Preventing Prostate Cancer

You may need to travel to  get a second opinion.

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

Tomatoes and other fruits and veggies help prevent prostate cancer

 

 

 

 

 

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):

100 IU vitamin E (as mixed tocopherols)
800 IU vitamin D
200 mcg selenium (as selenomethionine)
30 mg lycopene (as Lyc-O-Mato®)
50 mg 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

NextWhat is PSA and why take the PSA test?

If you are diagnosed with prostate cancer, you may safely take time to

  • seek second or third opinions from "centers of excellence"
  • get your biopsy slides re-read by a specialist
  • compare treatment options and their side effects
  • make an informed choice based on evidence and your personal values.

Recent News

Sunshine protects men against prostate cancer June 2005

High-risk Prostate Cancer Can Be Predicted Without A Biopsy June 2005

Two Clinical Trials Underway: for Prevention of Prostate Cancer and for Treatment-related Osteoporosis in Prostate Cancer Survivors October 27, 2004

Brothers at high risk for prostate cancer. Sept 2, 2004

Regular yearly PSA tests from age 35 necessary to track velocity, or speed of rise; 2 points or more rise in one year suggests aggressive disease July 15, 2004

Men with "high grade PIN" are at risk for invasive prostate cancer, study finds Oct 19 2004

Strong-flavored onions show promise for fighting cancer Oct 20, 2004.

New drug aimed at men diagnosed with High Grade PIN Oct 19 2004

Prostate cancer rate lower in men taking dutasteride for BPH Urology, Washington University School of Medicine, St. Louis (abstract) 04-10-15

Use of aspirin or other NSAIDs increases survival for men with prostate cancer. Such drugs may help men with prostate cancer. Oct 2004

Red Wine May Help Keep Prostate Cancer Away. Sept 2004

Smoking linked to more than 60 percent of overall cancer death burden in black men April 22 2004

If your brother has prostate cancer, your risk of the disease is nearly tripled 2003

Obesity Linked to More Aggressive Prostate Cancer Dec 23, 2003

Heavy Smoking Doubles Risk of Aggressive Prostate Cancer August 1, 2003.

Study Confirms PSA Test Reduces Prostate Cancer Deaths in Blacks and Whites National Cancer Institute August 2003

"Finasteride (Proscar) to Prevent Prostate Cancer?" A Doctors' Guide Review By Deanna M Green, PhD. Oct 20, 2003

Selenium: Epidemiology and Basic Science. Erica A. Klein, The Journal of Urology, February 2004

Infections and cancer risk
"In the United States and other developed countries, approximately 7 per cent of all cancers have been linked to infections. In developing countries, this number reaches almost 25 percent." Harvard School of Public Health, 2003/2004

Inflammation as a Target for Prostate Cancer Chemoprevention: Pathological and Laboratory Rationale. Kathleen C. Torkko et al. University of Colorado Health Sciences Center, Denver, Colorado. The Journal of Urology, February 2004

Prostate Cancer Treatment Guidelines for Patients
Version III, October 2002 The national Comprehensive Cancer Network

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This page made and last edited by J. Strax, July 18, 2005.