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Prostate Cancer Prevention (PDQ)

What is prevention?
Cancerpreventionisactiontakentolowerthechanceofgettingcancer.Bypreventingcancer,thenumberofnewcases
ofcancerinagrouporpopulationislowered.Hopefully,thiswilllowerthenumberofdeathscausedbycancer.
Topreventnewcancersfromstarting,scientistslookatriskfactorsandprotectivefactors.Anythingthatincreasesyour
chanceofdevelopingcanceriscalledacancerriskfactor;anythingthatdecreasesyourchanceofdevelopingcanceris
calledacancerprotectivefactor.
Someriskfactorsforcancercanbeavoided,butmanycannot.Forexample,bothsmokingandinheritingcertaingenes
areriskfactorsforsometypesofcancer,butonlysmokingcanbeavoided.Regularexerciseandahealthydietmaybe
protectivefactorsforsometypesofcancer.Avoidingriskfactorsandincreasingprotectivefactorsmayloweryourrisk
butitdoesnotmeanthatyouwillnotgetcancer.
Differentwaystopreventcancerarebeingstudied,including:

Changinglifestyleoreatinghabits.
Avoidingthingsknowntocausecancer.
Takingmedicinestotreataprecancerousconditionortokeepcancerfromstarting.

General Information About Prostate Cancer

KEY POINTS
Prostatecancerisadiseaseinwhichmalignant(cancer)cellsforminthetissuesoftheprostate.
ProstatecanceristhesecondmostcommoncanceramongmenintheUnitedStates.

Prostate cancer is a disease in which malignant (cancer) cells form in the

tissues of the prostate.
Theprostateisaglandinthemalereproductivesystem.Theprostateisjustbelowthebladder(theorganthatcollects
andemptiesurine)andinfrontoftherectum(thelowerpartoftheintestine).Itisaboutthesizeofawalnutand
surroundspartoftheurethra(thetubethatemptiesurinefromthebladder).Theprostateglandproducesfluidthat
makesuppartofthesemen.

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Anatomyofthemalereproductiveandurinarysystems,showingtheprostate,testicles,bladder,
andotherorgans.

Asmenage,theprostatemaygetbigger.Abiggerprostatemayblocktheflowofurinefromthebladderandcause
problemswithsexualfunction.Thisconditioniscalledbenignprostatichyperplasia(BPH).BPHisnotcancer,but
surgerymaybeneededtocorrectit.ThesymptomsofBPHorofotherproblemsintheprostatemaybelikesymptoms
ofprostatecancer.

Normalprostateandbenignprostatichyperplasia(BPH).Anormalprostatedoesnotblockthe
flowofurinefromthebladder.Anenlargedprostatepressesonthebladderandurethraand
blockstheflowofurine.

Prostate cancer is the second most common cancer among men in the
United States.
Prostatecancerismostcommoninoldermen.IntheU.S.,aboutoneoutoffivemenwillbediagnosedwithprostate
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cancer.Mostmendiagnosedwithprostatecancerdonotdieofit.
SeethefollowingPDQsummariesformoreinformationaboutprostatecancer:

ProstateCancerScreening
ProstateCancerTreatment

Prostate Cancer Prevention

KEY POINTS
Avoidingriskfactorsandincreasingprotectivefactorsmayhelppreventcancer.
Thefollowingriskfactorsmayincreasetheriskofprostatecancer:
Age
Familyhistoryofprostatecancer
Race
Hormones
VitaminE
Folicacid
Dairyandcalcium
Thefollowingprotectivefactorsmaydecreasetheriskofprostatecancer:
Folate
FinasterideandDutasteride
Thefollowinghavebeenprovennottoaffecttheriskofprostatecancer,ortheireffectsonprostatecancerriskare
notknown:

SeleniumandvitaminE
Diet
Multivitamins
Lycopene
Cancerpreventionclinicaltrialsareusedtostudywaystopreventcancer.
Newwaystopreventprostatecancerarebeingstudiedinclinicaltrials.

