By: Juno Choe, MD, PhD, Radiation Oncologist, Tri-Cities Cancer Center
Let’s talk about prostate cancer. Prostate cancer is the second leading cause of cancer in men in the United States, and only skin cancers are diagnosed at a higher rate. Approximately 1 in 9 men will be diagnosed with prostate cancer at some point during their lives. It is estimated that over 164,000 men will be diagnosed with prostate cancer this year in the United States. Many prostate cancers progress slowly, and for most men with prostate cancer, they will not die from their disease. Despite this, it is estimated that there will be over 29,000 deaths this year due to prostate cancer.
In my practice, I am often asked by patients the reasons why they have developed prostate cancer. In the vast majority of cases, there is no specific cause that can be identified. Prostate cancer has a high incidence within our population and it affects a large number of men. However, there are well known factors that increase the risk for developing prostate cancer.
Age is a big risk factor. The risk of developing prostate cancer increases dramatically after age 50 and more than 60% of prostate cancers are diagnosed in men over the age of 65. African American men have a higher risk of developing prostate cancer compared with the general population. They are also more likely to develop prostate cancer at a younger age and their prostate cancers tend to be more aggressive. The reasons for these differences are unknown. Family history can be an important risk factor. Men with a first degree relative such as a father or brother with a history of prostate cancer will be twice as likely to develop prostate cancer. Having two close relatives with prostate cancer will increase the lifetime risk of developing prostate cancer five-fold. There are also families with genetic mutations including BRCA1 or BRCA2 and Lynch syndrome. Affected men in these families will be at a much higher risk for developing prostate cancer. Unfortunately, all of these risk factors are impossible to modify.
There are other risk factors that we may be able to change. There seems to be an association between prostate cancer and consuming red meat and high fat dairy products and not eating enough fruits and vegetables. There is also an association between obesity and an increased risk for developing prostate cancer, as well as many other cancers. Therefore, my recommendation is to adopt a healthier lifestyle, eat fewer calories, and exercise more. Minimize your intake of fat from red meat and dairy products. There may be a connection between eating a Mediterranean diet and many health benefits including reduced prostate cancer risk. Therefore, try to incorporate more olive oil into your diet. A diet rich in fish as well as fruits, vegetables, and legumes (such as beans) may reduce your prostate cancer risk. Tomatoes are high in lycopene and may be particularly helpful in preventing prostate cancer. If you smoke, it is important to quit smoking to reduce the risk of developing numerous types of cancers and worsening lung function as well as heart attacks and strokes. Cigarette smoking has also been associated with higher prostate cancer mortality. There may be an association between too much calcium supplementation and prostate cancer risk. While calcium taken in moderation may be reasonable, it is a good idea to avoid taking more than 1,500 mg of calcium supplements per day.
There is no way to completely eliminate your risk of prostate cancer. However, a prostate specific antigen (PSA) blood test can help diagnose prostate cancer. The current U.S. Preventative Services Task Force recommendation states that men between the ages of 55 and 69 can consider periodic PSA screening for prostate cancer. Some patients at higher risk may consider starting PSA screening at an earlier age. It is important to have a discussion with your primary care provider regarding the pros and cons of PSA screening.
As one of the leading cancers in men, I believe it is important to have an awareness of prostate cancer. Making smart lifestyle choices can help reduce your risk for prostate cancer and can help you to lead a longer and healthier life.