Prostate cancer is expected to account for an estimated 33% (230,110) of incident cases and 10% of deaths from cancer in men in 2004.¹ Prostate cancer is generally slow-growing, but as the disease progresses, it metastasizes, primarily to bone (stage D).

After lung cancer, prostate cancer is the leading cause of cancer-related deaths among men in the United States.¹ The incidence of prostate cancer increases with age and is found most often in men older than age 50; more than 70% of all prostate tumors are found in men older than 65. It is more common in African American men, in whom it is more aggressive and progressive and results in more advanced disease. These men also have a higher grade carcinoma at diagnosis.

Although prostate cancer is less common in Asian and American Indian men, the risk for prostate cancer appears to increase in Asian men the longer they live in Western culture. Prostate cancer is less common in Asia and in Central America; a diet lower in dietary fats and red meat, along with more exposure to sunlight and therefore higher levels of vitamin D, may partially account for these differences.²

The cause of prostate cancer is still unclear; however, certain correlations seem to have developed.³

• Age and race are risk factors, as discussed above.
• Persons with a family history of prostate cancer may have a greater incidence. The risk doubles with one first-degree relative, increases fivefold with two close relatives, and approximates certainty with three or more close relatives affected with the disease.
• A diet high in animal fat and polyunsaturated fats also may be a factor for increased incidence.
• A diet deficient in cruciferous vegetables (eg, brussel sprouts and cauliflower) and tomatoes and other fruits (especially those that are sources of lycopene, antioxidants, and fiber) may be associated with a higher incidence of prostate cancer. A deficiency in vitamin D (dietary or from a lack of sunlight on skin) also may be a factor in a higher incidence of the disease.
• Obesity also may be a risk factor, and weight gain earlier in life may be negatively associated with survival in men who go on to develop prostate cancer.

In advanced disease, metastases to the bones of the pelvis, spine, and ribs are especially common. These metastases make the bone more susceptible to complications, such as fractures, and are usually painful.

Osteoporosis is common in men as well as women, and in the United States, it is prevalent in more than 1.5 million men older than 65, and another 3.5 million men are at risk.⁴ In men with advanced metastatic prostate cancer, androgen deprivation treatment to arrest the spread of cancer may contribute to additional bone loss as a result of increased bone turnover and a decrease in bone mineral density. These effects can result in skeletal-related events such as fractures,⁴ spinal cord compression, and pain. This condition is referred to as treatment-related osteoporosis or cancer-treatment–induced bone loss.

Prostate cancer can be treated effectively by surgery or radiation if it is diagnosed at an early stage. However, many men require additional treatment due to recurrence of the cancer. While in some men the disease is very aggressive and requires treatment, in others it is slow-growing and unlikely to cause serious problems.

The 5-year survival rate for prostate cancer diagnosed at all stages is 98%. The relative 10-year survival rate is 84%, and the 15-year survival rate is 56%.⁵

1.	Jemal A, Tiwari RC, Murray T, et al. Cancer Statistics, 2004. CA Cancer J Clin. 2004;54:8-29.
2.	Prostate Cancer Foundation. About Prostate Cancer: prostate cancer overview: causes and risk factors. Available at http://www.prostatecancerfoundation.org/site/pp.asp?c=it IWK20SG&b=70619. Accessed December 2004.
3.	Prostate Cancer Foundation. Report to the nation on prostate cancer 2004. Available at http://www.prostatecancerfoundation.org. Accessed December 2004.
4.	Smith MR. Management of treatment-related osteoporosis in men with prostate cancer. Cancer Treat Rev. 2003;29:211-218.
5.	American Cancer Society. Cancer Facts and Figures 2004. Atlanta, Ga: American Cancer Society; 2004.