Taking Care of the Men in our Lives
Prostate Cancer
September 14-20 is Prostate Cancer Awareness Week
Prostate cancer is the most common cancer in American men. By age 50 approximately one in four men have some cancerous cells in the prostate gland. By age 80, this ratio increases to one in two. It is also the second leading cause of cancer deaths in American men. An American man has about a 30 percent risk of having prostate cancer in his lifetime, but only 3 percent risk of dying of the disease. For many men, it is the possible consequences of treatment of the cancer--bladder control problems and impotence--that are a greater worry than the cancer itself.
But, if prostate cancer is detected early, when it is still confined to the prostate gland, there is a better chance of successful treatment with minimal side effects. The problem with diagnosing prostate cancer is that it often doesn't produce any symptoms in its early stages. That is why many prostate cancers aren't identified until they have spread beyond the prostate. While successful treatment of these cancers are more difficult, treatments do exist that can help control them.
The Causes
The causes of prostate cancer and why some types behave differently are unknown. Research indicates that it may be a combination of factors, including family history, ethnicity, hormones, diet and the environment.
- As you get older, your risk of prostate cancer increases.
- African-American men are more likely to have prostate cancer than other ethnic groups in the U.S. Asian-American men have the lowest incidence of prostate cancer. The rate in Caucasian men is also slightly higher than Hispanic and Native American men.
- If an immediate family member, i.e. brother, father, has prostate cancer, there is a greater risk of the disease than that of the average male.
- A high fat diet may increase the risk of prostate cancer. Researchers believe that fat increases the production of testosterone, and this may speed the development of prostate cancer cells.
The Symptoms
Prostate cancer is often difficult to diagnose. There are symptoms to be aware of; according to the Mayo Clinic they may include the following:
- Difficulties with urination--pain, weak urine flow or intermittent urine flow. Frequent urination at night or blood in the urine are also symptoms.
- Erectile disfunction lasting more than 2 months or recurring frequently.
- Pain in the lower back, hips or upper thighs; dull pain in the lower pelvic area. While these symptoms don't always point to prostate cancer, they can be signs of prostate-related problems.
Screening and Diagnosis
The American Cancer Society and the American Urological Association (AUA) recommend men older than 50 begin prostate cancer screening with an annual blood test to check for prostate-specific antigen (PSA). Men with any of the above-mentioned risk factors should consider PSA screening beginning at age 40. The AUA also recommends that men have a yearly digital rectal exam beginning at age 40. Most early prostate cancers are detected with these exams before any symptoms are experienced.
When initial test results indicate the presence of prostate cancer a biopsy is the next diagnostic step. During a biopsy, small tissue samples are taken and analyzed to determine if cancer cells are present. Once a definite cancer diagnosis has been made, further tests may be performed to determine if or how far the cancer has spread. The next step is grading, to determine if the cancer is a slow- or fast-growing form. The more different the cancer cells are from healthy cells, the more aggressive the cancer and the more probable that it will spread quickly. Finally, the cancer is assigned four stages based on how far it has spread.
Treatment
There are several different ways to treat prostate cancer. Surgery, radiation, hormone therapy, and chemotherapy, alone or in combination, usually work best. The treatment will depend on how fast the cancer is growing, how far it has spread, the age and health of the patient, the benefits and the potential side effects of the treatment. Physicians are not always in agreement as to the way to proceed because there have not been enough large trials that compare the different treatments. The University of Pennsylvania Cancer Center recommends that patients get more than one opinion and talk to both urologists and radiation oncologists to hear about the benefits and risks of surgery, hormonal therapy and radiation in the particular patient's case. And, if the cancer has spread at the time of diagnosis, it is recommended that a medical oncologist be consulted regarding chemotherapy. The most important thing is to discuss all the options and make a decision in accord with your lifestyle, beliefs and values.
Prevention
Every man wants to reduce his risk of prostate cancer. The three most important steps that can be taken to maintain prostate health, and health in general, are to eat well, keep physically active and get regular medical checkups.
High-fat diets have been linked to prostate cancer. Emphasizing fruits, vegetables and whole fibers and limiting high-fat foods may help reduce the incidence of prostate cancer. Foods rich in lycopenes, an antioxidant, such as raw or cooked tomatoes, tomato products, grapefruit and watermelon, may help lower the risk of cancer. Garlic, cruciferous vegetables such as arugula, broccoli, brussel sprouts, cabbage and cauliflower also appear to help fight cancer.
Soy products contain isoflavones that appear to keep testosterone in check. Since prostate cancer feeds off testosterone, isoflavones may reduce the risk and progression of the disease. Early research indicates that vitamin E may reduce the risk of prostate cancer among smokers. However, more study is needed to confirm this.
New Evidence Favors Fish
Scientists in Sweden have conducted a 30year study of 6,272 men with an average of 56 when the study began. Each man gave detailed information about his diet as well as his smoking, drinking and exercise habits. During the observation period, 466 men were diagnosed with prostate cancer and 340 dies from the disease.
A comparison of the men who developed prostate cancer with those who did not showed that eating fish was associated with protection. Those who ate a moderate to large amount of fish had only a third to half the risk of prostate cancer as the others. Men who ate the most fish also ate more vegetables and less meat. In addition, they got more exercise and smoked less. However, the fish remained protective even after the other lifestyle factors were considered.
Earlier this year, the twelve year Harvard Health Professionals Follow-Up Study of 47,882 men confirmed that eating fish more than three times a week was linked to a reduced risk of prostate cancer. The apparent benefit was greatest for widespread, aggressive prostate cancer which occurred 44% less often in the men who ate large amounts of fish than in those who rarely at fish.
The key is in the fat. Instead of the harmful saturated fats found in meat and milk, fish have two unique omega-3 fatty acids. Laboratory tests suggest that these fats may be able to slow the growth of prostate cancer cells. The men in the Swedish study ate fish from cold waters, such as salmon, mackerel and herring, all of which contain large amounts of these fatty acids. Fish, accompanied by whole grains, nuts and seeds, soy, vegetables and fruits, provides a style of eating that should decrease the risk of prostate cancer.
When it comes to cancer, there is no clear data linking exercise to a reduction in cancer incidence. However, it has been shown to strengthen the immune system, improve circulation and speed digestion, all of which may play a role in cancer prevention.
Other important factors
A Mayo Clinic study first published in March 2002, indicates that regular use of aspirin, ibuprofen (Advil, etc.) and other nonsteroidal anti-inflammatory drugs (NSAIDs) may help protect against prostate cancer. The study found that men age 60 and over who used NSAIDs daily may reduce their risk of prostate cancer by up to 60 percent and that the beneficial effect may increase with age.
For more information about Prostate Cancer and other cancers, consult the following websites:
The American Cancer Society, www.cancer.org
The Mayo Clinic, www.mayoclinic.com
The Abramson Cancer Center of the University of Pennsylvania, www.oncolink.com
The Memorial Sloan-Kettering Cancer Center, www.mskcc.org
The Harvard Medical School, www.health.harvard.edu
