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What to know about prostate cancer following O.J. Simpson’s death

O.J. Simpson, the football legend who became infamous after he was accused (and later acquitted) of murdering his ex-wife and her friend in 1994, died of cancer at age 76 on Wednesday, his family announced on X. “On April 10th, our father, Orenthal James Simpson, succumbed to his battle with cancer,” his family posted on the athlete’s account. Rumors that he had been diagnosed with prostate cancer surfaced in February, according to NBC News and, though he later denied being in hospice, Simpson himself referenced having cancer in May 2023. “In recent years, really recent years, I unfortunately caught cancer. So I had to do the whole chemo thing,” he said in a video posted on X.

Simpson’s death comes after several high-profile figures — chiefly, King Charles III and U.S. Secretary of Defense Lloyd Austin — were diagnosed with prostate cancer in the past several months. Here’s what to know about prostate cancer.

What is prostate cancer?

Prostate cancer is the second most common form of cancer in the U.S., accounting for 15% of new cancers diagnosed each year, according to the National Cancer Institute (NCI). Aside from skin cancer, it is the most common form of cancer among men and about 1 in 8 men will be diagnosed at some point in their lives, the American Cancer Society (ACS) says.

The prostate is a small gland that sits between the bladder and the rectum in men. It produces a fluid that helps keep sperm cells healthy and lubricates the urethra, which is the tube through which men urinate and ejaculate.

Who is at risk for prostate cancer?

All men and people assigned male at birth are at risk for prostate cancer. While most prostate cancers are diagnosed in people with no family history of the disease, it does seem to run in families, and people who have certain genetic mutations — including the same variants of the BRCA1 and BRCA2 genes linked to breast cancer — are at greater risk, according to the ACS.

The primary risk factor for prostate cancer, however, is age. It’s rare for prostate cancer to be diagnosed before age 40, but by age 80, about 80% of men will have some cancer cells in their prostates, according to the Journal of the American Medical Association (JAMA).

After encouraging declines, annual diagnoses of prostate cancer in the U.S. recently began to tick back up, rising 3% per year between 2014 and 2019, the ACS’s latest research found. Alarmingly, there’s been a particular rise in late-stage diagnoses, according to the report.

To an extent, these increases are unavoidable. Humans are simply living longer, and the older a man gets, the more at risk he becomes. But some experts are concerned that confusion following changes to screening guidelines may have led some men to delay or skip testing and get diagnosed at later stages in the disease.

How deadly is prostate cancer?

If prostate cancer is caught early — and as much as 85% of prostate cancers are diagnosed in these early stages — the chances of survival are exceptionally good. Nearly 100% of men diagnosed early in prostate cancer’s progression — between stages 1 and 3 — will still be alive five years later. According to Johns Hopkins Medicine, 95% will survive at least 15 years after diagnosis.

Although 1 in 44 men will die of prostate cancer, the disease isn’t what kills most men diagnosed with it, according to the ACS. This is especially true in older men, who have a very high chance of developing the cancer but will most likely die of some other cause. Still, treatments and testing have improved, Dr. Adam Murphy, professor of health equity research in urology at Northwestern University Feinberg School of Medicine, tells Yahoo Life, and survival rates remain high compared to other cancers.

But there are some crucial caveats.

Why prostate cancer poses a higher risk to Black men like O.J. Simpson

“If you are African American or Black in the U.S., that also increases your risk of prostate cancer from about 1 in 7 or 8 to about 1 in 6,” says Murphy. Black men are 70% more likely to have prostate cancer and nearly twice as likely to die of it, compared to other men, according to Memorial Sloan Kettering Cancer Center (MSK).

The reasons for these significantly higher rates are complex, scientists suspect. There may be a genetic component that puts Black men at greater risk for more aggressive forms of prostate cancer. Social and environmental factors — such as pollution exposures and poor access to health care — may also increase the likelihood of Black men developing prostate cancer and make it less likely they’ll get an early diagnosis, MSK experts note.

Murphy says that “a combination of vitamin D deficiency” — which has been linked to higher rates of prostate cancer and more aggressive forms — “higher rates of comorbid conditions, but also health care access” all play a role. Black men often receive less advanced treatment compared to what others get. “If Black men are in a place with a high-volume prostate cancer treatment center or in clinical trials, Black men do as well or better than their white counterparts once they are treated for advanced prostate cancer, but most men in those communities are not served” by these cutting-edge trials and treatment centers, Murphy explains. As a result, some doctors are calling for prostate cancer screening to begin earlier for Black men.

What are the signs of prostate cancer and how should men get screened?

Most men who develop prostate cancer don’t have any symptoms, but changes in urination are the most common signs, according to the Mayo Clinic. The ACS says that these changes may include:

  • Frequent nighttime urination

  • Trouble urinating or a slow or weak stream of pee

  • Blood in the urine or semen

The best way to keep ahead of your prostate cancer risks is to get screened by undergoing a PSA test, which measures blood levels of a biomarker of the cancer and can now be done with just a spot of blood, rather than having to have a whole vial drawn, Murphy says.

The U.S. Preventive Services Task Force (USPSTF) says that men should make their own decisions about screening between ages 55 and 69, and should not undergo screening from age 70 and up. The ACS, on the other hand, recommends PSA testing starting at:

  • Age 50 for those at average risk, such as those who are not Black and do not have a family history of prostate cancer

  • At age 45 for Black men and men with a first-degree relative who was diagnosed with prostate cancer at a young age

  • At age 40 for men with multiple first-degree relatives who were diagnosed at young ages

Murphy suggests that Black men in particular start getting PSA tests in their early 40s. If the results are in the normal range — under 2.5 nanograms per milliliter of blood (ng/ml) at that age — they may not need screening again for a few years. Those with elevated levels will likely need to get screened every year or every other year, but the takeaway, says Murphy, is that starting screening may actually mean finding out you have to do it less frequently in the future.

Equally important, Murphy says, is for men — Black men especially — to talk to their families. “The rates of people not knowing about their family history when they’re first diagnosed with prostate cancer are very high among Black men, because we don’t necessarily talk to other men and other family members” about personal health matters, he says.

Murphy adds: “Destigmatizing prostate cancer discussions is a big thing towards preventing people from dying of prostate cancer when they don’t need to.”

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