On a basic level, prostate cancer is caused by changes in the DNA of a prostate cell. Scientists have made great progress in understanding how certain changes in DNA can make normal prostate cells grow abnormally and form cancers. DNA is the chemical in each of our cells that makes up our genes, the instructions for nearly everything our cells do. We usually look like our parents because they are the source of our DNA. However, DNA affects more than how we look.
Some genes control when our cells grow, divide into new cells, and die. Certain genes that help cells grow, divide, and stay alive are called oncogenes. Others that normally slow down cell division, repair mistakes in DNA, or cause cells to die at the right time are called tumor suppressor genes. Cancer can be caused in part by DNA changes (mutations) that turn on oncogenes or turn off tumor suppressor genes.
Prostate Cancer Causes
DNA changes can either be inherited from a parent or can be acquired during a person’s lifetime.
Inherited DNA mutations
Inherited DNA changes in certain genes seem to cause about 5% to 10% of prostate cancers. Several mutated genes have been linked to a man’s inherited tendency to develop prostate cancer, including:
- RNASEL (formerly HPC1): The normal function of this tumor suppressor gene is to help cells die when something goes wrong inside them. Inherited mutations in this gene might let abnormal cells live longer than they should, which can lead to an increased risk of prostate cancer.
- BRCA1 and BRCA2: These tumor suppressor genes normally help repair mistakes in a cell’s DNA (or cause the cell to die if the mistake can’t be fixed). Inherited mutations in these genes more commonly cause breast and ovarian cancer in women. But inherited BRCA changes also account for a very small number of prostate cancers.
- DNA mismatch repair genes (such as MSH2 and MLH1): These genes normally help fix mistakes (mismatches) in DNA that are made when a cell is preparing to divide into 2 new cells. (Cells must make a new copy of their DNA each time they divide.) Men with inherited mutations in these genes have a condition known as Lynch syndrome, and are at increased risk of colorectal, prostate, and some other cancers.
Other inherited gene mutations may account for some cases of hereditary prostate cancer, although none of these is a major cause. More research is being done on these genes.
Can prostate cancer be found early?
Screening refers to testing to find a disease such as cancer in people who don’t have symptoms of that disease. For some types of cancer, screening can help find cancers at an early stage, when they are more easily cured.
Prostate cancer can often be found early by testing the amount of prostate-specific antigen (PSA) in a man’s blood. Another way to find prostate cancer is the digital rectal exam (DRE), in which the doctor puts a gloved finger into the rectum to feel the prostate gland. These 2 tests are described in more detail in our document Prostate Cancer Prevention and Early Detection.
If the results of either one of these tests are abnormal, further testing is needed to see if there is a cancer. If prostate cancer is found as a result of screening with the PSA test or DRE, it will probably be at an earlier, more treatable stage than if no screening were done.
There is no question that screening can help find many prostate cancers early, but there are still questions about whether this saves lives. There are clearly both pros and cons to the prostate cancer screening tests in use today.
At this time, the American Cancer Society (ACS) recommends that men thinking about having prostate cancer screening should make informed decisions based on available information, discussion with their doctor, and their own views on the benefits and side effects of prostate cancer screening and treatment.
Signs and symptoms of prostate cancer
Early prostate cancer usually causes no symptoms. But more advanced prostate cancers can sometimes cause symptoms, such as:
- Problems passing urine, including a slow or weak urinary stream or the need to urinate more often, especially at night.
- Blood in the urine
- Trouble getting an erection (erectile dysfunction)
- Pain in the hips, back (spine), chest (ribs), or other areas from cancer that has spread to bones
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord.
Other conditions can also cause many of these same symptoms. For example, trouble passing urine is much more often caused by benign prostatic hyperplasia (BPH) than cancer. Still, it’s important to tell your doctor if you have any of these problems so that the cause can be found and treated, if needed.
Adult Pediatric Urology & Urogynecology, PC
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