Avoiding risk factors and increasing protective factors may help prevent
cancer.
Avoidingcancerriskfactorsmayhelppreventcertaincancers.Riskfactorsincludesmoking,beingoverweight,andnot
gettingenoughexercise.Increasingprotectivefactorssuchasquittingsmoking,eatingahealthydiet,andexercising
mayalsohelppreventsomecancers.Talktoyourdoctororotherhealthcareprofessionalabouthowyoumightlower
yourriskofcancer.

The following risk factors may increase the risk of prostate cancer:
Age
Prostatecancerisrareinmenyoungerthan50yearsofage.Thechanceofdevelopingprostatecancerincreasesas
mengetolder.

Family history of prostate cancer

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Amanwhosefather,brother,orsonhashadprostatecancerhasahigher-than-averageriskofprostatecancer.

Race
ProstatecanceroccursmoreofteninAfrican-Americanmenthaninwhitemen.African-Americanmenwithprostate
canceraremorelikelytodiefromthediseasethanwhitemenwithprostatecancer.

Hormones
Theprostateneedsmalehormonestoworkthewayitshould.Themainmalesexhormoneistestosterone.
Testosteronehelpsthebodydevelopandmaintainmalesexcharacteristics.
Testosteroneischangedintodihydrotestosterone(DHT)byanenzymeinthebody.DHTisimportantfornormal
prostategrowthbutcanalsocausetheprostatetogetbiggerandmayplayapartinthedevelopmentofprostate
cancer.

Vitamin E
TheSeleniumandVitaminECancerPreventionTrial(SELECT)foundthatvitaminEtakenaloneincreasedtheriskof
prostatecancer.TheriskcontinuedevenafterthemenstoppedtakingvitaminE.

Folic acid
FolateisakindofvitaminBthatoccursnaturallyinsomefoods,suchasgreenvegetables,beansandorangejuice.Folic
acidisaman-madeformoffolatethatisfoundinvitaminsupplementsandfortifiedfoods,suchaswhole-grainbreads
andcereals.A10-yearstudyshowedthattheriskofprostatecancerwasincreasedinmenwhotook1milligram(mg)
supplementsoffolicacid.However,theriskofprostatecancerwaslowerinmenwhohadenoughfolateintheirdiets.

Dairy and calcium

Adiethighindairyfoodsandcalciummaycauseasmallincreaseintheriskofprostatecancer.

The following protective factors may decrease the risk of prostate

cancer:
Folate
FolateisakindofvitaminBthatoccursnaturallyinsomefoods,suchasgreenvegetables,beansandorangejuice.Folic
acidisaman-madeformoffolatethatisfoundinvitaminsupplementsandfortifiedfoods,suchaswhole-grainbreads
andcereals.A10-yearstudyshowedthattheriskofprostatecancerwaslowerinmenwhohadenoughfolateintheir
diets.However,theriskofprostatecancerwasincreasedinmenwhotook1milligram(mg)supplementsoffolicacid.

Finasteride and Dutasteride

Finasterideanddutasteridearedrugsusedtolowertheamountofmalesexhormonesmadebythebody.Thesedrugs
blocktheenzymethatchangestestosteroneintodihydrotestosterone(DHT).HigherthannormallevelsofDHTmay
playapartindevelopingprostatecancer.Takingfinasterideordutasteridehasbeenshowntolowertheriskfor
prostatecancer,butitisnotknownifthesedrugslowertheriskofdeathfromprostatecancer.
TheProstateCancerPreventionTrial(PCPT)studiedwhetherthedrugfinasteridecanpreventprostatecancerin
healthymen55yearsofageandolder.Thispreventionstudyshowedtherewerefewerprostatecancersinthegroupof
menthattookfinasteridecomparedwiththegroupofmenthatdidnot.Also,themenwhotookfinasteridewhodid
haveprostatecancerhadmoreaggressivetumors.Thenumberofdeathsfromprostatecancerwasthesameinboth
groups.Menwhotookfinasteridereportedmoresideeffectscomparedwiththegroupofmenthatdidnot,including
erectiledysfunction,lossofdesireforsex,andenlargedbreasts.
TheReductionbyDutasterideofProstateCancerEventsTrial(REDUCE)studiedwhetherthedrugdutasteridecan
preventprostatecancerinmenaged50to75yearsathigherriskforthedisease.Thispreventionstudyshowedthere
werefewerprostatecancersinthegroupofmenwhotookdutasteridecomparedwiththegroupofmenthatdidnot.
Thenumberoflessaggressiveprostatecancerswaslower,butthenumberofmoreaggressiveprostatecancerswas
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not.Menwhotookdutasteridereportedmoresideeffectsthanmenwhodidnot,includingerectiledysfunction,lossof
desireforsex,lesssemen,andgynecomastia(enlargedbreasts).

