Prostate Cancer

• Prostate cancer affects the prostate, a walnut-sized male sex gland located just below the bladder, and occurs most often in men older than 55.

• The majority of prostate cancers that are detected by screening tend to be small and grow slowly. Chances of surviving most early-stage, low-grade prostate cancers are excellent.

• Prostate cancer treatment is controversial. Many men with small cancers will not benefit from treatment, because the cancer grows so slowly that it will cause no problems. But it is currently not possible to determine which prostate cancers will grow rapidly, making decisions about when to start treatment and which treatment to use very difficult.

• Prostate cancer ranks as the most common form of cancer among men in the United States and is second only to lung cancer in the number of annual cancer deaths among U.S. men.

Obesity – Obese men who are diagnosed with prostate cancer have more than two-and-a-half times the risk of dying from the disease as compared to men of normal weight at the time of diagnosis, according to a study by Dr. Alan Kristal and colleagues. In an earlier study of more than 10,000 men, Kristal found that obese men have an 80 percent higher risk of developing aggressive prostate cancer. Learn more »

Diet – Separate studies led by Drs. Alan Kristal and Ulrike Peters have found a connection between greater consumption of dark green and cruciferous vegetables, especially broccoli and cauliflower, and decreased risk of aggressive prostate cancer. That research also shows that eating more tomatoes and fruit does not help prevent prostate cancer. Drs. Daniel Lin, Marian Neuhouser and Kristal are also examining how a biologically active compound in broccoli called sulforaphane affects mechanisms in prostate tissue that are related to cancer development.

Smoking – Middle-aged men who are long-term, heavy smokers face twice the risk of developing aggressive forms of prostate cancer than men who have never smoked, according to a study by Drs. Janet Stanford, Thomas Vaughan and colleagues. Learn more »

Red wine – Men who drank four or more 4-ounce glasses of red wine per week experienced about a 60 percent lower incidence of the more aggressive types of prostate cancer, according to a study led by Dr. Stanford. Learn more »

Selenium and Vitamin E – Through the nation's largest-ever cancer prevention study, our researchers are helping to determine whether vitamin E and the trace element selenium, taken together or separately, can prevent prostate cancer. The Hutchinson Center houses the group overseeing data analysis for the effort. The Selenium and Vitamin E Cancer Prevention Trial (SELECT) study launched in 2001 and has enrolled more than 34,000 men. Learn more »

Dr. Ulrike Peters and colleagues have published studies showing an association between taking supplemental doses of vitamin E and selenium and decreased prostate cancer risk in smokers. Another study published by Dr. Peters and colleagues found that risk of advanced prostate cancer was significantly smaller in men who took supplemental dosages of vitamin E for an average of 10 years.

Smokers, dairy and fatty foods – Research led by Dr. Marian Neuhouser has found that current or former heavy smokers who ate more dairy foods had a 41 percent reduced risk of aggressive prostate cancer, compared to men in that category with lower dairy intake. On the other hand, smokers who followed diets rich in omega-6 fatty acids—found in large quantities in safflower, soybean and corn oils—faced a more than doubled risk of prostate cancer, but only if they had a family history of prostate cancer. Learn more »

Family history – The Prostate Cancer Genetic Research Study (PROGRESS) is an international research project exploring why some families have several men, often in multiple generations, who have been diagnosed with prostate cancer. Discovering the inherited genetic mutations for prostate cancer in families and how they work will hopefully provide new clues to help diagnose, treat, cure and even prevent prostate cancer in future generations.

Improving existing detection methods – Measuring a man's prostate-specific antigen, or PSA, level is the most common test for early detection of prostate cancer, but studies have shown the method may detect tumors that would never require treatment while failing to find some aggressive cancers. Dr. Ruth Etzioni and colleagues were among the first to formally evaluate the test's ability to distinguish between true cancers and benign conditions. They have concluded that a variation on the PSA test that uses two types of PSA measurements could improve the test's accuracy for men with borderline-normal total PSA levels, potentially leading to a significant drop in medical costs and complications for this group of men. Learn more »

Avoiding ‘overdiagnosis’ – Dr. Etzioni and colleagues have also determined that roughly one-third of older men diagnosed with prostate cancer through the PSA test are "overdiagnosed" with the disease, meaning patients are receiving unnecessary surgeries or other treatments even though the disease isn't likely to threaten their health. Learn more »

Identifying aggressive prostate cancer – Dr. Peter Nelson is leading the first systematic surveillance study of men with prostate cancer, with a goal of finding biological clues—known as biomarkers—to answer a key question that has vexed researchers: when to take a "wait and watch" approach to prostate cancer and when to treat the disease. Five other institutions will enroll patients for the Prostate Active Surveillance Study and the Hutchinson Center will house the study's blood and DNA samples. Learn more »

Detecting aggressive prostate cancer – Dr. Janet Stanford and an international team of scientists have identified five inherited genetic variants strongly associated with aggressive, lethal prostate cancer. The discovery could lead to a simple blood test that would help determine which men should receive the most aggressive treatment options. Dr. Stanford, co-director of the Hutchinson Center’s Program in Prostate Cancer Research, is planning additional studies with collaborators to better understand the research findings. Learn more »

Diagnosis and ethnicity – Dr. Etzioni and colleagues published the first study to document that frequency of prostate cancer testing is associated with a patient's race. They found that African-American men with prostate cancer are half as likely as Caucasian men to receive annual blood tests—called prostate-specific antigen, or PSA, tests—to monitor their disease. Learn more »

Understanding progression – Dr. Valeri Vasioukhin and colleagues have uncovered a key driver behind the progression of prostate cancer—a discovery that could spawn new treatments to prevent the cancer's spread and improve survival rates. The researchers found that a protein called hepsin caused prostate-tumor cells to lose their grip from the surrounding tissue and spread from the prostate to bone, lung and liver. Learn more »

Understanding resistance to treatment – Drs. Peter Nelson and Elahe Mostaghel, along with colleagues at the University of Washington and Oregon Health Sciences University, uncovered what may be the key to understanding why prostate tumors eventually become resistant to androgen-deprivation, or hormone-withdrawal, therapy. Their findings could help lead to better treatments for cancer that has spread beyond the prostate to distant sites throughout the body, such as bone, lymph nodes and internal organs. Learn more »

Ethnicity and treatment – A Hutchinson Center research team has found that African-American men with prostate cancer were 26 percent less likely to receive aggressive hormone treatment for early stage prostate cancer than their Caucasian peers. Learn more »

Understanding side effects of treatment – Dr. Janet Stanford and colleagues have shown that survival rates are comparable for the two major treatments for prostate cancer—radiation and prostate-removal surgery. The research shows that radiation therapy is better for avoiding urinary incontinence and impotence, but surgery is better for avoiding complications of bowel function. This knowledge allows men to make treatment decisions based on quality-of-life concerns.

Dr. Stanford and colleagues also completed the first comprehensive study of sexual and urinary function among men who underwent radical prostatectomy—that is, surgery to remove the entire prostate—for early-stage cancer. The team found the impotence rate among these men was much higher than previously reported