Prostate Cancer

Prostate Cancer

Prostate cancer is the second leading cause of cancer death in men, after lung cancer. Statistics from the American Cancer Society (ACS) show that one in six men will be afflicted with this type of cancer during his lifetime.

The cause of prostate cancer is still unknown; however, research has shown that health, age, and family history may affect a man's chances of developing prostate cancer.

Magnitude

The ACS estimates that there will be about 217,730 new cases of prostate cancer in the United States in 2010. About 32,050 men will die of the disease.

Risk factors

Age is the most important risk factor for prostate cancer. The median age for prostate cancer is 68 and rates increase until about age 70.

Race is also a risk factor. African American men have a higher incidence of prostate cancer and are more likely to die from it than white men.

A first-degree relative with prostate cancer, such as a father or brother,  increases your risk of developing it two- or threefold.

Recent genetic studies suggest that certain genes may be responsible for increasing your risk.

Diet may also play a role. The ACS states that men who eat large amounts of fat have a greater chance of developing prostate cancer.

Early detection

According to the American Urological Association (AUA), the majority of new prostate cancers are local and usually cause no symptoms. Early detection is important, so that doctors can monitor and treat the tumors before the cancer spreads.

There are two tests doctors use to look for warning signs of prostate cancer:

  • Prostate-specific antigen (PSA) test: This test measures the amount of PSA in your blood. Cells in the prostate gland produce PSA and your chance of having prostate cancer goes up with higher levels.
  • Digital Rectal Exam (DRE): In this test, your doctor inserts a gloved, lubricated finger in your rectum to feel for bumps or irregularities on the prostate. Uncomfortable though painless, it is not as effective as the PSA test in detecting prostate cancer.

The AUA recommends that all men age 40 and older have a prostate cancer risk assessment to determine a baseline PSA level. A PSA level above the median for a patient’s age is a stronger predictor of future prostate cancer than family history or race.

ACS guidelines

The American Cancer Society recommends that men age 50 and older talk first with their health care professional about the benefits and risks of having a PSA blood test or a DRE.

African-American men and men with a family history of prostate cancer should discuss having these tests beginning at age 45. Men with an even higher risk (those with several first-degree relatives who had prostate cancer before age 65) should have this discussion beginning at age 40.

If you decide to get tested, the frequency of testing depends largely on your PSA level.

Men with prostate cancer usually have PSA levels above 4 nanograms per milliliter (ng/ml). Men with higher PSA levels (2.5 ng/ml or more) should have their doctors test them annually.

"The death rate from prostate cancer has dropped from 40,000 to 30,000 here in the U.S.," said Brian Hopkins, MD, a urologist at John Muir Health. "PSA screening and early detection have helped play a role in this statistical decrease."

Treatment

Once prostate cancer is detected, according to the AUA, a patient’s physician may recommend a number of treatment options. These include surgery, radiation, and hormone therapy.

"Depending on the patient's clinical situation, localized prostate cancer can be cured by surgery or radiation," said Michael Messer, MD, medical director of medical oncology at John Muir Health. "Even advanced cases can be effectively treated with medications."

Symptoms

Most people don’t experience symptoms from prostate cancer because doctors diagnose the condition before any develop.

"Prostate cancer does not have symptoms associated with it, that is why the serum PSA and digital rectum screenings are so important," said Dr. Hopkins.

However, if the disease advances or spreads, it may cause weak or interrupted urine flow, the need to urinate frequently, blood in the urine, or pain with urination. If prostate cancer spreads to the bones, it may cause pain in the hips, spine, ribs, or in other body parts.

Healthy Diet

You may be able to reduce your risk of prostate cancer by making healthier diet choices.

  • Eat more fish and less red or processed meat. Preliminary research findings from Europe show that men who follow this guideline have a lower incidence of prostate cancer.
  • Eat more tomatoes, especially those that have been cooked and crushed. Tomatoes are the richest source of lycopene, an antioxidant that studies show decreases the incidence of prostate cancer. (Lycopene is also present in other foods, including grapefruit and watermelon.)
  • Avoid excessive consumption of dairy products. Men who consume high levels of calcium (more than 1,500 mg/day) have a higher incidence of prostate cancer. The American Cancer Society recommends eating no more than three servings of dairy a day.
  • Participate in regular physical activity and maintain a healthy weight.
  • Eat a diet low in fat and high in vegetables, fruits, and grains. The ACS recommends limiting your intake of high-fat foods from animal sources and choosing most of the foods you eat from plant sources.