A Guide To Prostate Cancer Prevention

Prostate cancer is the second most common cancer diagnosed in men in the United States, after skin cancer.

The good news? Making smart choices in how we live can make a difference in reducing the risk of advanced prostate cancer. More men today are doing what they can to prevent the disease and screen for prostate cancer risk. They're getting active, eating better and getting regular check-ups with their provider.

Key Takeaways: Prostate Cancer Prevention

• Prostate cancer is common but highly treatable when caught early. It often grows slowly, has high survival rates and may not cause serious harm if the cancer is found while still confined to the prostate.
• Prostate cancer risk varies by age, race and family history. African American men and those with a family history face higher risk and may benefit from earlier screening and ongoing conversations with their provider.
• Screening matters, even if you don’t think you have prostate cancer symptoms. Prostate cancer often has no early warning signs, making PSA blood tests and digital rectal exams critical tools for early detection.
• Healthy lifestyle choices can reduce the risk of aggressive prostate cancer and death. Regular exercise, maintaining a healthy weight, eating a balanced diet and avoiding smoking and excessive alcohol can significantly improve long-term outcomes, even for men with genetic risk.

What Is Prostate Cancer?

Prostate cancer develops in a man's prostate, a tiny, walnut-shaped gland situated between the pubic bone and rectum that makes the fluid that nourishes and transports sperm. It is usually a slow-growing cancer and often curable.

Although prostate cancer is the second leading cause of cancer death in men, it is very treatable and may not cause serious harm if found while still isolated in the prostate gland.

About 90% of men with prostate cancer have a five-year survival rate, and more than 60% live 10 years or longer after the disease is discovered and treated.

In men, prostate cancer incidence is more than twice that of second‐ranking lung cancer.

What Are The Risk Factors For Prostate Cancer?

Because early detection can make all the difference, understanding your risk factors for prostate cancer is crucial.

“A lot of men will ask once they've been diagnosed with prostate cancer, ‘Doc, what did I do that caused this? Or what can I have done to prevent this?’ And my answer to them is really nothing,” said Robert Korsch, DO, a urological surgeon at Franciscan Health Michigan City. “It's a lot of these risk factors are things that you cannot modify are not lifestyle changes. It's all inherent really in your DNA.”

As we age, screening makes even more sense, especially because more than 75% of diagnoses occur in men older than 65.

Prostate cancer usually has no early warning signs, so men need to get screened, especially if they have these risk factors:

Advanced age

Your risk of developing prostate cancer increases as you get older. Men ages 50 and older are at higher risk. Almost 2/3 of all prostate cancers are found in men over age 65.

Being African American

Prostate cancer occurs more frequently in Black men - and they're more likely to have an aggressive form of the disease.

One study found that living in a disadvantaged neighborhood increased the likelihood of aggressive prostate cancer by 30% among Black men, but had no impact in white men, suggesting the contribution of race‐specific factors, such as minority stress.

"Interestingly African-American men have a much higher of prostate cancer than both white men and Asian men," radiation oncologist Sandeep Bhave, MD, an independent physician who practices at the Franciscan Health Cancer Center in Indianapolis, said. "For that reason, African-American men should discuss with their doctor about screening around the age of 45."

Family history of prostate cancer

If prostate cancer or breast cancer runs in your family, you may have an increased risk of developing prostate cancer.

"If you have a family history of prostate cancer, it's prudent start talking to your physician about screening at age of 40," Dr. Bhave said.

Dr. Korsch adds: “Men with a first degree relative with prostate cancer increases their risk by threefold. Even men with like a second degree relative of prostate cancer can increase their risk 1.5 fold”

Mutations in the BRCA gene or ATM gene can also increase your risk of prostate cancer.

“These are true gene mutations that increase the risk of prostate cancer in that lineage of that family,” Dr. Korsch said.

Diet

Men who have a diet high in red meat or high-fat dairy foods and low in vegetables and fruits may have a greater chance of getting prostate cancer.

"If you have a high-fat diet, reducing the amount of fats in your diet can also reduce your risk of prostate cancer," Dr. Bhave said.

Exposure to chemicals in the workplace

Men who were in contact with toxic chemicals at work may have a higher risk for prostate cancer. This includes firefighters. There is also some evidence that men who were exposed to Agent Orange, which was used during the Vietnam War, might be at higher risk for prostate cancer. But the exact link is not clear.

By understanding these risk factors, men can take proactive steps toward reducing their prostate cancer risk.

What Lifestyle Choices Can Help Prevent Prostate Cancer?

Researchers found that among men at increased genetic risk of prostate cancer, the men who maintained a healthy lifestyle were much less likely to die of the disease over nearly three decades.

"Healthy" meant they exercised regularly, didn't smoke, kept their weight down and ate fish over processed meats. However, healthy habits did not appear to protect men from developing prostate cancer in the first place. The research suggests that a healthy lifestyle may decrease your risk of aggressive prostate cancer - which is much more important.

While genetics plays a significant role in determining risk levels, a study published in the journal European Urology offered a hopeful message. Lifestyle changes, it found, can tilt the survival odds in your favor, even for those with a family history of prostate cancer.