The following have been proven not to affect the risk of prostate cancer,
or their effects on prostate cancer risk are not known:
Selenium and vitamin E
TheSeleniumandVitaminECancerPreventionTrial(SELECT)studiedwhethertakingvitaminEandselenium(a
mineral)willpreventprostatecancer.TheseleniumandvitaminEweretakenseparatelyortogetherbyhealthymen55
yearsofageandolder(50yearsofageandolderforAfrican-Americanmen).Thestudyshowedthattakingselenium
aloneorseleniumandvitaminEtogetherdidnotdecreasetheriskofprostatecancer.

Diet
Itisnotknownifdecreasingfatorincreasingfruitsandvegetablesinthediethelpsdecreasetheriskofprostatecancer
ordeathfromprostatecancer.InthePCPTtrial,certainfattyacidsincreasedtheriskofhigh-gradeprostatecancer
whileothersdecreasedtheriskofhigh-gradeprostatecancer.

Multivitamins
Regularuseofmultivitaminshasnotbeenproventoincreasetheriskofearlyorlocalizedprostatecancer.However,a
largestudyshowedanincreasedriskofadvancedprostatecanceramongmenwhotookmultivitaminsmorethan
seventimesaweek.

Lycopene
Somestudieshaveshownthatadiethighinlycopenemaybelinkedtoadecreasedriskofprostatecancer,butother
studieshavenot.Ithasnotbeenproventhattakinglycopenesupplementsdecreasestheriskofprostatecancer.

Cancer prevention clinical trials are used to study ways to prevent cancer.
Cancerpreventionclinicaltrialsareusedtostudywaystolowertheriskofdevelopingcertaintypesofcancer.Some
cancerpreventiontrialsareconductedwithhealthypeoplewhohavenothadcancerbutwhohaveanincreasedriskfor
cancer.Otherpreventiontrialsareconductedwithpeoplewhohavehadcancerandaretryingtopreventanother
cancerofthesametypeortolowertheirchanceofdevelopinganewtypeofcancer.Othertrialsaredonewithhealthy
volunteerswhoarenotknowntohaveanyriskfactorsforcancer.
Thepurposeofsomecancerpreventionclinicaltrialsistofindoutwhetheractionspeopletakecanpreventcancer.
Thesemayincludeeatingfruitsandvegetables,exercising,quittingsmoking,ortakingcertainmedicines,vitamins,
minerals,orfoodsupplements.

New ways to prevent prostate cancer are being studied in clinical trials.
Clinicaltrialsaretakingplaceinmanypartsofthecountry.InformationaboutclinicaltrialscanbefoundintheClinical
TrialssectionoftheNCIwebsite.CheckNCI'slistofcancerclinicaltrialsforprostatecancerpreventiontrialsthatare
acceptingpatients.

