Prostate Cancer in Older Men

Dorothy A. Calabrese, MSN, RN, CURN, CNP

Disclosures

Urol Nurs. 2004;24(4) 

In This Article

Risk Factors and Etiology

There are several known risk factors for prostate cancer. These include increasing age, race, family history, and dietary intake of fats (Presti, 2004). A man age 60 to 79 has a probability of 1 in 8 of being diagnosed with prostate cancer, a significant increase compared to a younger man age 40 to 59 who has a 1 in 103 chance of a prostate cancer diagnosis (Presti, 2004). African-American men are at increased risk, although the reason for the phenomena is unknown. Relatives diagnosed with prostate cancer put a man at increased risk. The number of relatives and their age at diagnosis increases the risk; the younger the age of the relative at the time of diagnosis, the higher the relative risk for the male relative (Presti, 2004). A diet high in fat is a possible risk factor. Cadmium exposure (cigarette smoke, alkaline batteries, and working in the welding industry) may increase the risk, although this is a weak risk factor (Presti, 2004).

Published studies do not prove a cause-effect association for vasectomy as a risk factor (Presti, 2004). The underlying reason for the possible relationship is unknown. Elevations in antispermatozoa antibodies, decreases in seminal hormone concentrations, and decreases in prostatic secretion have been reported in men who have undergone vasectomy. How these effects might relate to the development of Ca P is unknown (Platz, Kantoff, & Giovannucci, 2000). There is also speculation that men who have undergone vasectomy may seek medical care more frequently, leading to earlier diagnosis of Ca P (Presti, 2004).

The etiology of Ca P is unknown. Many theories have been proposed through the years, but none has ultimately been proven. Increased male hormones and infections are two theories that continue to be discussed. What is currently known is that the gene responsible for familial Ca P resides on the long arm of chromosome 1 and PCAP and CAPB genes. In addition, there are tumor-suppression genes in several areas of the human genome that have been identified as possible areas involved in developing Ca P (Presti, 2004). As scientific knowledge of Ca P increases, the cause and natural course of the disease may be discovered.

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