prostate cancer screening routine while you’re still healthy.
Digital rectal examinations (DRE) are another type of screening that examines changes manually by palpating the gland via the rectum.
Since some cancers are small and difficult to feel, the results of a DRE may be inconsistent. DRE also has the potential to cause an elevated PSA18.
MRI to Screen for Prostate Cancer
Magnetic resonance imaging (MRI) is another method that can be used to screen for prostate cancer. Unlike a biopsy, this method is painless and non-invasive.
Research published in the Lancet has shown that MRI prostate screening may help some men avoid unnecessary prostate biopsy19. Prostate MRI may also be used to look for prostate cancer in men who had an inconclusive biopsy.
The researchers concluded that using MRI to triage men could have helped 27 percent of patients avoid a primary biopsy. For those men who still undergo a biopsy, directing those biopsies with MP-MRI findings could help detect up to 18 percent more cases of clinically significant cancer.
MRI technology can detect over 90 percent of prostate cancers, as well as other conditions, such as infections or benign prostatic hyperplasia19.
In addition, an MRI procedure can take as little as 20 minutes, compared to a prostate biopsy, which can take between 1-2 hours.
An MRI scan of the prostate can also help providers determine the stage of a tumor, as well as monitor how well the treatment is going20.
Prostate Cancer Survival Rate
The survival rate for all cancers is measured as a percentage. This percentage is based on a five-year relative survival rate calculated by the Surveillance, Epidemiology, and End Results (SEER) database21.
A 5-year survival rate tells you the percent of individuals who live at least 5 years after being diagnosed with a certain type of cancer.
As far as prostate cancer survival rates, if you combine all SEER stages (localized, regional, and distant), the five-year relative survival rate is 98%.
This means if you looked at 100 men diagnosed with prostate cancer this year, 98 of them will still be alive in five years (or if they are deceased, prostate cancer isn’t the cause).
If you break down the relative survival rate by SEER stage, men with local or regional prostate cancer have a five-year survival rate of nearly 100%. For men categorized with distant spread, the five-year survival rate drops much lower to 30%21.
The stark difference in survival rates between early-stage prostate cancer and prostate cancer that has spread shows how early detection offers a true advantage for treatment.
Finding prostate cancer early is key to staying healthy after a cancer diagnosis. The prostate cancer survival rate is nearly 100% when found early.
How Can I Reduce My Risk of Prostate Cancer?
The American Cancer Society has outlined a handful of suggestions that could help reduce your chances of developing prostate cancer22. Some studies concerning weight have yielded interesting results: while men who are overweight could have a slightly lowered risk of developing prostate cancer, they could have a higher risk of developing a fatal form of the disease23.
In terms of physical activity, the available data is more intuitive: regular physical activity suggests a slightly lowered chance of prostate cancer, with vigorous activity perhaps being even more effective–particularly on the disease’s aggressive, advanced-stage forms24. Data is more clear when it comes to diet; a multitude of studies have hinted that diets rich in fish, as well as some specific vegetables such as legumes, cruciferous vegetables (think broccoli), and tomatoes, could lead to a lower risk of prostate cancer25.
In terms of vitamins and other supplements, data tends to be a bit more murky. Several studies have suggested that men with calcium-rich diets could have a higher risk of prostate cancer, while others have refuted these claims26. A large study known as the Selenium and Vitamin E Cancer Prevention Trial (SELECT) showed that men taking Vitamin E supplements actually had a slightly higher risk of developing prostate cancer, while men taking selenium supplements saw no change when they had lower baseline levels of the substance at the study’s start27.
However, men with higher initial levels of selenium were found to be at a higher risk of developing high-grade prostate cancer.
With the above in mind, the ACS suggests that you28:
- Stay at a healthy weight
- Be physically active
- Eat at least 2.5 cups of various fruits and veggies daily
- Consult a physician before taking any vitamins or other supplements
- Be aware of other risk factors you may be susceptible to
Cutting-Edge Prostate Cancer Screening
For prostate cancer prevention to be effective, you want to start early while you’re still healthy. Early detection means that you may be able to catch cancer when it is still low-grade and easier to treat.
Get your Ezra Full Body MRI Scan — it only takes one hour, and it screens for potential early cancer and early disease in up to 13 organs, including the prostate. Sign up for a consultation today.
