When the common disease can be deadly

On Thursday, O.J. Simpson, 76, lost his battle with cancer. Although the former football star became infamous for the murder trial he faced in the 1990s, in recent years, he had been photographed looking frail or walking with a cane. 

In February, it was reported that Simpson had prostate cancer although his family has not confirmed it.

Prostate cancer is the second most common form of male cancer after skin cancer. Typically, the disease doesn’t kill people — in part because it typically grows slowly, the cancer is often low-grade and many treatment options are available, according to the American Cancer Society (ACS). But in some cases, it can be deadly.

Here’s what to know about this type of cancer. 

Is prostate cancer curable?

When the cancer is localized to the prostate, often, it is curable, reports the National Institutes of Health (NIH). The ACS estimates that nearly 300,000 men will be diagnosed with this type of cancer in the year 2024 — but only around 35,250 will die from the disease. Put another way, the five-year survival rate of prostate cancer, when it is detected early, is over 99% according to the Prostate Cancer Foundation.

Between 1993 and 2013, the death rate for prostate cancer was cut in half, thought to be due to advances in screening and better treatments, according to the ACS. But in recent years, that number has stabilized, suggesting that more cancers are being caught in late stages. 

Still, an estimated 3.3 million men who had prostate cancer at some point in their lives are still living today. 

Treatment for prostate cancer includes a number of options, depending on the specific diagnosis. Patients may undergo surgery, chemotherapy, immunotherapy, radiation or targeted drug therapy. For many people, one of these treatments will work. An estimated 1 in 8 men will be diagnosed with prostate cancer, but only 1 in 39 (or 2.6%) men will die from it, according to the NIH. 

Signs prostate cancer is deadly

As with most types of cancer, certain groups are more at risk for getting prostate cancer. The average age of diagnosis is 67, and prostate cancer is considered rare in men who are under 40. African American men and Caribbean men of African ancestry are also more at risk for the disease.

Other risk factors for the disease include obesity, family history of cancer, plus factors like high blood pressure, lack of exercise and being taller than average, according to the NIH.

If prostate cancer spreads to other parts of the body (if it metastasizes), it can become deadly. When it spreads, prostate cancer commonly moves to the bones, lungs, lymph nodes, liver or brain. It’s not known whether Simpson’s cancer had metastasized. 

According to a study from 2021, though, about 1 in 6 deaths of people living with prostate cancer didn’t die from the cancer itself. Those living with cancer can be more susceptible to other health issues, or may already have another health issue, like cardiovascular disease. Other common causes of death in people with prostate cancer include COPD (chronic obstructive pulmonary disease), and things like stroke or aneurysm.

In the US, African American men are twice as likely to die of prostate cancer compared to other groups, according to the Centers for Disease Control and Prevention (CDC). However, the CDC notes, that stat may have more to do with health inequities — a study from 2020 suggested that if health care access were equal, the mortality rate might actually be slightly lower for African American men. 

The NIH also notes that diets high in saturated fat and milk products may contribute to causing the cancer, and may increase the risk of recurrence once diagnosed.

Currently, there is no standard test to screen for prostate cancer. A doctor may draw blood for a prostate specific antigen test (PSA), or may perform a rectal exam, but both of these types of screenings require follow-ups before a diagnosis will be made. In 2018, the U.S. Preventive Services Task Force recommended that men who are 55 to 69 should make an individual decision about whether they should be screened based on a discussion with their doctors. Men over the age of 70 should not be routinely screened.