Prostate Cancer

In adult men, the prostate is a walnut-sized gland weighing about 20 grams, located just below the bladder and in front of the rectum. It surrounds the urethra (the passage that carries urine from the bladder) and is part of the male reproductive system. The prostate produces and stores about 30% of semen, playing an important role in sperm motility and fertility.

Prostate cancer occurs when cells in the prostate grow and divide abnormally, eventually forming a malignant tumor. While the cancer may remain confined to the prostate, it can also invade nearby tissues and spread to other organs through the blood vessels or lymphatic system.

Early stage

Most early-stage prostate cancers cause no symptoms. They are often detected incidentally during routine health screenings or while being evaluated for benign prostatic hyperplasia (BPH). Compared to many other cancers, prostate cancer usually progresses slowly. However, once it advances, patients may develop urinary symptoms or symptoms related to metastasis.

Urinary symptoms

• Difficulty starting urination
• Weak or interrupted urine stream
• Feeling of incomplete bladder emptying
• Urgency or urge incontinence
• Increased urinary frequency, both day and night
• Acute urinary retention (inability to urinate)
• Blood in urine or semen (hematuria, hematospermia)
• Pain during ejaculation

Symptoms of metastasis

• Flank pain (from ureteral obstruction, leading to hydronephrosis or renal failure)
• Bone pain due to skeletal metastasis
• Back pain, leg weakness, or numbness from spinal metastasis

Prostate cancer develops when the function of genes that normally suppress abnormal cell growth is impaired, and oncogenes that promote cancer cell development become activated. Its onset and progression are influenced by age, family history, diet, and male hormones.

Age

Age is the strongest risk factor. Prostate cancer is extremely rare before age 45, but the risk increases significantly with advancing age. While the association with aging is clear, the exact mechanisms remain under study.

Family history

About 9% of cases are associated with family history. The risk increases if multiple family members are affected.

Environmental and dietary factors

Dietary habits are among the best-recognized contributors. For example, Asian men who migrate to the United States have a higher incidence of prostate cancer than those in Asia, and subsequent generations show rates similar to American men. High-fat diets—particularly those rich in animal fat—are associated with nearly a twofold increase in risk.

Prevention of Prostate Cancer

Well-established risk factors for prostate cancer include age, race, hormones, family history, obesity, and occupational exposure to harmful substances. While age and race cannot be modified, other factors may be managed through lifestyle changes.

Maintain a healthy weight and exercise regularly

Obesity increases the risk of prostate cancer. Balanced nutrition and regular exercise (at least 30 minutes per session, three or more times a week) are recommended. Avoid prolonged sitting and incorporate consistent physical activity into daily life.

Regular screening

Annual digital rectal examinations (DRE) and prostate-specific antigen (PSA) testing are recommended beginning at age 50. For men with a family history of prostate cancer (father or brother), screening should begin at age 45.

Limit occupational exposure

Prostate cancer risk is higher among workers exposed to pesticides, organic solvents, radiation, and metallic dust, as well as in jobs with prolonged vibration exposure or low physical activity. Compliance with workplace safety guidelines and minimizing exposure is essential.

Dietary recommendations

• Reduce animal fat intake: High-fat diets, especially those rich in animal fat, are associated with increased prostate cancer risk.
• Soy and soy-based foods: Foods such as tofu and fermented soy products (e.g., miso) may offer protective benefits.
• Vegetables and fruits: Fresh, seasonal vegetables and fruits help reduce cancer risk.