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Prostate cancer prevention: What you can do
From MayoClinic.com
Special to CNN.com
Prostate cancer prevention is a "hot" area of
medical research — the focus of several large-scale, long-term
studies. This research holds exciting possibilities for
the future and suggests some prostate cancer prevention
strategies for you to use now.
As you decide what prevention strategies to adopt, keep
in mind that several of the strongest known risk factors
for prostate cancer are beyond your control. These include:
• Age. Prostate cancer is unusual in men under 50, but incidence
of the disease increases dramatically after that age.
• Race. African-American men are at increased risk of prostate
cancer.
• Genetics. Your risk of prostate cancer is higher if other
men in your family have had the disease.
If you have these characteristics, it means only that your
likelihood of developing prostate cancer is higher than
that of a man without the characteristic. A 55-year-old
African American man whose father had prostate cancer is
still more likely to live out his life without prostate
cancer than he is to develop it. The full range of factors
that cause prostate cancer is still largely unknown.
Even if you don't have any of the three uncontrollable risk
factors for prostate cancer, it pays to follow the lifestyle
linked to a lower risk of the disease. The habits that protect
against prostate cancer might help you to avoid other diseases
as well — heart disease and colorectal cancer, for example.
Find out which of these habits you've already adopted, and
consider others you can make later on.
Diet and prostate cancer
Much of the research on prostate cancer prevention focuses
on nutrition. Key factors include:
• Fat. Prostate cancer rates vary greatly from one country
to another, with the highest rates appearing in countries
where people tend to eat a lot of fat. In fact, the number
of prostate cancer deaths in a given country rises in direct
proportion to the average total calories from fat in that
country's typical diet.
• Vegetables. Some studies link a diet high in vegetables
to a lower risk of prostate cancer. For example, one study
found that men who ate 28 or more servings of vegetables
each week had lower rates of prostate cancer compared to
men who ate less than 14 servings.
• Fish. In one study, prostate cancer was two to three times
more common in men who ate no fish as in men who ate moderate
to large amounts of fish. Types of fish that are rich in
the fatty acids that protect against prostate cancer and
other diseases include salmon, herring, and mackerel.
So far, research does not support definite nutritional guidelines
for preventing prostate cancer. However, you can reasonably
act on these suggestions:
• Eat more fruits, vegetables and whole grains.
• Reduce intake of saturated fat and cholesterol.
• Limit sweets and salt.
• Drink alcoholic beverages in moderation, if at all.
• Eat moderate-sized portions and control calories.
• Healthy diet basics: Using a food pyramid
Obesity and prostate cancer
Researchers have not established a direct link between obesity
and incidence of prostate cancer. However, obesity might
affect levels of hormones related to prostate cancer risk.
Strategies for preventing obesity include:
• Following guidelines for a healthy diet
• Meeting with your doctor to develop a plan for physical
activity
• Doing some form of aerobic exercise for 30 minutes or
more daily
• Obesity
• Aerobic exercise: What 30 minutes a day can do for your
body
Chemical agents and prostate cancer
Certain drugs, vitamins and minerals may reduce your risk
of prostate cancer, a strategy known as chemoprevention.
Current research does not support the routine use of any
drug or nutritional supplement to prevent prostate cancer.
Yet several chemical agents show potential benefits.
Drug protection
Proscar (finasteride), traditionally prescribed to treat
prostate enlargement, or benign prostatic hyperplasia (BPH),
reduced overall rates of prostate cancer by 25 percent in
the 18,000-man Prostate Cancer Prevention Trial (PCPT).
Men who took finasteride, however, were more likely to experience
impotence, loss of sexual desire and breast enlargement
than those who took a placebo. In addition, the men who
did develop prostate cancer while taking Proscar were more
likely to have aggressive forms of the disease. The reasons
for these results are unknown.
Another BPH drug, duasteride, also seems to have properties
that prevent prostate cancer. A large, international study
is now underway to further test this finding.
