What Causes Prostate Cancer, and How Do You Prevent It?

You’ve probably heard of prostate cancer. After all, it’s one of the most common cancers worldwide. About 1 in 8 men in the U.S. will get it during their lifetime. 

Scientists don’t know exactly what causes prostate cancer in an individual. But they know that it’s linked to many different factors, including gene changes and certain health conditions. It’s also associated with other factors like age, ethnicity, diet, and activities. 

Research also shows that there are different types of prostate cancer with different risks — and the causes of more aggressive prostate cancers can be different from what causes slower growing prostate cancers. Some of the causes of aggressive prostate cancers are related to lifestyle, which means there are strategies you can use to potentially lower your risk.

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Read on for more information about prostate cancer, how and why it occurs, and how to keep your prostate healthy. 

What causes prostate cancer?

Scientists don’t know exactly what causes prostate cancer. Cancer is a disease where cells in the body grow and accumulate in an abnormal way. 

This typically happens due to a combination of: 

• Your genetics

• The environment your body is exposed to

• Age (cancer becomes more likely as you get older) 

Prostate cancer probably begins with changes in your genes (DNA). Your genes are in charge of how your cells function and behave — including how they grow. But sometimes, the genes in your prostate cells can change or get damaged. This can lead to abnormal prostate cells that grow too fast (cancer cells). 

As the cancer cells continue to grow, they can crowd out healthy cells. The cancer cells can also spread into other parts of your body and cause problems.  

How do you diagnose prostate cancer?

If your healthcare provider suspects you have prostate cancer, they may recommend you get a prostate biopsy. A biopsy is a medical procedure in which a small amount of cells is removed from your body. It’s the best test there is for helping diagnose prostate cancer. 

Your healthcare providers will examine the cells under a microscope to figure out whether you have prostate cancer — and how likely it is to spread. If you do have prostate cancer, your healthcare team will assign it to a certain “stage.” This helps you and your team make decisions about your care. 

Prostate cancer staging is based on:

• Your prostate-specific antigen (PSA) level

• How far the tumor has spread in your prostate (T classification)

• How abnormal and aggressive your cancer cells are (Gleason score and grade group)

• Whether the cancer has spread to other parts of your body

Depending on what type of prostate cancer you have, your doctor will recommend either watchful waiting (surveillance) or appropriate treatment. 

Are there different types of prostate cancer?

Yes. There are several different types of prostate cancer. These different cancers are caused by different types of abnormal prostate cells. These include:

• Adenocarcinoma (most common)

• Sarcoma

• Transitional cell carcinoma

• Small cell carcinoma

Most people who have prostate cancer have adenocarcinoma of the prostate. When people talk about the type of prostate cancer they have, they tend to refer to the cancer’s severity. The severity refers to whether the prostate cancer is localized or has spread. This is known as “staging.”   

Who is at risk for prostate cancer?

It’s impossible to say for sure who will get prostate cancer. Anyone with a prostate can get prostate cancer, including men, trans women, and nonbinary people. But research studies show that some of the most important risk factors include your:

• Age: Age is the biggest risk factor for prostate cancer, especially after age 50. Prostate cancer is less common in men younger than 40, but your risk increases with every decade — even into your 90s.

• Race and ethnicity: Black men have a higher risk of prostate cancer. Black men are 75% more likely to get prostate cancer compared with white men, while men who are Asian/Pacific Islanders are less likely to get prostate cancer compared with white men. 

• Family history: Having more than one first-degree relative (parent, sibling, child) with prostate cancer increases your risk. Your risk is even higher if you have multiple generations of family members who had prostate cancer, or if you have relatives who had it at a young age or died from it. 

• Inherited genes: Certain gene mutations can make you more likely to get prostate cancer. This includes genes like BRCA1 or 2, HOXB13, ATM, and other DNA repair enzymes. Multiple genes can also affect your risk of prostate cancer risk — not just single genes. This is called “polygenic risk.” There are clinical tests that can measure the presence of these genetic risks at an individual level.

• Environment: Exposure to certain toxins can increase your risk of getting prostate cancer. This includes chemicals like Agent Orange, chlordecone (an insecticide), and bisphenol A (found in plastics).

• Location: Prostate cancer is more common in people who live in certain areas of the world. This includes North America, northern Europe, Australia, and Caribbean islands. We don’t know exactly what causes this. It may be related to screening frequency, genetics, and environmental factors.

