Men''s Health - September 2003

Men's Health

Recent Studies Advance The Understanding of Prostate Cancer

September Is Prostate Cancer Awareness Month

Research reports chronicling advances this year in the prevention and treatment of prostate cancer show that a drug used to combat baldness can cut the risk of prostate cancer by 25 percent. A picture of a man, smiling

Studies also point to a newly discovered gene that appears to play a key role in governing the spread of cancerous prostate cells to other parts of the body.

In addition, studies confirmed that frequent exercise, maintaining a proper weight, and routine prostate screenings appear to be significant steps in prevention and management of prostate cancer.

These recent findings are just the latest fruits of research into prostate cancer - developments that have made prevention and treatment more promising than ever before.

Still, experts say, early detection remains vitally important in efforts to combat the disease, which will affect one in six US men. September is national Prostate Cancer Awareness Month.

Among the latest findings:

Researchers recently reported that men who took the baldness drug finasteride for seven years had a 25 percent lower chance of getting prostate cancer, compared with those who took a placebo (inactive substance). The federally sponsored study marked the first time it was shown a drug could prevent prostate cancer.
A second study found a gene that may be key to stopping the spread of prostate cancer. The gene, designated RKIP, which produces the RKIP protein, can stop cancer cells from leaving the prostate and entering the bloodstream.

A study of men with localized prostate cancer found those at high risk of having the disease spread beyond the gland were more likely to be obese and to exercise less than twice a week. These men also were less likely to have had annual prostate screenings. By contrast, men with the lowest risk of cancer progression kept their body weight down, got regular exercise, and had routine prostate cancer screenings.

"It's a remarkable time to be taking care of people with this disease," says Dr. Ian M. Thompson, a urologist at the University of Texas Health Science Center and the lead researcher in the study of the baldness drug.

With all the advances in prostate research, he says, "The prognosis is a lot better than 20 years ago."

Progress in prevention and treatment notwithstanding, experts say screening for prostate cancer remains crucial.

"It's a very simple issue," says Dr. Richard Atkins, president of the National Prostate Cancer Coalition. "Prostate cancer detected early is often much more treatable than when discovered late.

"Late-stage prostate cancer is very difficult to control and it, sadly, remains too often a lethal disease," Dr. Atkins says.

Second Most Common Cancer in Men

The prostate gland, part of the male reproductive system, is about the size and shape of a walnut and weighs about one ounce. It is located below the bladder, in front of the rectum, and its main function is producing fluid for semen.

Prostate cancer is the most common cancer, excluding skin cancers, in American men.

The American Cancer Society (ACS) estimates that during 2003 about 220,900 new cases of prostate cancer will be diagnosed in the US. One man in six will be diagnosed with prostate cancer during his lifetime, but only one man in 32 will die of this disease.

African-American men are more likely to have prostate cancer and to die from it than are Caucasian or Asian men. The reasons for this are still not known.

Prostate cancer is the second leading cause of cancer death in men in the US, exceeded only by lung cancer. The ACS estimates that 28,900 men in the US will die of prostate cancer during 2003. Prostate cancer accounts for about 10 percent of cancer-related deaths in men.

Screening Essential, Experts Say

Early prostate cancer often does not cause symptoms, according to the National Cancer Institute (NCI) of the National Institutes of Health (NIH).

Experts say that because there are no specific signs or symptoms prostate screening is important.

An annual physical examination, prostate-specific antigen (PSA) blood test, and digital rectal exam (DRE) provide the best chance of identifying prostate cancer in its earliest stages.

The following are the most common symptoms of prostate cancer:

weak or interrupted flow of urine
urinating often (especially at night)
difficulty urinating or holding back urine
inability to urinate
pain or burning when urinating
blood in the urine or semen
nagging pain in the back, hips, or pelvis
difficulty having an erection

As a man gets older, his prostate may grow bigger and obstruct the flow of urine, or interfere with sexual function. An enlarged prostate gland - a condition called benign prostate hyperplasia - may require treatment with medications or surgery to relieve symptoms.

This common benign prostate condition, which is not cancer, can cause many of the same symptoms as prostate cancer.

