Men's Cancers

June is Men's Health Awareness Month

June is a month designated to raise awareness about cancers affecting men and encourage early detection and treatment of disease among men and boys.

The cancers that most frequently affect men are:

prostate
colon
lung
skin cancers

Knowing about these cancers and how they can be prevented or found early can save your life.

Prostate Cancer

The chance of getting prostate cancer goes up as a man gets older. Most prostate cancers are found in men over the age of 65. For reasons that are still unknown, African American men are more likely than white men to develop prostate cancer. Having one or more close relatives with prostate cancer also increases a man’s risk of having prostate cancer.

What you can do: Screening and Prevention

The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer. Starting at age 50 talk to your doctor about the pros and cons of testing so you can decide if getting tested is the right choice for you. If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with your doctor starting at age 45. If you decide to be tested, you should have the PSA blood test (it measures the blood level of PSA, a protein that is produced by the prostate gland) with or without a rectal exam. How often you are tested will depend on your PSA level.

Learn more about this test by reading U-M offers new early detection test for prostate cancer

Prostate Cancer Risk Factors

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for cancers of the lungs, larynx (voice box), mouth, throat, esophagus, kidneys, bladder, colon, and several other organs.

But risk factors don't tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. And some people who get the disease may not have any known risk factors.

The following are the risk factors for prostate cancer:

Age
Prostate cancer is very rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. Almost two out of three prostate cancers are found in men over the age of 65.
Race/Ethnicity
Prostate cancer occurs more often in African-American men than in men of other races. African-American men are also more likely to be diagnosed at an advanced stage, and are more than twice as likely to die of prostate cancer as white men. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than in non-Hispanic whites. The reasons for these racial and ethnic differences are not clear.
Family History
Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man's risk of developing this disease.
Geography
Prostate cancer is most common in North America, northwestern Europe, Australia, and on Caribbean islands. It is less common in Asia, Africa, Central America, and South America. The reasons for this are not clear.
Family History
Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man's risk of developing this disease.
Genes
Scientists have found several inherited genes that seem to raise prostate cancer risk, but they probably account for only a small number of cases overall. Genetic testing for most of these genes is not yet available.
Diet
The exact role of diet in prostate cancer is not clear, but several different factors have been studied. Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables. Doctors are not sure which of these factors is responsible for raising the risk.
Obesity
Most studies have not found that being obese (having a high amount of extra body fat) is linked with a higher risk of getting prostate cancer.
Smoking
Most studies have not found a link between smoking and the risk of developing prostate cancer. Some recent research has linked smoking to a possible small increase in the risk of death from prostate cancer, but this is a new finding that will need to be confirmed by other studies.
Inflammation of the prostate
Some studies have suggested that prostatitis (inflammation of the prostate gland) may be linked to an increased risk of prostate cancer, but other studies have not found such a link. Inflammation is often seen in samples of prostate tissue that also contain cancer. The link between the two is not yet clear, but this is an active area of research.
Sexually transmitted infections
Researchers have looked to see if sexually transmitted infections (like gonorrhea or chlamydia) might increase the risk of prostate cancer, possibly by leading to inflammation of the prostate. So far, studies have not agreed, and no firm conclusions have been reached.
Vasectomy
Some earlier studies had suggested that men who had a vasectomy (minor surgery to make men infertile) -- especially those younger than 35 at the time of the procedure -- may have a slightly increased risk for prostate cancer. But most recent studies have not found any increased risk among men who have had this operation. Fear of an increased risk of prostate cancer should not be a reason to avoid a vasectomy.

Source: American Cancer Society - What are the risk factors for prostate cancer?

Lung Cancer

Smoking is the cause for more than 80% of all lung cancers, but people who do not smoke can also have lung cancer.

What you can do: Screening and Prevention

Lung cancer is one of the few cancers that can often be prevented simply by not smoking. If you are a smoker, ask your doctor or nurse to help you quit. If you don’t smoke, don’t start, and avoid breathing in other people’s smoke. If your friends and loved ones are smokers, help them quit.

