One study being conducted by researchers at UNC-Chapel Hill is under way to find some answers.
They also want to know why African-American men are twice as likely to be diagnosed with prostate cancer as white men.
Some people, such as Lawrence Fleming, are working to erase the most obvious cause: ignorance.
Fleming is into details -- on his job with Progress Energy and with his health; he stays in control of his diabetes.
He thought he was in control of his prostate health.
"I assumed my team of doctors was making sure everything was being checked and covered," Fleming said.
Late last year, his doctor told him his most recent PSA blood test, used to detect prostate cancer, was fine.
But it wasn't fine.
With prostate exams, understanding your PSA number is vital.
Don't assume that your number is normal, experts said. Get the number in writing and discuss it with your health-care provider.
If it's higher than 2.5, you may want to see an urologist and ask about a biopsy.
That's what Lawrence Fleming did.
"I found out I needed a biopsy and went to the urologist. It came back that it was prostate cancer," Fleming said.
He had surgery to remove the prostate cancer. Now, he's cancer free and part of a prostate cancer awareness action team.
The team spreads the word that the only symptoms of prostate cancer are no symptoms at all.
They also spread the word that African-American men should get regular rectal exams and PSA tests beginning at age 40. Other men should begin getting these exams and tests at age 50.
The earlier the cancer is found, doctors said, the more treatable it is.
"It's our contention that getting information into the hands of African-American men is going to make a significant difference in their mortality rate," Leroy Darkes, medical director of the Rex Senior Health Care clinic in Raleigh, said.
Fleming and Darkes are members of an awareness team that will hold a prostate cancer conference on Saturday, Sept. 17, at the North Raleigh Hilton. The afternoon educational sessions, which begin at 2:30 p.m., are free and open to the public.
"Knowledge is very important," Fleming said. "People say what you don't know can't hurt you. In this case, it can kill you."
Copyright 2023 by Capitol Broadcasting Company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.