In the study, men who committed to six healthy lifestyle choices reduced their risk of dying from prostate cancer by 45 percent. The essential decisions they made included:

• Eating a healthy diet full of fatty fish, tomato products and limited processed meats
• Getting regular vigorous exercise
• Maintaining a healthy weight
• Reducing alcohol intake
• Stopping smoking
• Talking to their provider about risk factors

Of all the lifestyle habits these men adopted, exercise seemed most important, followed by maintaining a healthy weight. So, to reduce your risk, it's important to embrace an active, health-conscious lifestyle, exercise regularly, eat wisely and keep tabs on your weight. These choices help reduce your risk and enhance your overall quality of life.

How Do Genetics Play A Role In Prostate Cancer?

The European Urology study found that men with genetic risk scores in the top 25 percent were over four times more likely to die of the disease compared to those in the bottom 25 percent.

Men can understand their genetic risk based on family history. According to the American Cancer Society, having a father or brother with prostate cancer more than doubles a man's risk of developing the disease. But based on the findings, a healthy lifestyle could help lower the excess risk linked to family history.

While most men today may not know their polygenic risk score - a comprehensive assessment of genetic risk factors - advancements in medical science could soon change this. By making it more accessible, this score could one day offer personalized insights into one's health track.

What Are The Signs Of Prostate Cancer?

In the early stages, prostate cancer doesn't cause any symptoms.

“The majority of prostate cancer is what we call clinically localized, meaning that the prostate cancer is just confined to the prostate and it has not spread outside the prostate,” Dr. Korsch said. “When prostate cancer is just contained within the prostate – which is practically 90-plus percent of men with prostate cancer – it is asymptomatic. Men do not have symptoms from this.”

Later prostate cancer symptoms

As prostate cancer metastasizes and progresses to an advanced stage, signs and symptoms surface. These symptoms include:

• Frequent urination or trouble urinating
• Painful and burning urination
• Weak urine flow
• Erectile dysfunction
• Blood in urine or semen
• Pelvic discomfort
• Painful ejaculation
• Discomfort in the pelvic area
• Bone pain
• General body stiffness

These signs can also indicate other illnesses. So, if you have any signs, you should seek an evaluation from a specialist in urological services who focuses on conditions of the male reproductive system.

Who Should Get A Prostate Cancer Screening?

Multiple trials have shown the greatest benefit in cancer detection when prostate cancer screening occurs between the ages of 55 and 70. Screening can make sense if the person is in reasonably good health and understands the limitations of what a prostate screening can show.

What Is a Prostate Cancer Screening Like?

A prostate cancer screening typically consists of a digital rectal exam, which physically checks the prostate for abnormal areas, or a PSA, or prostate-specific antigen, blood test. The PSA test examines the level of prostate-specific antigens in the blood.

What Do My PSA Test Results Mean?

In general, results below 4.0 ng/mL (nanograms per milliliter) are seen as normal.

“Generally speaking, for men aged 50 to 70, we want to see a PSA less than four,” Dr. Korsch said. “That usually indicates an overall lower risk of prostate cancer. And once that PSA starts getting up above four on more than one occasion, it just indicates that the risk of prostate cancer may be a little bit higher, and you should see a urologist to do some further testing.”

An elevated prostate-specific antigen level may indicate the presence of prostate cancer and may prompt additional testing or a biopsy to confirm whether cancer is present.

“It's key to understand that it is prostate-specific, but not cancer-specific,” Dr. Korsch said. “So just because it is elevated or determined to be abnormal, it does not mean that a man has prostate cancer, but it can sometimes give an indication that there may be a higher risk for prostate cancer to demand if the PSA is elevated.

“To also rule out the large proportion of men with a high PSA that do not have prostate cancer to spare them of a biopsy, we use a lot of these new genetic tests and biomarkers. With the increase in utilization of these new genetic tests, we are sparing about 20, 30% of men of an unnecessary biopsy. So we're limiting biopsies to just those men who we feel are going to be at highest risk.”

After other factors are eliminated, a prostate biopsy and prostate MRI may be scheduled to look for any concerning lesions, tumors, or growth within the prostate that looks suspicious for prostate cancer.

Does An Elevated PSA Test Always Mean Prostate Cancer?

“There are several other benign conditions of the prostate that can actually result in an elevated PSA,” Dr. Korsch said. “So not all PSA rises are due to prostate cancer.”

Other causes of an elevated PSA include:

• Prostatitis 
• Benign prostatic hyperplasia (BPH)
• Urinary tract infection or irritation
• Certain medications

“Think of it like as a marker of irritation,” Dr. Korsch said. “So when the prostate's irritated, whether it be from prostate cancer, whether it be from inflammation or just enlargement of the prostate, these are all medical conditions that can raise a man's PSA and only one of those is truly harmful being prostate cancer.”

Take Action: Your Prostate Health Is In Your Hands

With an estimated 333,830 men being diagnosed with prostate cancer in the U.S. in 2026, the need for prevention has never been greater. You can safeguard your health by embracing healthy lifestyle choices, having regular conversations with your doctor, and staying informed about your risk of prostate cancer. These actions also make you part of a community of men dedicated to beating the odds.