Prostate cancer affects the prostate gland, which is involved in producing seminal fluid (part of semen). It is the most common cancer affecting men, almost always older men (it’s rare under 50), but it is not as deadly as you might think: 5-year survival is 90%+ and most men with prostate cancer die from something else.

The cause of prostate cancer is not known but having a first-degree relative with prostate cancer roughly doubles the risk while a diet that is high in processed meats, red meat, and dairy may also increase risk. Various vitamins and other supplements have been claimed to reduce risk but the evidence behind these claims is poor.

Prostate cancer often cause no symptoms at all (especially in the early stages) but can cause difficulty urinating, blood in the urine, and pain (pelvis and lower back). It is important to know that benign prostate hypertrophy (BPH), which is extremely common in older men, can cause very similar symptoms. A biopsy (removal of a small piece of tissue) is needed to make the diagnosis.

The treatment of prostate cancer may include surgery, radiation, hormone treatments, and chemotherapy, although more conservative approaches (e.g. wait-and-see while treating any symptoms) are often appropriate given the nature of this cancer.

Screening for prostate cancer is controversial. The well-known Prostate Specific Antigen (PSA) blood test can pick up prostate cancer but it is not a perfect test (e.g. there are many false positives) and many studies have shown no improvement in outcomes even with earlier diagnosis. To make matters more complex, the various treatments cause significant quality-of-life problems (e.g. erectile dysfunction after surgery). This is a problematic area and men are best advised to do their own research and to have discussions with their own doctors before making any decisions.

Prostate cancer is common but not as deadly as many other cancers. Screening is controversial and so definitive advice cannot be given. Men are advised to discuss this with their own doctors.