Men's Health

THE STATS
What is the chance for a diagnosis of prostate cancer?

• In New Zealand, prostate cancer is the most common cancer in men. About 2,500 new cases of prostate cancer are diagnosed each year
• 1 in 10 New Zealand men will develop prostate cancer
• The number of men who die of prostate cancer is  similar to the number of women who die of breast cancer
• Men who develop prostate cancer are mostly over the age of 65. It rarely occurs in men younger than 55. About one in  14 men will develop prostate cancer before the age of  80. In very elderly men, prostate cancer often grows very slowly and may cause no symptoms
• While there are cases of prostate cancer showing up in younger men, it is recommended that men begin an annual screening at age 50 and at age 40 if there is a family history
• The chance of developing prostate cancer increases:
  - As men get older
  - If there is a family history of prostate cancer e.g. a man with a father or brother diagnosed with prostate cancer

 
WHAT IS PROSTATE CANCER?

The prostate is a gland found only in men and is located just below the bladder and in front of the rectum. Prostate cancer occurs when cells within the prostate grow uncontrollably, creating small tumors. The term “cancer” refers to a condition in which the regulation of cell growth is lost and cells grow uncontrollably. Most cells in the body are constantly dividing, maturing and then dying in a tightly controlled process. Unlike normal cells, instead of dying as they should, cancer cells outlive normal cells and continue to form new, abnormal cells.

Abnormal cell growths are called tumors. The term “primary tumor” refers to the original tumor; secondary tumors are caused when the original cancer spreads to other locations in the body. Prostate cancer typically is comprised of multiple very small, primary tumors within the prostate. At this stage, the disease is often curable (rates of 90% or better) with standard interventions such as surgery or radiation that aim to remove or kill all cancerous cells in the prostate. Unfortunately, at this stage the cancer produces few or no symptoms and can be difficult to detect.

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WHAT IS METASTATIC PROSTATE CANCER?

Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. If untreated and allowed to grow, the cells from these tumors can spread in a process called metastasis. In this process, prostate cancer cells are transported through the lymphatic system and the bloodstream to other parts of the body, where they lodge and grow secondary tumors. The most common sites of cancer metastasis are the lungs, bones and liver. Once the cancer has spread beyond the prostate, cure rates drop dramatically.

In most cases, prostate cancer is a relatively slow-growing cancer, which means that it typically takes a number of years for the disease to become large enough to be detectable, and even longer to spread beyond the prostate. This is good news. However, a small percentage of patients experience more rapidly growing, aggressive forms of prostate cancer. Unfortunately, it is difficult to know for sure which prostate cancers will grow slowly and which will grow aggressively – complicating treatment decisions.

The spread of cancer outside the prostate can be detected by the presence of prostate cancer cells in areas surrounding the prostate such as the seminal vesicle (glands near the bladder), lymph nodes in the groin area, the rectum and bones. When prostate cancer spreads to another site, such as bone, the new tumor is still considered to be prostate cancer, not bone cancer.
 

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HOW COMMON IS PROSTATE CANCER?
1 in 10 Kiwis will develop prostate cancer in their lifetime. Each year in New Zealand, about 2,500 new cases of prostate cancer are diagnosed each year
 

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HOW CURABLE IS PROSTATE CANCER?
As with all cancers, "cure" rates for prostate cancer describe the percentage of patients likely remaining disease-free for a specific time. In general, the earlier the cancer is caught, the more likely it is for the patient to remain disease-free.
Because approximately 90% of all prostate cancers are detected in the local and regional stages, the cure rate for prostate cancer is very high—nearly 100% of men diagnosed and treated at this stage will be disease-free after five years. By contrast, in the 1970s, only 67% of men diagnosed with local or regional prostate cancer were disease-free after five years.

Yet being diagnosed with prostate cancer can be a life-altering experience. It requires making some very difficult decisions about treatments that can affect not only the life of the man diagnosed, but also the lives of his family members in significant ways for many years to come.
 

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RISK FACTORS

Prostate cancer is the most commonly diagnosed cancer in New Zealand, affecting 1 in 10 men. The older you are, the more likely you are to be diagnosed with prostate cancer

The roles of ethnicity and family history are important as well. African American men are 60% more likely to develop prostate cancer compared with Caucasian men and are nearly 2.5 times as likely to die from the disease.

While New Zealand's overall rate of testicular cancer is similar to many other developed countries overseas, a recent study found "interesting" results when it came to ethnicity. Maori men had 50% more testicular cancer than European New Zealanders, while Asian and Pacific men had 50 % less than Europeans

Genetic studies suggest that strong familial predisposition may be responsible for 5%-10% of prostate cancers.

Men with a first-degree relative - father, brother or son - with a history of prostate cancer are twice as likely to develop the disease, while those with two or more relatives are nearly four times as likely to be diagnosed. The risk is even higher if the affected family members were diagnosed at a young age, with the highest risk seen in men whose family members were diagnosed before age 60.

Although genetics might play a role in deciding why one man might be at higher risk than another, social and environmental factors, particularly diet and lifestyle, are likely to have an effect as well.

In recent years, research has shown that diet modification might decrease the chances of developing prostate cancer, reduce the likelihood of having a prostate cancer recurrence, or help slow the progression of the disease.

When weighing risk factors for prostate cancer, it’s also important to recognise that there are non-risk factors, or factors that have not been linked to an increase in risk.