About This PDQ Summary

About PDQ
PhysicianDataQuery(PDQ)istheNationalCancerInstitute's(NCI's)comprehensivecancerinformationdatabase.The
PDQdatabasecontainssummariesofthelatestpublishedinformationoncancerprevention,detection,genetics,
treatment,supportivecare,andcomplementaryandalternativemedicine.Mostsummariescomeintwoversions.The
healthprofessionalversionshavedetailedinformationwrittenintechnicallanguage.Thepatientversionsarewrittenin
easy-to-understand,nontechnicallanguage.Bothversionshavecancerinformationthatisaccurateanduptodateand
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mostversionsarealsoavailableinSpanish.
PDQisaserviceoftheNCI.TheNCIispartoftheNationalInstitutesofHealth(NIH).NIHisthefederalgovernments
centerofbiomedicalresearch.ThePDQsummariesarebasedonanindependentreviewofthemedicalliterature.They
arenotpolicystatementsoftheNCIortheNIH.

Purpose of This Summary

ThisPDQcancerinformationsummaryhascurrentinformationaboutprostatecancerprevention.Itismeanttoinform
andhelppatients,families,andcaregivers.Itdoesnotgiveformalguidelinesorrecommendationsformaking
decisionsabouthealthcare.

Reviewers and Updates

EditorialBoardswritethePDQcancerinformationsummariesandkeepthemuptodate.TheseBoardsaremadeupof
expertsincancertreatmentandotherspecialtiesrelatedtocancer.Thesummariesarereviewedregularlyandchanges
aremadewhenthereisnewinformation.Thedateoneachsummary("DateLastModified")isthedateofthemost
recentchange.
Theinformationinthispatientsummarywastakenfromthehealthprofessionalversion,whichisreviewedregularly
andupdatedasneeded,bythePDQScreeningandPreventionEditorialBoard.

Clinical Trial Information

Aclinicaltrialisastudytoanswerascientificquestion,suchaswhetheronetreatmentisbetterthananother.Trialsare
basedonpaststudiesandwhathasbeenlearnedinthelaboratory.Eachtrialanswerscertainscientificquestionsin
ordertofindnewandbetterwaystohelpcancerpatients.Duringtreatmentclinicaltrials,informationiscollected
abouttheeffectsofanewtreatmentandhowwellitworks.Ifaclinicaltrialshowsthatanewtreatmentisbetterthan
onecurrentlybeingused,thenewtreatmentmaybecome"standard."Patientsmaywanttothinkabouttakingpartin
aclinicaltrial.Someclinicaltrialsareopenonlytopatientswhohavenotstartedtreatment.
ClinicaltrialsarelistedinPDQandcanbefoundonlineatNCI'swebsite.Manycancerdoctorswhotakepartinclinical
trialsarealsolistedinPDQ.Formoreinformation,calltheCancerInformationService1-800-4-CANCER(1-800-4226237).

Permission to Use This Summary

PDQisaregisteredtrademark.ThecontentofPDQdocumentscanbeusedfreelyastext.Itcannotbeidentifiedasan
NCIPDQcancerinformationsummaryunlessthewholesummaryisshownanditisupdatedregularly.However,auser
wouldbeallowedtowriteasentencesuchasNCIsPDQcancerinformationsummaryaboutbreastcancerprevention
statestherisksinthefollowingway:[includeexcerptfromthesummary].
ThebestwaytocitethisPDQsummaryis:
NationalCancerInstitute:PDQProstateCancerPrevention.Bethesda,MD:NationalCancerInstitute.Datelast
modified<MM/DD/YYYY>.Availableat:http://www.cancer.gov/types/prostate/patient/prostate-prevention-pdq.
Accessed<MM/DD/YYYY>.
Imagesinthissummaryareusedwithpermissionoftheauthor(s),artist,and/orpublisherforuseinthePDQ
summariesonly.IfyouwanttouseanimagefromaPDQsummaryandyouarenotusingthewholesummary,you
mustgetpermissionfromtheowner.ItcannotbegivenbytheNationalCancerInstitute.Informationaboutusingthe
imagesinthissummary,alongwithmanyotherimagesrelatedtocancercanbefoundinVisualsOnline.VisualsOnline
isacollectionofmorethan2,000scientificimages.

Disclaimer
Theinformationinthesesummariesshouldnotbeusedtomakedecisionsaboutinsurancereimbursement.More
informationoninsurancecoverageisavailableonCancer.govontheManagingCancerCarepage.

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