We hear so much about the most common prostate cancer (PCa) risk factors that it’s hard to believe anything was left off the list. The top risk factors are aging (roughly 60% of PCa cases are diagnosed over age 65), family history of PCa (having a close family relative who had PCa doubles the risk), and ethnicity (for unknown reasons, Black men are 75% more likely than White men to develop PCa).

We also recognize that exposure to environmental toxins can raise the chances of PCa. Vietnam vets who were exposed to Agent Orange not only have generally higher PCa risks but are also more likely to develop aggressive disease. Also, a recent study linked rescue workers who responded to the 9/11 destruction of New York’s World Trade Center with higher PCa rates.^[i]

Other obvious risk factors include the Western diet and sedentary lifestyles. We have posted numerous blogs on the importance of consuming more vegetables and fruits and committing to regular vigorous exercise as measures that can reduce PCa risk. Diet and exercise are crucial for heart health as well as prostate health. As the Foundation for the American Urological Association notes, “Obesity (or being very overweight) is known to increase a man’s risk of dying from prostate cancer. One way to decrease your risk is to lose weight and keep it off.”

Not only do professional and patient organizations do their best to raise awareness of these PCa vulnerabilities, much of this knowledge is pure common sense. But there are three risk factors that most men do not connect with PCa or PCa-specific mortality, and I want to shine a spotlight on them because perhaps your own doctor has not brought them to your attention.

1. SMOKING – You know that smoking increases your chance of getting lung cancer, which is the highest cancer cause of death in men. You may be relieved to know that smoking does not appear to be a general risk cancer for PCa, but there’s a catch: if you are a smoker and you develop PCa, you have a higher chance of PCa killing you. In fact, one study found that the heaviest smokers had a 24% to 30% greater risk of death from PCa than did nonsmokers.^[ii]
2. EARLY ONSET OF PUBERTY – The teenage years can be a rough time, but it may be that the earlier a boy reaches puberty is connected with developing PCa later in life—and what is rougher than dealing with cancer? Initially, tall height in adulthood was thought to be correlated with PCa, but by digging more deeply into the biology, it’s not the height itself but attaining taller height in early puberty. According to a 2018 paper, childhood diets that are high in animal fat and protein may lead to early puberty which “has been proposed to contribute to later PCa risk largely by extending the time during which the prostate is exposed to androgens… In addition to promoting height, elevated levels of this growth factor may influence cancer risk by stimulating epithelial cell proliferation, preventing apoptosis [cell death], and amplifying the effects of DNA-damaging agents.”^[iii]
3. IT’S NOT WHAT YOU COOK, IT’S HOW YOU COOK IT – In this case, I’m talking about meat. As I posted in an earlier blog, “New evidence suggests that high temperature cooking, including grilling, broiling, barbecuing and pan-frying, changes the actual chemistry in beef, pork, chicken, fish and pretty much every other type of animal flesh.” When meat is exposed to high heat and/or smoking, two particular chemical compounds form. They are not particularly carcinogenic (cancer-causing) in themselves, but as our bodies digest and process them, enzymes act upon them in a way that sets up cancerous mutations in our cells, including prostate cells.

If your doctor has not discussed these three sneaky threats to your prostate, it’s probably because the more common risk factors are always in the limelight. We know about them, and we have ways to keep an ear to the ground in terms of PSA testing and imaging. But what about the warning we don’t even know about?

Think of the difference between a rattlesnake and a tiger. The rattlesnake gives a warning before it strikes, but the silence of a big cat sneaking up on you before it pounces is far more lethal. If you’re a smoker, or you had an early puberty and are a tall adult, or you love that charred crust on your meat, consider taking a good honest look at your lifestyle choices. Ask yourself if danger is creeping in without your knowledge. Don’t let these less well-known dangers that have no obvious PCa warning catch you off guard.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Goldfarb DG, Zeig-Owens R, Kristiansson D, Li J et al. Temporal association of prostate cancer incidence with World Trade Center rescue/recovery work. Occup Environ Med. 2021 Sep 10;oemed-2021-107405.
[ii] Huncharek M, Haddock KS, Reid R, Kupelnick B. Smoking as a risk factor for prostate cancer: a meta-analysis of 24 prospective cohort studies. Am J Public Health. 2010 Apr;100(4):693-701.
[iii] Alimujiang A, Colditz GA, Gardner JD, Park Y et al. Childhood Diet And Growth In Boys In Relation To Timing Of Puberty And Adult Height: The Longitudinal Studies Of Child Health And Development. Cancer Causes Control. 2018 Oct; 29(10): 915–926.