Senior Director & Unit Head, Urology, Kidney Transplant, Uro-Oncology, Robotic Surgery, Max Hospital, Gurugram
Part 2 of 11 in Prostate Cancer: Diagnosis and Management
Prostate Cancer Risk Factors and Why Men of African Descent Face the Highest Risk
September 6, 2026
Prostate cancer incidence varies more by geography and ethnicity than almost any other cancer. The highest rates in the world are recorded in northern Europe, while south-central Asia records among the lowest, and incidence rises sharply once men pass 65. Men of African descent carry a materially higher risk of developing prostate cancer than any other ethnicity, a pattern Dr. Amit Goel, Director and Head of Unit for Urology, Uro-oncology, Renal Transplant and Robotic Surgery at Max Hospital, Gurugram, named directly at the start of his Jivo Masterclass to an audience of doctors from across Africa.
Age, Family History and Diet
Increasing age and a family history of prostate cancer are two of the most consistently cited risk factors, alongside dietary patterns. Certain nutrients appear protective: soy protein, vitamin E and selenium are associated with lower risk and are worth building into the diet of a patient whose risk is already elevated. On the genetic side, an aberration on the long arm of chromosome 1 has been linked to a higher likelihood of developing the disease.
Where in the Prostate Cancer Develops
Most prostate cancers are adenocarcinomas that arise in the acini of the prostatic ducts; rarer variants include small cell, mucinous, endometrioid, transitional cell, squamous cell, signet ring and neuroendocrine cancers. Within the gland itself, the peripheral zone is by far the most common site for cancer to develop, while the transitional and central zones are affected far less often, which is part of why a digital rectal exam, reaching the peripheral zone directly, remains a useful screening tool.
This article is based on a Jivo Masterclass session conducted by Dr. Amit Goel, Director and Head of Unit, Renal Transplant, Uro-oncology, Urology and Robotic Surgery, Max Hospital, Gurugram, India. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Amit Goel taught doctors across Africa on April 20, 2025.
FROM THE LIVE Q&A
Moderator
What is the management of metastatic prostate cancer?
Dr. Amit Goel
It depends on where the metastasis is. Bilateral orchidectomy is still a valid option for patients who don't want to spend money on ongoing hormone injections, and it works about as well as hormone therapy. For bone metastasis with pain or fracture risk, bone-strengthening injections and radiotherapy to the affected bone are added. Once the disease becomes castration-resistant, treatment moves to stronger anti-androgens such as abiraterone or enzalutamide, chemotherapy for visceral metastasis, and increasingly immunotherapy.
Frequently Asked Questions
What are the survival chances after surgical treatment for a patient with prostate adenocarcinoma, and is there a possibility of recurrence?▼
Surgery is offered specifically in patients where the goal is cure. But every patient needs lifelong follow-up, with PSA testing every three to six months, because recurrence can and does happen. Nobody can promise a patient that surgery guarantees no recurrence. That possibility is exactly what the word cancer is telling us.
What is the average cost of robotic surgery for prostate cancer?▼
Approximately 8,700 US dollars, which is the total cost of the robotic surgery.
What is the management of metastatic prostate cancer?▼
It depends on where the metastasis is. Bilateral orchidectomy is still a valid option for patients who don't want to spend money on ongoing hormone injections, and it works about as well as hormone therapy. For bone metastasis with pain or fracture risk, bone-strengthening injections and radiotherapy to the affected bone are added. Once the disease becomes castration-resistant, treatment moves to stronger anti-androgens such as abiraterone or enzalutamide, chemotherapy for visceral metastasis, and increasingly immunotherapy.
Who is at highest risk of prostate cancer?▼
Men of African descent carry the highest risk of any ethnic group, and risk generally rises with age, especially after 65, and with a family history of the disease.
Can diet affect prostate cancer risk?▼
Soy protein, vitamin E and selenium are associated with a protective effect, while diet more broadly is considered one of several contributing risk factors.
In This Series: Prostate Cancer: Diagnosis and Management
- 1.Diagnosis and Management of Prostate Cancer
- 2.Prostate Cancer Risk Factors and Why Men of African Descent Face the Highest Risk
- 3.Recognizing Prostate Cancer: From Early Symptoms to Advanced and Metastatic Disease
- 4.How Prostate Cancer Is Diagnosed: PSA Testing and Digital Rectal Examination
- 5.Prostate Biopsy: TRUS-Guided and MRI Fusion Techniques
- 6.The Gleason Score: Grading Prostate Cancer and What It Means for Treatment
- 7.Staging Prostate Cancer: TNM Classification and PSMA PET Scans
- 8.Choosing a Treatment: Risk-Based Options From Active Surveillance to Surgery
- 9.Robotic, Laparoscopic and Open Radical Prostatectomy: Comparing the Evidence
- 10.The Retzius-Sparing Technique: Protecting Continence and Erectile Function After Surgery
- 11.Managing Metastatic and Castration-Resistant Prostate Cancer