Prostate cancer is the most common cancer in men in the United Kingdom, after skin cancer. It is the second leading cause of death from cancer in men. Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer.

Almost all prostate cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Prostate cancer often has no early symptoms. Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions.

Prostate cancer usually grows very slowly. Most men with prostate cancer are older than 65 years and do not die from the disease. Finding and treating prostate cancer before symptoms occur may not improve health or help you live longer. Talk to your doctor about your risk of prostate cancer and whether you need screening tests.

KEY POINTS

• 1. Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate.
• 2. Signs of prostate cancer include a weak flow of urine or frequent urination.
• 3. Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer.
• 4. Certain factors affect prognosis (chance of recovery) and treatment options.

Prostate cancer does not normally cause symptoms until the cancer has grown large enough to put pressure on the urethra.

This normally results in problems associated with urination. Symptoms can include:

• 1. Needing to urinate more frequently, often during the night
• 2. Needing to rush to the toilet
• 3. Difficulty in starting to pee (hesitancy)
• 4. Straining or taking a long time while urinating
• 5. Weak flow
• 6. Feeling that your bladder has not emptied fully
• 7. Blood in the urine or semen.
• 8. Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia.
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Many men's prostates get larger as they get older due to a non-cancerous condition known as prostate enlargement or benign prostatic hyperplasia.

Symptoms that the cancer may have spread include bone and back pain, a loss of appetite, pain in the testicles and unexplained weight loss.

The following tests and procedures may be used:

• Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormal areas.
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• Prostate-specific antigen (PSA) test : A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH (an enlarged, but noncancerous, prostate).
• Transrectal ultrasound : A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Transrectal ultrasound may be used during a biopsy procedure.

• Transrectal magnetic resonance imaging (MRI): A procedure that uses a strong magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. A probe that gives off radio waves is inserted into the rectum near the prostate. This helps the MRI machine make clearer pictures of the prostate and nearby tissue. A transrectal MRI is done to find out if the cancer has spread outside the prostate into nearby tissues. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will check the tissue sample to see if there are cancer cells and find out the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumour will spread. The lower the number, the less likely the tumour is to spread.

  A transrectal biopsy is used to diagnose prostate cancer. A transrectal biopsy is the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells.

• The stage of the cancer (level of PSA, Gleason score, grade of the tumour, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the body).
• The patient’s age.
• Whether the cancer has just been diagnosed or has recurred (come back).

Treatment options also may depend on the following:

• Whether the patient has other health problems.
• The expected side effects of treatment.
• Past treatment for prostate cancer.
• The wishes of the patient.

Most men diagnosed with prostate cancer do not die of it.

About 1 man in 7 will be diagnosed with prostate cancer during his lifetime. Prostate cancer develops mainly in older men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66. There has been 46,690 new cases of prostate cancer in the UK with 11,287 deaths, 84% of people have survived prostate cancer in England and Wales.

• Prostate cancer is the second most common cancer in the UK (2014).
• Prostate cancer accounts for 13% of all new cases in the UK (2014).
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• In males in the UK, prostate cancer is the most common cancer, with around 46,700 cases diagnosed in 2014.
• More than half (54%) of prostate cancer cases in the UK each year are diagnosed in males aged 70 and over (2012-2014).
• Incidence rates for prostate cancer in the UK are highest in males aged 90+ (2012-2014).
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• Since the late 1970s, prostate cancer incidence rates in males have more than doubled (155% increase) in Great Britain; this is linked with PSA testing.
• Over the last decade, prostate cancer incidence rates in males have increased by around a twentieth (5%) in the UK.
• Most prostate cancer cases are diagnosed at an early stage.
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• Incidence rates for prostate cancer are projected to rise by 12% in the UK between 2014 and 2035, to 233 cases per 100,000 males by 2035.
• 1 in 8 men will be diagnosed with prostate cancer during their lifetime.
• Prostate cancer in England is less common in males living in the most deprived areas.
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• Prostate cancer is most common in Black males, then White males and least common in Asian males.
• In the UK more than 181,000 men were still alive at the end of 2006, up to ten years after being diagnosed with prostate cancer.
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• In Europe, around 417,000 new cases of prostate cancer were estimated to have been diagnosed in 2012. The UK incidence rate is 17th highest in Europe.
• Worldwide, more than 1.11 million men were estimated to have been diagnosed with prostate cancer in 2012, with incidence rates varying across the world.

