Link may exist to prostate cancer
By:Arthur E. Feldman
Prostate cancer is the most common cancer in American men, excluding skin cancer, and is the second most common cancer-related cause of death.
This year, the disease will be diagnosed in an estimated 184,500 men in the United States and will kill approximately 30,000 men nationwide. Black men have the highest prostate cancer incidence in the world.
The two major risk factors for prostate cancer are aging and testosterone. Other risk factors include a family history of prostate cancer, being of African-American descent and consumption of a high-fat diet. A diet high in dairy products also may be a contributing factor.
Since 1991, the death rate from prostate cancer has decreased 16 percent among Caucasian males, and since 1993, it has decreased 11 percent among black males.
Many experts have attributed this decline to the availability of screenings, especially a blood test for the prostate-specific antigen. Prostate cancer is also screened by a digital-rectal examination of the prostate gland.
If at least one of the tests — the PSA or the DRE — is found to be abnormal, then a prostate ultrasound with fine-needle biopsies is advisable.
Once prostate cancer is diagnosed, attention is focused on treatment options, which include watchful waiting in older patients with low-grade small-volume disease; surgery (radical prostatectomy); radiation (either external beam and/or a seed implant); hormonal therapy; or cryotherapy (when the prostate is frozen solid under ultrasound guidance while the patient is under anesthesia).
Treatment is a personal decision between a patient and his doctor and is dependent on the tumor grade, patient’s age, presence of other diseases and lifestyle.
More aggressive therapies are favored for younger patients in good health with at least a 10-year life expectancy. However, these aggressive therapies tend to have more side effects and complications.
There is much debate to determine whether routine screenings should be recommended.
Definitive conclusions will be available when studies are completed that compare survival rates of men who get the PSA screening versus those who do not.
To help screen for prostate cancer, it is generally recommended that men with a family history of the disease and African-American men be screened annually from age 40, while men at lower risk should be screened annually from age 50.
There are some simple and easy dietary changes that may help prevent prostate cancer, including increased consumption of vitamin E, selenium, lycopene, soy products and green tea and reducing the intake of dietary fat.
According to recent reports, limiting the consumption of dairy products may also lower the chance of prostate cancer.
Dr. Feldman is a board-certified urologist and a member ofSomerset Medical Center Medical and Dental staff.