Preventing Prostate Cancer
One in every six men gets prostate cancer at some point in his lifetime.
Prostate cancer is the second leading cause of male cancer deaths in the United States.
In 2004, 230,110
new cases of prostate cancer were expected to be diagnosed in American men. And 29,000 men were expected to die of the disease (estimates, Centers for Disease Control, 2004/5).
Find out if you might be at higher risk. Even if you have no special risk factors, aim for prevention through diet, exercise and lifestyle choices
- Special risks - race, environment, diet, toxin exposure (e.g. Agent Orange) and family history of prostate or breast cancer are risk factors for early onset and/or aggressive prostate cancer.
- Age as the commonest risk. Simple steps toward healthy aging may help reduce this risk along with risk of diabetes and heart disease.
- Evidence suggests men can lower risk of prostate cancer through diet, exercise and outdoor activity.
- Although men under 40 have a very low risk of prostate cancer (0.01%, or 1 in 9,876), men with one or more high risk factors may wish to talk to their doctors and ask for a baseline PSA test as early as age 35 and no later than 40.
African Americans have the highest risk of prostate cancer in the world
If you're an African American man you're at risk for more aggressive forms of the disease. You're also at higher risk for dying of this disease than white men are. Reasons are not fully known but may include genetic factors, diet, inadequate vitamin D and poorer medical care.
Black men are advised to get a baseline PSA test at age 35 so the doctor can start tracking PSA "velocity," or rate of rise. Find a doctor who takes an interest in your prostate health.
Men with a family history have a higher risk
Whatever your race, if your brother has prostate cancer, your risk is almost tripled. If your father or uncles have (or had) prostate cancer you too are at higher risk. Some evidence suggests higher risk of prostate cancer for any man whose mother developed breast cancer. About 10 per cent of all newly diagnosed prostate cancer can be traced to heredity.
If a family member, especially a brother, has prostate cancer, get baseline PSA tests starting at age 35 to start tracking "velocity" or rate of rise.
The risk of developing prostate cancer increases gradually beginning at age 40 years.
- Men from 40 to 59 have a 2.58% chance (1 in 39)
- Men from 60 to 79 have a 14.76% chance (1 in 7)
All men between 50 and 70 are advised to take the PSA test once a year.
Men over 70 may opt to continue annual tests. The current median age at diagnosis of prostate cancer is reported to be 71 years and the median age at death is 78 years.
Diet and exercise
You can cancer-proof your daily life.
The basics, approved by the American Cancer Society and by prostate cancer specialists, are: eat fruits and vegetables in plenty; reduce red meat; avoid animal fats and hydrogenated fats and greasy foods (lard, doughnuts, cookies, fries), use sparing amounts of olive oil for cooking and salads.
Stay within your healthy weight range and make time to enjoy exercise.
Men who eat a daily helping of cooked tomatoes may lower their risk of prostate cancer.
Tea, especially green tea, until lately looked promising as part of a prostate cancer prevention daily diet. Most of the evidence, though, came from test tubes or tests on mice. A recent study on humans showed no significant effect. More studies will be done. \
What about supplements? A group of urologists and other doctors run a business, Theralogix, to sell a vitamin combination to men at risk of prostate cancer. This is their formula (obviously, the doses could be followed using any reputable brands of supplements):
||vitamin E (as mixed tocopherols)
||selenium (as selenomethionine)
||lycopene (as Lyc-O-Mato®)
||soy isoflavones (as Novasoy)
You may be interested in their evidence and outlook on diet. A recent study found no evidence that vitamin E protects against cancer. Vitamin D may be important in the prevention of prostate cancer. Last year (2004) the National Institutes of Health sponsored a conference on cancer and vitamin D.
Inflammation: does inflammation from chronic infection influence the development of prostate cancer?
The earliest stages of prostate cancer may develop hand in hand with chronic inflammation. This very early stage, new research suggests, might be reversible with anti-inflammatory drugs and dietary supplements.
Johns Hopkins researchers say that "with an onslaught of carcinogens from the environment and diet," genetic mistakes are made, causing abnormalities in prostate cells. The Hopkins theory suggests that these may tend to arise where inflammation is present.
Investigators are testing preventive effects of anti-inflammatory agents and antioxidant nutrients on animals. (Johns Hopkins, 2002)
Certain infections cause changes that can lead to cancer. This can happen because of chronic inflammation or from an infectious agent (like a virus) changing the behavior of infected cells.
Whether inflammation of the prostate arises from infection and then contributes to prostate cancer is unknown. If there is a connection, some other factor must explain why men in the West are more likely to develop aggressive prostate cancer than are men in Asia and other parts of the world where infection and pesticide exposure are actually more common.
Conceivably, this "other" factor might turn out to be dietary or to do with total calorie intake or vitamin D absorption.... no one knows.
"Chronic inflammation," researchers note "... is extremely common in the peripheral zone of the prostate where most cancers arise."
Studies of health and cancer in populations around the world have produced some evidence of the role of chronic inflammation as a cause of prostate cancer.
Studies of sexually transmitted infections, clinical prostatitis, and genetic and circulating markers of inflammation and response to infection, according to researchers at the University of Colorado, hint at a link between chronic inflammation of the prostate and prostate cancer.
On the other hand, two recent studies have found that frequent ejaculation protects against prostate cancer.
More studies are needed to see if it makes sense to target prostate inflammation so as to prevent prostate cancer.
In any case, poor nutrition, obesity, smoking and other factors that undermine health seem to play an important role in increasing risk of prostate cancer. Till now, researchers believed that infection-associated cancers are much commoner in conditions of deprivation. Poor living conditions, bad water and inadequate health care increase the likelihood of cancer resulting from chronic infections.
Yet prostate cancer is commoner in developed countries than in much poorer countries. And inflammation is often present in prostate biopsies, radical prostatectomy specimens and tissue removed during TURPs for BPH (benign prostatic hyperplasia). This might just reflect the fact that prostate inflammation is extremely common.
"Poor" nutrition may mean something very different than it does in the developing world. A type of over-nutrition with over-weight or obesity yet lack of essential nutrients may be involved.
Source: The Journal of Urology Volume 171(2, Part 2 of 2)February 2004 pp S30-S35 Inflammation as a Target for Prostate Cancer Chemoprevention:: Pathological and Laboratory Rationale.
LUCIA, M. SCOTT; TORKKO, KATHLEEN C. Departments of Pathology and Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado
What is PSA and why take the PSA test?