Lung Cancer Risk Factors

The following are the risk factors for lung cancer:

Tobacco Smoke:
Smoking is by far the leading risk factor for lung cancer. In the early 20th century, lung cancer was much less common than some other types of cancer. But this changed, once manufactured cigarettes became readily available, and more people began smoking. About 80% of lung cancer deaths are thought to result from smoking. The risk for lung cancer among smokers is many times higher than among non-smokers. The longer you smoke and the more packs a day you smoke, the greater your risk. This includes cigar, pipe and other alternative sources of tobacco like hookah.
Radon:
Radon is a naturally occurring radioactive gas that results from the breakdown of uranium in soil and rocks. It cannot be seen, tasted, or smelled. According to the US Environmental Protection Agency (EPA), radon is the second leading cause of lung cancer, and is the leading cause among non-smokers.
Asbestos:
Workplace exposure to asbestos fibers is an important risk factor for lung cancer. Studies have found that people who work with asbestos (in some mines, mills, textile plants, places where insulation is used, shipyards, etc.) are several times more likely to die of lung cancer, and also of developing Mesothelioma, a type of cancer that starts in the lungs.
Other carcinogens (cancer-causing agents) found in some workplaces that can increase lung cancer risk:
- Radioactive ores such as uranium
- Inhaled chemicals or minerals such as arsenic, beryllium, cadmium, silica, vinyl chloride, nickel compounds, chromium compounds, coal products, mustard gas, and chloromethyl ethers
- Diesel exhaust
Radiation therapy to the lungs
People who have had radiation therapy to the chest for other cancers are at higher risk for lung cancer, particularly if they smoke. Typical patients are those treated for Hodgkin disease or women who get radiation after a mastectomy for breast cancer. Women who receive radiation therapy to the breast after a lumpectomy do not appear to have a higher than expected risk of lung cancer.
Arsenic
High levels of arsenic in drinking water may increase the risk of lung cancer. This is more commonly found in Asia and South America and is even more pronounced in smokers.
Personal or family history of lung cancer
If you have had lung cancer, you have a higher risk of developing another lung cancer. Brothers, sisters, and children of those who have had lung cancer may have a slightly higher risk of lung cancer themselves, especially if the relative was diagnosed at a younger age. It is not clear how much of this risk might be due to genetics and how much might be from shared household exposures (such as tobacco smoke or radon).
Certain dietary supplements
Studies are looking at the possible role of antioxidant supplements in reducing lung cancer risk have not been promising so far. In fact, two large studies found that smokers who took beta carotene supplements actually had an increased risk of lung cancer. The results of these studies suggest that smokers should avoid taking beta carotene supplements.
Air Pollution
In cities, air pollution (especially from heavily trafficked roads) appears to raise the risk of lung cancer slightly. This risk is far less than the risk caused by smoking, but some researchers estimate that worldwide about 5% of all deaths from lung cancer may be due to outdoor air pollution.

Source: American Cancer Society - What are the risk factors for non-small cell lung cancer?

Skin Cancer

Anyone who spends time in the sun can have skin cancer. People with fair skin, especially those with blond or red hair, are more likely to get skin cancer than people with darker coloring. People who have had a close family member with melanoma and those who had severe sunburns before the age of 18 are more likely to get skin cancer.

What you can do: Screening and Prevention

Most skin cancers can be prevented by avoiding the midday sun, between 1pm and 3 pm. Be aware of all moles and spots on your skin, and report any changes to your doctor right away. Have a skin exam during your regular health check-ups. When in the sun, wear hats with wide brims, long-sleeved shirts, sunglasses, and use a broad-spectrum sunscreen with an SPF of 30 or higher.