Always consult your physician for more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Cancer Society

Centers for Disease Control and Prevention (CDC)

Healthfinder, US Department of Health and Human Services (HHS)

Men's Health Network

National Cancer Institute (NCI)

National Institutes of Health (NIH)

National Prostate Cancer Coalition

September 2003

Recent Studies Advance The Understanding of Prostate Cancer

Second Most Common Cancer in Men

Screening Essential, Experts Say

Risk Factors for Prostate Cancer

Online Resources

Risk Factors for Prostate Cancer

In general, all men are at risk for prostate cancer. However, there are specific risk factors that increase the likelihood that certain men will develop the disease, including the following:

age
Age is a risk factor for prostate cancer, especially men age 50 and older. More than 80 percent of all prostate cancers are diagnosed in men over the age of 65.

race
Prostate cancer is nearly twice as common among African-American men than it is among Caucasian-American men. Japanese and Chinese men native to their country have the lowest rates of prostate cancer. In Japan, the incidence of prostate cancer has increased as Western diets and lifestyles have been adopted.

diet
Epidemiological data suggests that the diet consumed in Western industrialized countries may be one of the most important contributory factors for developing prostate cancer. Consider the following information regarding diet and its effect on the risk for prostate cancer:

fat
Studies suggest that men who eat a high-fat diet may have a greater chance of developing prostate cancer.
fiber
Dietary fiber intake may influence circulating levels of testosterone and estradiol, which, in turn, may decrease the progression of prostate cancer.
soy protein
Besides lower fat intake, another major difference between Asian and American diets is the consumption of soy, averaging 35 g/day per capita. Soy contains isoflavone which, in several studies, have been found to inhibit the growth of prostate cancer.
vitamin E and selenium
Vitamin E, an antioxidant, combined with selenium, has been shown to inhibit tumor growth in laboratory animals.
carotenoids
Carotenoids containing lycopenes have been shown to inhibit the growth of human prostate cancer cells in tissue cultures (cells grown in the laboratory). The primary source of lycopenes is processed tomatoes in tomato juice and tomato paste.
herbal preparations
Combination herbal preparations should be used with caution as reported side effects have included venous thrombosis, breast tenderness, and loss of libido. Many herbal preparations have not been studied in men with prostate cancer.

obesity
Obesity not only contributes to diabetes and high cholesterol, but has also been associated with some common cancers, including hormone-dependent tumors such as prostate, breast, and ovarian cancer.

environmental exposures
Some studies show an increased chance for prostate cancer in men who are farmers, or those exposed to the metal cadmium while making batteries, welding, or electroplating.

having a vasectomy, BPH (benign prostatic hyperplasia), or STD (sexually transmitted disease)
Researchers have looked at whether men who have had a vasectomy, BPH, or those who have been exposed to a sexually transmitted disease are at increased risk for prostate cancer.

family history of prostate cancer
Having a father or brother with prostate cancer doubles a man's risk of developing this disease. The risk is even higher for men with several affected relatives, particularly if the relatives were young at the time of diagnosis.

Geneticists divide families into three groups, depending upon the number of men with prostate cancer and their ages of onset, including the following:

sporadic - a family with prostate cancer present in one man, at a typical age of onset; sporadic means occurs by chance.

familial - a family with prostate cancer present in more than one person, but with no definitive pattern of inheritance and usually an older age of onset.
hereditary - a family with a cluster of three or more affected relatives within any nuclear family (parents and their children), a family with prostate cancer in each of three generations on either the mother or father's side, or a cluster of two relatives affected at a young age (55 or less). Five to 10 percent of prostate cancer cases are considered hereditary.

genetic factors
Normally, cells contain 46 chromosomes, or 23 pairs, half of which are inherited from our mother, half from our father. Some genes, when altered or mutated, give a higher risk for uncontrolled cell growth, which, in turn, can lead to tumor development. These genes have various names, but overall are referred to as "cancer susceptibility genes."

About 9 percent of all prostate cancers and 45 percent of cases in men younger than age 55 can be attributed to a cancer susceptibility gene that is inherited as a dominant trait (from parent to child).