HOW CAN WE PREVENT PROSTATE CANCER
The ultimate goal of prostate cancer prevention strategies is to prevent men from developing the disease. Unfortunately, despite significant progress in research over the past 18 years, this goal has not yet been achieved. Both genetic and environmental risk factors for prostate cancer have been identified, but the evidence is not yet strong enough to be helpful to men currently at risk for developing prostate cancer.
By contrast, some success has been seen with strategies that can delay the development and progression of prostate cancer. Studies with finasteride and dutasteride, which are typically used for men with the noncancerous condition BPH, have shown that they can reduce by about 25% the chances that a man will be diagnosed with prostate cancer. The Prostate Cancer Prevention Trial was one of the largest prostate cancer trials ever, and involved over 18,000 men over a decade. This study showed that finasteride was able to reduce the risk of being diagnosed by 25%, but initially found a slightly higher rate of aggressive prostate cancers in men who took finasteride. Later looks at this data have suggested that this may be an artifact or due to a greater ability to find more aggressive cancers due to a smaller gland size (i.e. a biopsy needle can more easily hit a cancer in a smaller gland than a larger gland). Given that this agent is well tolerated, current recommendations call for a discussion about the risks and benefits of these agents in the prevention of prostate cancer, and of the potential risks and benefits of using these agents for other conditions, such as BPH.
In the meantime, diet and lifestyle modifications have been shown to reduce the risk of prostate cancer development and progression, and can help men with prostate cancer live longer and better lives.
More information about how dietary and lifestyle changes can be incorporated into everyday life can be found in the Nutrition, Exercise and Prostate Cancer guide.
Top 10 Considerations for Preventing Prostate Cancer
To understand how to prevent prostate cancer, one must first understand what causes it. There are four major factors that influence one’s risk for developing prostate cancer, factors which unfortunately cannot be changed.
Age: The average age at diagnosis of prostate cancer World wide is 69 years and after that age the chance of developing prostate cancer becomes more common than any other cancer in men or women.
Race: African, Coloured and Indian have a 55% greater chance of developing prostate cancer and twice the risk of dying from it.
Family history: A man with a father or brother who developed prostate cancer has a twofold-increased risk for developing it. This risk is further increased if the cancer was diagnosed at a younger age (less than 55 years of age) or affected three or more family members.
Given the facts above, which are difficult to change, there are many things that men can do, however, to reduce or delay their risk of developing prostate cancer. Why is prostate cancer so common in the Western culture and much less so in Asia, and why when Asian men migrate to western countries the risk of prostate cancer increases over time? We believe the major risk factor is diet – foods that produce oxidative damage to DNA. What can you do about it to prevent or delay the onset of the disease?
1. Eat fewer calories or exercise more so that you maintain a healthy weight.
2. Try to keep the amount of fat you get from red meat and dairy products to a minimum.
3. Watch your calcium intake. Do not take supplemental doses far above the recommended daily allowance. Some calcium is OK, but avoid taking more than 1,500 mg of calcium a day.
4. Eat more fish – evidence from several studies suggest that fish can help protect against prostate cancer because they have “good fat” particularly omega-3 fatty acids. Avoid trans fatty acids (found in margarine).
5. Try to incorporate cooked tomatoes that are cooked with olive oil, which has also been shown to be beneficial, and cruciferous vegetables (like broccoli and cauliflower) into many of your weekly meals. Soy and green tea are also potential dietary components that may be helpful.
6. Avoid smoking for many reasons. Alcohol in moderation, if at all.
7. Seek medical treatment for stress, high blood pressure, high cholesterol, and depression. Treating these conditions may save your life and will improve your survivorship with prostate cancer
8. What about supplements? Avoid over-supplementation with megavitamins. Too many vitamins, especially folate, may “fuel the cancer”, and while a multivitamin is not likely to be harmful, if you follow a healthy diet with lots of fruits, vegetables, whole grains, fish, and healthy oils you likely do not even need a multivitamin.
9. Relax and enjoy life. Reducing stress in the workplace and home will improve your survivorship and lead to a longer, happier life.
10. Finally, eating all the broccoli in the world, though it may make a difference in the long run, does not take away your risk of having prostate cancer right now. If you are age 50 or over, if you are age 40 or over and Black in the South African context(African, Coloured or Indian) or have a family history of prostate cancer, you need more than a good diet can guarantee. You should consider an annual rectal examination and PSA test.
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