• Smoking habits: There's some evidence that smoking cigarettes could increase your risk, though more research is needed in this area.

Can diet affect your risk of prostate cancer?

The effect of diet on prostate cancer risk isn’t clear. There’s no definitive cause-and-effect connection between prostate cancer and diet. But there’s some evidence that prostate cancer is associated with certain foods:

• Dairy: People who eat a lot of dairy may be slightly more at risk for prostate cancer.

• High-fat or high-carb foods: Eating a lot of sugary or high-fat foods (especially animal products) may raise your risk for prostate cancer. These foods can also cause obesity, which may change your hormone levels and promote inflammation.

• Red meat: Eating red meat is associated with many different types of cancer, including prostate cancer. There’s also evidence that eating a plant-based (vegetarian or vegan) diet can lower your risk of prostate cancer.

• Processed meat: This includes foods like salami, bacon, and lunch meat. There’s evidence that eating these foods every day increases your prostate cancer risk.

• Alcohol: This includes beer, wine, and liquor. There’s growing evidence that alcohol can increase your risk for prostate cancer. 

Are certain health conditions associated with prostate cancer?

Yes. There’s evidence that having obesity increases your risk for aggressive prostate cancer — especially if you have a lot of thigh or belly fat. Having a high amount of belly fat may also make you more likely to die from prostate cancer. This may be because central body fat can affect certain body hormones that are linked to prostate cancer (like IGF-1). 

On the other hand, people with obesity are actually less likely to be diagnosed with nonaggressive prostate cancer. Obesity can falsely lower your PSA, which can delay biopsy and diagnosis. This could be why men who are labeled as obese are more likely to have aggressive cancer when they receive the diagnosis of prostate cancer. 

There’s also some evidence that hypertension (high blood pressure) is associated with prostate cancer. A 2017 meta-analysis found that people with prostate cancer were more likely to have hypertension than the general population. More research is needed in this area. 

Is prostate cancer genetic?

Yes. Cancer — including prostate cancer — is caused by genetic changes. Some of these changes are inherited from family members. Others are acquired during your life — due to age, exposures, diet, and lifestyle.

You can have a gene change (also called a “mutation”) in two different ways:

• You’re born with it. This is called an “inherited'' gene mutation. In other words, your father or mother had the same mutation and passed it to you. There are over 20 different genes associated with prostate cancer. Keep in mind that both females and males can have these mutations. 

• You acquired it at some point during your life. This is called an “acquired” gene mutation. This means you were born without the gene change, and it happened at some point during your life. 

Should you get genetic testing for prostate cancer?

It depends. If you receive a diagnosis of prostate cancer, ask your doctor about genetic testing. It may be recommended if you have a more aggressive type of prostate cancer, or if cancer runs in your family. 

Need more information on this topic? Learn more about gene mutations and genetic testing in our GoodRx article: Is prostate cancer genetic?

Are problems with the prostate always cancer?

No. Prostate conditions are common, especially in older people. Benign prostatic hyperplasia (BPH) and prostatitis can both cause changes in your prostate, but they aren’t cancer. 

If you’ve noticed any symptoms like problems with urination or pain in your pelvic area, talk with your healthcare provider. They can help you decide if you want to be screened for prostate cancer. 

How to keep your prostate healthy

No one knows for sure how to prevent prostate cancer. But there’s some evidence that you may be able to reduce your risk by:

• Eating a balanced diet high in whole grains, fruits, and vegetables

• Cutting back on red meat, processed meat, sugar, and alcohol

• Eating foods that are rich in vitamins and minerals

• Exercising

• Maintaining a moderate weight 

• Quitting smoking, if you smoke

If you do have a higher risk for prostate cancer, there are also some medications that can potentially reduce your risk. Talk with your healthcare provider about whether this is right for you, as there are pros and cons to this approach. 

Can masturbation or frequent ejaculation cause prostate cancer?

No, this is a myth. Some people worry that masturbation or frequent ejaculation can raise the  risk of prostate cancer, but this is not true. In fact, there’s some evidence that higher ejaculation frequency might actually lower the risk of prostate cancer. 

Can having a vasectomy increase the risk of prostate cancer?

It’s not clear. If there’s a connection, the risk seems to be very low. 

Some studies have found that having a vasectomy might slightly increase your risk for prostate cancer. But other studies have found that there’s no association between the two. 

According to the American Urological Association, vasectomy is not a risk factor for prostate cancer. 

Why trust our experts?

Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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