Skin Cancer Risk Factors

Basal and Squamous Cell Cancer
These types of cancer usually occur on the sun exposed, areas or surfaces, of your skin. They generally affect surface cells that grow slowly, but may also go into deeper layers of the skin. These types of skin cancer are more easily cured if caught early.

Ultraviolet(UV) UV light exposure
Exposure to ultraviolet (UV) rays is thought to be the major risk factor for most skin cancers. Sunlight is the main source of UV rays. Tanning beds are another source of UV rays. People who get a lot of UV exposure from these sources are at greater risk for skin cancer.
Having light-colored skin
The risk of skin cancer is much higher for whites than for African Americans or Hispanics. This is due to the protective effect of the skin pigment melanin in people with darker skin. Whites with fair (light-colored) skin that freckles or burns easily are at especially high risk.
Older age
The risk of basal and squamous cell skin cancers rises as people get older. This is probably because of the buildup of sun exposure over time. These cancers are now being seen in younger people as well, probably because they are spending more time in the sun with their skin exposed.
Male gender
Men are about twice as likely as women to have basal cell cancers and about 3 times as likely to have squamous cell cancers of the skin. This is thought to be due mainly to higher levels of sun exposure.
Exposure to certain chemicals
Exposure to large amounts of arsenic increases the risk of developing skin cancer. Arsenic is a heavy metal found naturally in well water in some areas. It’s also used in making some pesticides and in some other industries. Workers exposed to coal tar, paraffin, and certain types of oil may also have an increased risk of skin cancer.
Radiation exposure
People who have had radiation treatment have a higher risk of developing skin cancer in the area that received the treatment. This is particularly a concern in children who have had radiation treatment for cancer.
Previous skin cancer
Anyone who has had a basal or squamous cell cancer has a much higher chance of developing another one.
Long-term or severe skin inflammation or injury
Scars from severe burns, areas of skin over serious bone infections, and skin damaged by some severe inflammatory skin diseases are more likely to develop skin cancers, although this risk is generally small.
Psoriasis treatment
Psoralens and ultraviolet light (PUVA) treatments given to some patients with psoriasis (a long-lasting inflammatory skin disease) can increase the risk of developing squamous cell skin cancer and probably other skin cancers.
Xeroderma pigmentosum (XP)
This very rare inherited condition reduces the skin’s ability to repair DNA damage caused by sun exposure. People with this disorder often develop many skin cancers starting in childhood.
Basal cell nevus syndrome (Gorlin syndrome)
In this rare congenital (present at birth) condition, people develop many basal cell cancers over their lifetime.
Reduced immunity
The immune system helps the body fight cancers of the skin and other organs. People with weakened immune systems (from certain diseases or medical treatments) are more likely to develop non-melanoma skin cancer, including squamous cell cancer and less common types such as Kaposi sarcoma and Merkel cell carcinoma.
Human papilloma virus (HPV) infection
Human papilloma viruses (HPVs) are a group of more than 100 viruses that can cause papillomas, or warts. The warts that people commonly get on their hands and feet are not related to any form of cancer. But some of the HPV types, especially those that affect the genital and anal areas and around the fingernails, seem to be related to skin cancers in these areas.
Smoking
People who smoke are more likely to develop squamous cell skin cancer, especially on the lips. Smoking is not a known risk factor for basal cell cancer.

Melanoma
This type of cancer can start anywhere on the skins surface, it does not have to be on an area exposed to the sun. It is curable if found in the very early stages.

Ultraviolet (UV) light exposure
Exposure to ultraviolet (UV) rays is a major risk factor for most melanomas. Sunlight is the main source of UV rays. Tanning lamps and beds are also sources of UV rays. People who get a lot of UV exposure from these sources are at greater risk for skin cancer, including melanoma.
Moles
A nevus (mole) is a benign (non-cancerous) pigmented tumor. Moles are not usually present at birth but begin to appear in children and young adults. Most moles will never cause any problems, but a person who has many moles is more likely to develop melanoma.

