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Causes and Risk Factors of Prostate Cancer

Prostate Cancer is a malignant-malignant tumor of the prostate gland that is seen in men over 40-45 years of age and its frequency increases significantly as age increases. Prostate cancer is the second most common cancer in men, and ranks fifth in cancer-related deaths worldwide. The lifetime risk of developing prostate cancer was 6%, and the rate of death from this disease was approximately 2.9%. In autopsy examinations performed on men who died outside of prostate cancer, the rate of microscopic prostate cancer was found to be 60-80%, especially in men aged 80 and over. It shows that the risk of prostate cancer increases with age. Roughly, only 1/5 of lifetime prostate cancers are diagnosed in men, and the remaining 4/5 die from a cause other than prostate cancer. Roughly 1/5 of those diagnosed and treated with prostate cancer die from prostate cancer. In other words, although it is so common, it is not such a lethal type of cancer. This information indicates that our patients should be divided into two groups as clinically significant or fatal prostate cancer and clinically insignificant or untreated prostate cancer. Improvements in diagnostic tools and increase in life expectancy increase the number of diagnosed prostate cancers. With the widespread use of PSA (prostate specific antigen), the number of patients diagnosed with prostate cancer has doubled, and the number of clinically insignificant and perhaps untreated prostate cancers is also increasing. In this percentage, screening using PSA blood test after a certain age leads to earlier and more prostate cancer diagnosis, negative side effects of treatment in some patients, deterioration in quality of life and additional surgery risk and some economic losses. Moreover, treatment methods are not standard for every patient, especially in prostate cancer confined to the prostate, treatment alternatives vary according to the patient's age, cancer stage and grade, sexual activity or not, and the socio-cultural and economic conditions of the patient. It seems more reasonable to screen people who are genetically at risk for prostate cancer.

Definitive Risk Factors for prostate cancer:

1- Age: The risk of developing prostate cancer increases with age. The average age at diagnosis of prostate cancer is 69 years. Prostate cancer is rare under the age of 40 (1/10 000), the risk of prostate cancer is 1/103 in the 40-59 age group and 1/8 in the 60-79 age group. This shows us that age is the most important risk factor.

2-Familial and genetic predisposition: Prostate cancer seen in a member of the family, risk of being seen in other male family members is 4-6 times higher than normal people. This rate was found to be 5 times higher if the individual with the disease was diagnosed at the age of 60, and 7 times higher in other family members if this diagnosis was made at the age of 50. Accordingly, the second most important risk for prostate cancer is the presence of a patient with prostate cancer in his family. This risk increases as the number of prostate cancer patients in the family increases. In addition, if there is a family history of prostate cancer, the risk of breast cancer has also increased in women. 9% of all prostate cancers and 45% of prostate cancers under the age of 55 are genetic, and the prognosis of prostate cancers with this genetic feature is worse.

3-Race: Prostate cancer is seen 3-4 times more frequently in black race than yellow (far eastern) and white race, and it progresses worse than other races. Death rates due to prostate cancer were found to be higher in black races. The average serum androgen (male hormone) ratios were found to be approximately 20% higher in the black race than in the other races, although this is important in showing us a relationship between plantation hormone and prostate cancer, this relationship has not been proven. Although anti-androgens are used as the main treatment, the role of androgens in prostate cancer has been counted among possible risk factors.

4-Nutrition: Western-type fatty, fiber-free, plant-based diet, and obesity are among the possible risk factors for prostate cancer. Because the incidence of prostate cancer in the Far East is much less common than in the American population, while this rate is close to the current rates in the United States among immigrants from the Far East. This shows how important nutrition is in the risk of developing clinical prostate cancer. Fish consumption has been shown to reduce prostate cancer. Obesity has also been shown to adversely affect the course of prostate cancer. Intake of lycopene, selenium, omega-3 fatty acids (fish) and vitamin E reduces the risk, while calcium and excessive vitamin D intake increases the risk.

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