Dr. Waterhouse: There are no signs that warn patients of prostate cancer at its earliest stages, which is why it is of paramount importance that patients seek health care for “well visits (check-ups)” when they have do not have symptoms. In it late stages of the disease, prostate cancer can cause urinary symptoms including increased urinary frequency, decrease in urinary force, or even blood in the urine. Once prostate cancer spreads from the prostate, it may involve the bone and cause bone pain or back pain.
Dr. Moore: There are several known risk factors for developing prostate cancer. Advancing age is a factor with approximately 60% of prostate cancer being diagnosed in men older than 65 years of age. Race and ethnicity is a risk factor since African American men develop prostate cancer at a rate that exceeds other populations. Although the reasons are unclear, geography plays a role. Prostate cancer is more prevalent in North American than it Is in Central and South American or Asia. Family history plays a role. Men with multiple affected relatives, brothers of men diagnosed with prostate cancer, and men with relatives diagnosed at a young age all have an increased risk of developing prostate cancer in their lifetime. Genetic mutations such as in the BRCA gene (usually associated with breast and ovarian cancer) and HNCPP (often associated with colorectal cancers) also increase the risk of developing prostate cancer.
Dr. Carter: There is a fair amount of data to suggest that diet may play a role in the development of prostate cancer. Some studies have found that a diet high in animal fats, including dairy, maybe a factor in the development of prostate cancer.
Conversely, some studies have concluded that a diet low in vegetables may be a risk factor for developing prostate cancer. Researchers have not all agreed on this particular point. More specifically, lycopene, an anti-oxidant found in high concentration in tomatoes, has been associated with a lower incidence of prostate cancer, especially the more lethal tumors.
Dr. Waterhouse: I do not know definitive interventions that will prevent prostate cancer but eating a more plant-based diet rich in multiple antioxidants and with reduced animal fat and fried foods is a reasonable start. There is controversy over the influence of taking drugs like Dutasteride and Finasteride that are used to treat men who have urinary symptoms related to benign prostate enlargement, although they may influence the risk of developing prostate cancer. I do not routinely recommend these drugs for prostate cancer prevention.
The early use of PSA as a screening tool for prostate cancer has helped medical providers identify prostate cancer at early stages. Related to this effort, the Large Urology Group Practice Association (LUGPA) has been and continues to be very active with promoting the availability of this tool for Medicare coverage to enable healthcare providers to diagnose prostate cancer at its earliest stages for Black men and all men.
Dr. Moore: All of the above factors are beyond our control. There are, however, healthy lifestyle choices which, although not definitely proven, may contribute to the risk of developing prostate cancer. These include smoking, lack of exercise, poor diet, and chemical exposures (such as agent orange).
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