The Silent Killer: What Causes Prostate Cancer?

In 2023 alone, 288,300 new cases of prostate cancer will be diagnosed in the United States, according to the American Cancer Society. And while that number might not seem all that high considering the U.S. population, 34,700 deaths will be related to this silent killer.

While new cases of prostate cancer were on a decline for many years, the illness has been rearing its ugly head since 2014 with an annual increase of 3%. For this reason, understanding prostate cancer causes is critical.

Prostate cancer is a form of cancer that originates in the prostate, a small gland in males responsible for producing seminal fluid, which nourishes and transports sperm. According to the U.S. Centers for Disease Control and Prevention, it is diagnosed using the results of a needle biopsy, which your doctor might suggest if a recent prostate exam elicits irregular findings.

The Mayo Clinic indicates that prostate cancer is one of the most prevalent types of cancer. It often progresses slowly and remains localized within the prostate gland, posing minimal threat. There are aggressive variants, however, that can rapidly spread to other parts of the body.

Prostate cancer is often referred to as the "silent killer," because it can develop without presenting noticeable symptoms. This stealthy nature makes it challenging to detect and diagnose until it has reached advanced stages. By the time symptoms become apparent, the cancer may have already spread beyond the prostate, significantly reducing the odds for successful treatment.

Timely detection of prostate cancer, when it is still confined to the prostate gland, offers the greatest opportunity for effective treatment. Regular screenings and early detection are key in identifying the disease before it progresses to an advanced stage, improving the chances of successful management and survival.

Unfortunately, the exact cause of prostate cancer remains a mystery. But certain factors are associated with its development.

The Mayo Clinic notes that prostate cancer initiates when the DNA of cells in the prostate undergoes specific alterations. DNA serves as a cell's blueprint, providing instructions for its functions. These genetic changes instruct the cells to proliferate and divide at a faster rate compared to healthy cells. These abnormal cells can evade the natural process of cell death, allowing them to persist and build up.

And though prostate cancer causes are unknown, men should be aware of some key risk factors. These tend to fall within the categories of age, family history (including genetics), and race. For example, according to the Prostate Cancer Foundation, about 60% of prostate cancer is diagnosed in males over age 65, and 8% of prostate cancer is driven by genetic factors.

Dr. Brian Norouzi, a urologist at Providence St. Joseph Hospital in Orange, Calif., agrees.

“The most common cause of prostate cancer is a familial history," he said. "There are also certain genetic abnormalities like the presence of the BRCA gene that increases the risk of aggressive cancer."

The Prostate Cancer Foundation cites these risk factors:

• Tall height

• Lack of exercise and a sedentary lifestyle

• Very high calcium intake

• Black race

• Family history

• Agent Orange exposure

Men often wonder: Can masturbation cause prostate cancer? Simply put: No, it does not. Research has found no evidence that frequent ejaculations mark an increased risk of prostate cancer, according to Harvard Health. It may also be reassuring to know that high ejaculation frequency was linked to a decreased risk.

“Several studies have investigated the association between ejaculation frequency and prostate cancer," said Dr. William Thieu, urologist and men’s health clinic director at Santa Clara Valley Medical Center in California. "Some of these studies have found no connection while others have found that more frequent ejaculation may be associated with a decreased risk of prostate cancer.”

Thieu noted that an 18-year study of close to 32,000 men found that those who ejaculated more than four times a month in their 20s were 19% less likely to develop prostate cancer and men in their 40s who had the same ejaculation frequency were 22% less likely to do so.

And, a 2023 study published in the World Journal of Men’s Health found that men that ejaculated less than four times a month had a greater than 2.5 times risk of aggressive prostate cancer and 4.7 times risk of advanced metastatic disease compared to men who ejaculate more than four times a month.

That said, various social, environmental and lifestyle factors contribute to the risk of developing prostate cancer and influence a patient's prognosis.

The Prostate Cancer Foundation says that dietary choices play a significant role, with a higher risk associated with a low intake of vegetables and a high consumption of processed meat and saturated fat.

Men who are overweight or obese face an increased likelihood of developing an aggressive form of prostate cancer. Studies have revealed that individuals who are obese often experience longer and more challenging post-surgery recovery, along with a heightened risk of death from prostate cancer.

Research has shown a significant link between certain lifestyle factors and the risk of prostate cancer. Having regular prostate exams plays a vital role in detecting early signs of this disease. It is generally recommended for men to begin undergoing prostate exams around age 50, or earlier if advised by their health care provider.

Taking proactive steps to prioritize regular checkups can help in the early detection and timely management of both prostatitis and prostate cancer, improving the chances of successful treatment outcomes.

Sources: Brian Norouzi, MD, urologist, Providence St. Joseph Hospital, Orange, Calif.; William Thieu, MD, MS, urologist, men's health clinic director, Santa Clara Valley Medical Center, Santa Clara, Calif.

For more information on men's health, check out these additional resources:

Prostate Cancer: The Basics Every Man Needs to Know

Prostate Biopsy: What It Is, How to Prepare, Side Effects, Recovery & Results

Prostate Cancer: Diagnosis, Treatment, and How to Prevent It

The Prostate Cancer Symptoms You Should Know