Finally, nonsteroidal anti-inflammatory drugs (NSAIDS) might
prevent prostate cancer. These drugs include ibuprofen (Advil,
Motrin, others) and naproxen (Aleve). NSAIDS inhibit an
enzyme called COX-2, which is found in prostate cancer cells.
More studies are needed to confirm whether NSAID use actually
results in lower rates of prostate cancer or reduced deaths
from the disease.
Plant-based protection
Soybeans and other legumes contain phytoestrogens, which
are plant-based chemicals that behave like the hormone estrogen
in the human body. These chemicals might help to prevent
prostate cancer. In fact, one possible explanation for lower
rates of prostate cancer in Asian men is that they eat more
soy protein.
Researchers are not sure how phytoestrogens could produce
this effect. Phytoestrogens may decrease levels of androgens,
male hormones that stimulate the growth of prostate cancer.
Or, phytoestrogens might simply balance out androgen effects.
Tomatoes and related products, such as tomato sauce and
ketchup, might offer protection in a different way — by
providing lycopene. This vitamin-like substance acts as
an antioxidant, lowering cancer risk by preventing DNA damage
in the nuclei of cells. Go for the richest sources of lycopene
— processed tomatoes, pink grapefruit and watermelon rather
than supplemental lycopene in tablet form.
Selenium and vitamin E
Years of nutrition research have suggested that daily doses
of the mineral selenium, vitamin E or both may help to prevent
prostate cancer. The Selenium and Vitamin E Cancer Prevention
Trial (SELECT), launched in 2001, is following up on these
observations.
By its projected endpoint in 2013, SELECT will have data
on prostate cancer diagnosis and treatment from over 32,000
men. These men are taking selenium, vitamin E, a combination
of both, or a placebo. By studying such a large number of
people over so many years, researchers will gain detailed
evidence about the preventive effects of these two substances.
A word of caution: Taking herbal medicines or nutritional
supplements without medical guidance poses some risks —
particularly if you combine such products with over-the-counter
or prescription medications. Before using any drug, herb
or supplement, talk to your doctor.
• Finasteride (Systemic)
• Selenium Supplements (Systemic)
• Vitamin E (Systemic)
Prostate cancer risk: A common sense perspective
The reasons for interest in preventing prostate cancer are
clear. Prostate cancer is the second most common cause of
cancer death in men, exceeded only by lung cancer.
Even so, prostate cancer affects far more men than it eventually
kills. According to the National Cancer Institute, about
one-fifth of men in the United States will be diagnosed
with prostate cancer during their lifetime. Yet only 3 percent
of American men will die of the disease.
Why does the number of prostate cancer diagnoses exceed
the number of deaths by such a large ratio? One answer is
that prostate cancer progresses more slowly than many other
types of cancer. Many men live with it for years. Some survive
disease-free after treatment. And others refrain from treatment
while closely monitoring the cancer's progression — an approach
known as "watchful waiting."
To keep your risks in perspective, stay in regular contact
with your doctor about your prostate health. Ask about prevention
strategies that make the most sense for you, given your
current health and medical history.
An annual prostate checkup can't reduce your risk of cancer,
as perhaps a healthy diet and exercise can. But having regular
checkups is crucial to staying healthy. If prostate cancer
does develop, a digital rectal exam (DRE) and a prostate-specific
antigen (PSA) test may discover the problem in its earliest
stages. This is the time when treatment can be most effective.
September 30, 2005
© 1998-2006 Mayo Foundation for Medical Education and
Research (MFMER). All rights reserved. A single copy of
these materials may be reprinted for noncommercial personal
use only. "Mayo," "Mayo Clinic," "MayoClinic.com,"
"Mayo Clinic Health Information," "Reliable
information for a healthier life" and the triple-shield
Mayo logo are trademarks of Mayo Foundation for Medical
Education and Research. Terms of Use.
© 2001 Planetree, Inc. All rights
reserved.
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