September 2, 2004 — Michael Legacki feels like he's a walking target. With five brothers diagnosed with prostate cancer, Legacki knows his risk of developing the condition himself is high.
"I’m very anxious about it, but itI’s a fact of life. I feel confident that if I stay on top of it, II’ll find it early enough that it wonI’t be too terrible," says Legacki, 55.
About 230,000 men develop prostate cancer each year and the average man faces a 1 in 6 chance of being diagnosed. But men whose brother or father had prostate cancer face a 1 in 2 risk of developing the disease themselves, and often at a younger age.
"Prostate cancer does have a hereditary or familial component to it. We donI’t know exactly the gene, although we are narrowing in on that gene." says David Wood, M.D., professor of urology at the U-M Medical School.
Ongoing research at the University of Michigan Comprehensive Cancer Center is looking at men diagnosed with prostate cancer and their unaffected brothers to help determine what genes are involved. Legacki and his brother Frank are enrolled in the trial.
"I was diagnosed with prostate cancer. II’m the oldest of eight children, and there are six boys," says Frank Legacki, 64. "I had two brothers who had prostate cancer before me, so I was on high alert. Now five of the six brothers have had prostate cancer, and my brother Mike here is the only one whoI’s dodged the bullet so far."
Mike Legacki knows he faces a high risk of developing prostate cancer, and recent research shows most men in a similar situation do too. Men participating in a recent study said they felt they had a 50 percent chance of developing prostate cancer within their lifetime, and more than half of the 111 men surveyed said they were at least somewhat concerned about developing the disease.
In addition, researchers found these men were altering their lifestyle to prevent prostate cancer, taking multivitamins or turning to complementary and alternative medicines linked to prostate health or cancer prevention, such as vitamin C, vitamin E, selenium and saw palmetto.
But Wood warns that supplements are not a perfect solution for preventing prostate cancer.
"Complementary and alternative medications in and of themselves are safe drugs. But they are a drug and itI’s important that patients tell their physicians what type of complementary and alternative medications they're taking," he says. "The second concern I have is that men will take these medications in lieu of standard medical practice, and thatÂs a major concern. It is a good addition, but it's not a substitution for standard care."
Michael Legacki says heI’s aware of medical studies indicating a possible benefit to supplements such as lycopene or selenium, but he is not using complementary medicine.
"I do watch my diet and just try to take care of myself generally. I have been getting check-ups regularly, including a PSA test, and so far itI’s been good," Legacki says.
Annual PSA, or prostate specific antigen, tests are recommended for all men after age 50. Men at higher risk — including men with a family history of the disease — should begin screenings earlier.
"The first thing a man who has a brother with prostate cancer should realize is that heI’s at a higher risk of developing prostate cancer," Wood says. "Those unaffected men should have a PSA blood test and a digital rectal exam every year starting at age 45. They should also realize that if theyI’re going to take complementary alternative medication, they should tell their doctor what drugs theyI’re taking."
The Prostate Cancer Genetics Project at U-M is continuing to recruit patients who have brothers, fathers or sons with prostate cancer or who have developed prostate cancer before age 55. For information, call (800) 723-9170. For questions about prostate cancer research or care at the U-M Comprehensive Cancer Center, call the Cancer AnswerLine at (800) 865-1125.
Who's at risk
- Age. The risk of prostate cancer increases after age 50 or after age 40 in African-Americans or in men with a family history.
- Family history. Men with one first-degree relative with prostate cancer face double the risk and men with two first-degree relatives are at five times the risk.
- Race. Prostate cancer affects African-Americans 1.5 times more often than white men.
- Diet. Some studies suggest a high-fat diet increases the risk of prostate cancer.
- Geography. Prostate cancer rates are highest in Scandinavian countries and lowest in Asia.
Preventing prostate cancer
Researchers are looking into several possibilities for preventing prostate cancer:
 Diet. Some studies suggest a diet high in the antioxidant lycopene may help prevent prostate cancer. Lycopene is most commonly found in tomatoes.
 Dietary supplements. Selenium and vitamin E have been linked to possible prostate cancer prevention. Studies are ongoing.
 Drugs. A drug called finasteride may reduce the risk of developing prostate cancer. Research is not conclusive, however, and studies have shown some risk to the drug as well.
Men should consult their doctor before taking any dietary supplements or drugs.
Symptoms
Symptoms of prostate cancer depend on the size of the tumor and how far the cancer may have spread. While not all prostate cancer will cause symptoms, these are some possible signs:
- Frequent and urgent need to urinate.
- Problems urinating, including difficulty starting urine flow, small urination and weak flow.
- Blood or pus in the urine or semen.
- Painful or burning urination.
- Painful ejaculation.
- Pain in lower back, hips, and thighs.
Resources
U-M Prostate Cancer Genetics Project
http://www.cancer.med.umich.edu/prostcan/geneproj.htm
U-M Comprehensive Cancer Center: Prostate cancer education
http://www.cancer.med.umich.edu/prostcan/prosintro.htm
U-M Multidisciplinary Urologic Oncology Clinic
http://www.cancer.med.umich.edu/clinic/uroclinic.htm
Michigan Cancer Consortium: Deciding what to do about early stage prostate cancer
http://www.prostatecancerdecision.org/
National Cancer Institute: What you need to know about prostate cancer
http://www.cancer.gov/cancerinfo/wyntk/prostate
American Cancer Society: Learn about prostate cancer
http://www.cancer.org/docroot/lrn/lrn_0.asp
Written by Nicole Fawcett;
edited by Jacqueline Strax, Sept 22, 2004.