Sources: American Cancer Society - What are the risk factors for basal and squamous cell skin cancers? and
What is melanoma skin cancer?

Colon Cancer

Any adult can have colorectal cancers (cancers of the colon and rectum), but most of these cancers are found in people age 50 or older. People with a personal or family history of this cancer, or who have polyps in their colon or rectum, or those with inflammatory bowel disease are more likely to have colon cancer. Also, eating a diet that includes a greater percentage of high fat foods (especially from animal sources), being overweight, smoking and being inactive can make a person more likely to have colon cancer.

What you can do: Screening and Prevention

Colon cancer almost always starts with a polyp. Testing can save lives by finding polyps before they become cancer. If pre-cancerous polyps are removed, colon cancer can be prevented. Eating a low-fat diet that is rich in fruits and vegetables may also make you less likely to have this cancer.

The American Cancer Society recommends one of the following testing options for all people beginning at age 50:

Tests that find polyps and cancer

Colonoscopy every 10 years, or
Flexible sigmoidoscopy every 5 years*, or
Double-contrast barium enema every 5 years*, or
CT colonography (virtual colonoscopy) every 5 years*

Tests that primarily find cancer

Yearly fecal occult blood test (FOBT)**, or
Yearly fecal immunochemical test (FIT)**, or
Stool DNA test (sDNA), interval uncertain**

* If the test is positive, a colonoscopy should be done.
** The multiple stool take-home test should be used. One test done by the doctor is not adequate for testing. A colonoscopy should be done if the test is positive.

Colon Cancer Risk Factors

The following are the risk factors for colon cancer:

Age
Younger adults can develop colorectal cancer, but the chances increase markedly after age 50; More than 9 out of 10 people diagnosed with colorectal cancer are older than 50.
Personal history of colorectal polyps or colorectal cancer
If you have a history of adenomatous polyps (adenomas), you are at increased risk of developing colorectal cancer. This is especially true if the polyps are large or if there are many of them.
Personal history of inflammatory bowel disease
Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, is a condition in which the colon is inflamed over a long period of time. f you have IBD, your risk of developing colorectal cancer is increased and you should start screening at an earlier age.
Family history of colorectal cancer
Most colorectal cancers occur in people without a family history of colorectal cancer. Still, as many as 1 in 5 people who develop colorectal cancer have other family members who have been affected by this disease.
Inherited syndromes
About 5% to 10% of people who develop colorectal cancer have inherited gene defects (mutations) that cause the disease.
- Familial adenomatous polyposis (FAP)
  FAP is caused by changes (mutations) in the APC gene that a person inherits from his or her parents. About 1% of all colorectal cancers are due to FAP.
- Hereditary non-polyposis colon cancer (HNPCC)
  HNPCC, also known as Lynch syndrome, accounts for about 2% to 4% of all colorectal cancers.
Racial and ethnic background
African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups in the United States. The reasons for this are not yet understood. Jews of Eastern European descent (Ashkenazi Jews) have one of the highest colorectal cancer risks of any ethnic group in the world. Several gene mutations leading to an increased risk of colorectal cancer have been found in this group. The most common of these DNA changes, called the I1307K APC mutation, is present in about 6% of American Jews.
Type 2 diabetes
People with type 2 (usually non-insulin dependent) diabetes have an increased risk of developing colorectal cancer. Both type 2 diabetes and colorectal cancer share some of the same risk factors (such as excess weight). But even after taking these factors into account, people with type 2 diabetes still have an increased risk.
Lifestyle-related factors
Several lifestyle-related factors have been linked to colorectal cancer. In fact, the links between diet, weight, and exercise and colorectal cancer risk are some of the strongest for any type of cancer. Other lifestyle-related factors associated with an increased risk of colon cancer include: smoking and heavy alcohol use.

Sources: American Cancer Society - What are the risk factors for colorectal cancer?