Originally published: 05.01.08 by Alan W. Davis, M.D., and Pamela H. Davis, M.D.
Detected early, the cure rate is significant
Why should we discuss prostate cancer with you? Because in 2008 more than 186,000 men will be diagnosed with the disease and approximately 2 million men in the United States are already living with it. The truth is, a man is 35% more likely to be diagnosed with prostate cancer than a woman is to be diagnosed with breast cancer.
The good news: Early detection (catching the tumor before it becomes highly aggressive) is nearly curative. Indeed, the prognosis is outstanding when tumors are small and confined to the prostate itself. Understanding what the prostate does, what symptoms to look for, how to know if you are at risk and what you might do to prevent this cancer are all ways you can partner with your physician to be an advocate for your health.
The prostate gland is an almond-sized organ that surrounds the urethra at the base of the bladder in front of the rectum. It helps control the flow of urine by pressing against the urethra. The prostate also secretes fluid into the semen, which helps lubricate the urethra and energize the sperm.
Men without prostate glands are generally sterile. As men age, the gland gradually grows larger and this is called benign prostatic hypertrophy. This is not associated with prostate cancer, but symptoms may be similar.
Some men who are diagnosed with prostate cancer do not have any symptoms. Others may complain of changes in urination, such as increased frequency, urgency, burning or hesitation. Other symptoms include difficulty in having an erection, painful ejaculation, or pain in the lower back or hips.
Screening for prostate cancer is simple and straightforward. There are two basic tests offered. One is a blood test called a PSA (prostate-specific antigen) where a small amount of blood is drawn from the arm and levels lower than 4ng/ml are considered normal.
The other test is a digital rectal exam (DRE). Both of these tests should be offered yearly to men 50 and older. Men at higher risk should be tested starting at age 40 or 45. The PSA test is evaluated in conjunction with a DRE, which involves examining the prostate with a gloved and lubricated finger via the rectum. Urologists can usually detect overall enlargement from prostate cancer. If cancer is suspected, the next test would be a biopsy in which several small samples are taken via the rectum under ultrasound guidance. These are interpreted by a pathologist and if warranted, further testing including CT scans, MRIs or X-rays may be necessary to map out the extent of disease.
Who is at high risk for and what causes prostate cancer? The risk factors for this include advanced age, family history or genetics, diet and lifestyle. In general, the risk of prostate cancer increases with age and some studies suggest that the risk may be as high as 80% over the age of 80. Genetics are very important as well. Prostate cancer is much more common in men who have a first-degree relative who has or had prostate cancer. Additionally, black men are 61% more likely to develop prostate cancer than Caucasian men.
Lifestyle choices such as smoking and poor diet seem to increase the risk of prostate cancer. In fact, diet may be far more important in preventing this disease than many would have suspected. As it turns out, our mothers were right. We should eat our fruits and vegetables — specifically, five to nine servings a day.
As far as prostate cancer goes, lycopene — a natural chemical found in tomatoes, watermelons, pink grapefruit and guava — is a powerful antioxidant.
To be sure, a long-term study found that men who consumed at least two servings of tomato sauce a week had a 30% lower risk of developing prostate cancer.
Additionally, men who ate five or more servings of cruciferous vegetables such as broccoli, cauliflower, cabbage, Brussels sprouts, bok choy, and kale, lowered their risk by 10% to 20%. Studies also have found that increasing intake of soy-based foods may be helpful because soy blocks testosterone’s effect on the growth of prostate tumors.
As suspected, men who eat significant quantities of red meat are at higher risk while men who eat fish at least twice a week are at lower risk.
Lastly, obesity cannot be overlooked. As obesity rates have risen, so has the rate of prostate cancer.
In addition to diet, it is crucial that you get yearly tests. Nearly 100% of early, non-invasive prostate cancer is curable if detected early. Do not ignore symptoms if they occur. Consider making lifestyle changes like stopping smoking, getting more exercise and losing weight. Figure out a way to eat tomatoes or tomato sauce at least twice a week and really increase your intake of green and cruciferous veggies. For even more information, visit the Prostate Cancer Foundation Web site www.prostatecancerfoundation.org.