Preventing prostate cancer

By Independent Reporter

Possible remedies include having more sex and more vegetables

A new study published in the British Medical Journal from researchers at Memorial Sloan-Kettering Cancer Center in New York has resurrected the debate about the benefits or otherwise of preventive prostate cancer screening.

The new research suggests that aside from men with a history of prostate cancer, other groups at high risk for the disease may be identified with a single Prostate Specific Antigen (PSA) test when they are in their 40s.

“Men at low risk of death from prostate cancer without screening have little to gain from being screened but still risk over diagnosis and over treatment; men likely to die from prostate cancer without screening could avoid cancer specific mortality if they choose to be screened,” the authors write.

But Dr. Michael LeFevre, the co-vice chair of the U.S. Preventive Services Task Force (USPSTF)committee that advised against widespread screening using PSA, told Time magazine in an email response to questions about the findings that at the time the task force made its recommendation, existing trials did not include men under age 50.

Still, he wrote, “Men choosing to be screened should be informed of the potential for significant harm, and that the benefit demonstrated in the best studies is between small and none. Those who place a higher value on the possibility of benefit, however, small, than they do the well-established risk of harm may still choose to be screened.

But we should not oversell the test based on hope, we should do the science that demonstrates that approaches other than that taken in existing trials minimizes the harms and increases the benefit.”  Most prostate cancers are slow growing but the few cases of aggressive prostate cancers sometimes spread from the prostate to other parts of the body, particularly the bones and lymph nodes.

Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse, or erectile dysfunction.  The USPSTF committee has previously recommended that no one should get screened for prostate cancer, claiming the simple blood test for prostate-specific antigen, or PSA, does more harm than good.

According to the Time magazine story, no one denies that PSA tests can help to catch prostate cancer early. But two issues are still unresolved. One is how well screening can actually work to prevent cancer deaths; the other is what kind of negative effects screening brings along with its benefits.

It notes that no diagnostic test is 100% accurate, and if a PSA test comes back positive for prostate cancer, the patient will usually be referred for a biopsy to confirm the diagnosis. That test can have side effects. Then, if the patient does have cancer,  the available treatments for it — surgery, radiation, as well as other options — also have side effects, chief among them impotence, incontinence, and urinary incontinence.

As the debate over the value of a PSA test continues, recent research appears to point at diet as an ameliorating factor in prostate cancer prevention.

Non-dietary preventive measures

1. Have more sex

A 2004 study in the Journal of the American Medical Association analysed data on 29,342 men and found that guys who had 21 or more orgasms a month were about 30 percent less likely to develop prostate cancer than those who racked up only four to seven a month.

2. Move it.

Exercise reduces the risk of fatal forms of prostate cancer by 41%. What’s more, among survivors of prostate cancer, those who exercised vigorously had a 56% lower risk of death from the disease.

3. Check for so-called bed bugs.

A stealth STD may increase your risk for prostate cancer. In a new Harvard study, men with a history of trichomoniasis were more than twice as likely to develop advanced-stage prostate cancer as those who never had the parasite.

Dietary recommendations to prevent prostate cancer

1. Drink more coffee.

Regular, decaf, half-caf, whatever—it is all good, say Harvard researchers. They found that men who drank six or more cups of regular or decaf coffee were 59% less likely to develop advanced prostate cancer than those who eschewed the brew.

2. Go green.

In a 2008 British study, scientists found a disease-fighting benefit from consuming just 4 servings of the vegetable a week. It’s likely that compounds found in vegetables like broccoli, called isothiocyanates, can activate genes that disturb the chemical processes that may cause cancer and inflammation.

3. See red, eat red.

For the 1,324th time, eat more cooked tomato products to reduce your risk of prostate cancer. This quirky link was first noticed in the 1990s by Harvard researcher Edward Giovannucci, M.D., Sc.D., and subsequent studies have confirmed the power of edible red. Credit lycopene, a pigment in tomatoes that’s more potent after they’re cooked.

4. Top off your oil

Plus, Harvard researchers found that men who ate fish three times a week reduced their risk of aggressive prostate cancer by 25 percent. Fish oil has the omega-3 fatty acids DHA and EPA said to inhibit tumours.

5. Ditch the doughnuts.

Men with the highest blood levels of trans fats have more than twice the prostate-cancer risk of men with the lowest levels. Avoid commercially baked doughnuts and cookies, as well as packaged baked goods containing hydrogenated oil.

6. Shelve the selenium supplements.

Selenium, a mineral found naturally in Brazil nuts, red meat, fish, and grains, became popular as a supplement in the late ‘90s because researchers believed it could help prevent prostate cancer. But a recent study showed that selenium did nothing to defend against the disease (or any other cancer for that matter). Worse, taking selenium slightly increased the risk of diabetes in some men.