Body weight, physical activity, and diet

The effects of body weight, physical activity, and diet on prostate cancer risk are not clear, but there are things you can do that might lower your risk, such as:

• 1. Eating at least 2½ cups of a wide variety of vegetables and fruits each day.
• 2. Being physically active.
• 3. Staying at a healthy weight.

Tomatoes and other red foods

Tomatoes, watermelon, and other red foods owe their bright color to a powerful antioxidant called lycopene. Studies show that men who consume this fruit and tomato-based products have a lower risk of prostate cancer than those who don’t.

Other findings suggest that cooking tomatoes makes it easier for your body to absorb lycopene. The redder the tomato, the better because lycopene accumulates during ripening. That means that pale, store-bought tomatoes that are picked too early have less lycopene than vine-ripened tomatoes.

The power of fruits and veggies

By eating fruits and vegetables throughout the day, you’ll be less likely to fill up on processed junk food.

Feast on fish

When compared to a high-fat diet, eating a low-fat diet and taking fish oil supplements has been found to slow the growth of prostate cancer cells. It’s easier to treat cancer that hasn’t yet spread outside the prostate.

Soybean and tea

A nutrient called isoflavones has been linked to a reduced risk of prostate cancer. 

Isoflavones are found in:

• 1. Tofu (made from soybeans)
• 2. Chickpeas
• 3. Lentils
• 4. Ifalfa sprouts
• 5. Peanuts
• Some studies have shown that men who drink green tea, or take green tea extract supplements, have a lower risk of prostate cancer than those who don’t.
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Pour Another Cup of Coffee

Decades of studies suggest that indulging a serious coffee habit is linked to a decreased risk of fatal prostate cancer:

• Drinking four to five cups of coffee every day can lower your chances of fatal and high-grade prostate cancer.
• Regardless of how many cups you drink overall, every three cups of coffee you drink can reduce your risk of fatal prostate cancer about 11 percent.

This describes a dose-response relationship between prostate cancer and coffee. That means the effect on prostate cancer goes up or down with the amount of coffee you drink. These effects may not extend to someone who only grabs an occasional cup.

However, high doses of caffeine can cause major health issues, such as irregular heartbeat and seizures. According to Mayo Clinic, the daily recommended amount of caffeine for most healthy adults is 400 milligrams — or about 1 1/2 cups.

How coffee is prepared can also be a factor. A study in Norway looked at coffee brewed with a filter, and boiled coffee, which doesn’t use such a filter. Men who drank boiled coffee seemed to have a lower risk of prostate cancer than men who drank coffee prepared another way or not at all.

The chemicals cafestol and kahweol have well-known cancer-fighting abilities. Researchers believe these chemicals are trapped when coffee runs through a paper filter. Boiled coffee may allow these cancer-fighting chemicals to stay in your daily brew.

The role of fat

Studies indicate a link between animal fats and an increased risk of prostate cancer. In addition to meat, animal fats are found in lard, butter, and cheese. Whenever possible, replace animal-based fats with plant-based fats. 

This, instead of that:

• 1. Olive oil instead of butter
• 2. Fruit instead of candy
• 3. Fresh vegetables instead of prepackaged foods
• 4. Nuts or seeds instead of cheese

Also, overcooking meat produces carcinogens, so be careful not to over-cook your meat.

Stop smoking

Prostate cancer patients who smoke are more likely to have a recurrence of the disease. 

Smokers are also more likely to have an aggressive form of prostate cancer.

It's not too late to quit. 

When compared with current smokers, prostate cancer patients who quit smoking for more than 

10 years had the same mortality risk as those who never smoked.

Controversial foods

Folate

Some studies suggest that low folate levels in your blood increase your risk for cancer. Folate is found in a variety of foods, including green vegetables, beans, and orange juice. Increasing your intake of these foods may reduce the risk of prostate cancer. 

However, supplementing with folic acid, a man-made form of folate, may increase the risk of cancer.

Dairy

Some studies have linked dairy products, or diets high in calcium, with an increased risk of prostate cancer, but this risk is considered minimal.

The importance of exercise

Too much fat, especially in the middle of your body, is linked to an increased risk of prostate cancer.

Regular exercise can help you maintain a healthy weight. Benefits of exercise include increased muscle mass and better metabolism. 

Try:

• 1. Walking
• 2. Running
• 3. Bicycling
• 4. Swimming

Exercise doesn't have to be boring. Vary your routine and invite your friends to participate. 

You're more likely to workout if it's fun.

Talk to your doctor

Ask your doctor about your risk for developing prostate cancer. Some points to discuss include:

• 1.What medical screening tests you should have as you age
• 2. Family history of cancer
• 3. Dietary recommendations