En español | Two widely popular prostate cancer protection measures — PSA testing and vitamin E — were blasted recently by scientists with the U.S. Preventive Services Task Force advising against routine prostate cancer screening and by a new study concluding that high doses of vitamin E may actually increase — rather than decrease — the risk for prostate cancer. Those two key pieces of news have left many men wondering: Is there anything I can do to protect against this disease?
Yes. And fortunately, health-conscious men already may be taking some of the right steps to reduce their risk. "Almost every heart-healthy behavior you can imagine is associated with a lower potential risk of prostate cancer," says Mark Moyad, M.D., director of preventive and alternative medicine at the University of Michigan Medical Center department of urology.
Here are a man's best bets for eluding prostate cancer, according to researchers and health experts.
1. The right diet: beyond marinara sauce
For years, men who wanted to lower their risk for prostate cancer were advised to eat more cooked tomatoes, which are rich in lycopene, an antioxidant that appears to fight tumors. Today some health experts say that changing your diet could cut the risk for prostate cancer by as much as 30 percent to 50 percent. "But the advice needs to be more than just 'eat tomatoes,' " says Stephen Freedland, a urologist at Duke University School of Medicine. He and other scientists are working to identify other foods that might help protect against prostate cancer. They also are looking at what foods you may want to avoid.
Fill up on:
- Fish. The omega-3 fatty acids in fish — especially oily varieties such as salmon and mackerel — dampen inflammation, which appears to promote prostate tumors. In one recent study, men who ate oily fish more than once a week reduced their risk for developing aggressive prostate cancer by 57 percent.
- Leafy greens. Eating several servings of spinach and other leafy greens per week may cut the risk of prostate cancer, according to recent research by genetic epidemiologist John Witte and colleagues at the University of California in San Francisco. Witte found that filling up on beans, summer squash, garlic, red peppers, berries and orange melon could help, too.
- Coffee. A recent Harvard University study found that men who drink at least six cups of coffee a day were 60 percent less likely to develop lethal prostate cancer. Fortunately, decaffeinated coffee appeared to be just as effective as the high-test variety.
Cut back on:
- Simple carbohydrates. Sugary candy and soda, as well as starchy foods such as white bread and white rice are all high-glycemic carbs, which spark inflammation. One recent study found that men who ate the most sweet, starchy food were 64 percent more likely to develop advanced prostate cancer.
- Corn oil. It's a top source of omega-6 fatty acids, another trigger for inflammation that may promote prostate cancer, says Freedland.
- Well-done red meat. Well-done meats are loaded with cancer-causing compounds, says Witte. He recently completed a study showing that men who eat well-done beef (especially hamburgers) several times a week may double their risk for aggressive prostate cancer. The increased risk of prostate cancer, he says, was specifically tied to the time and "doneness" of the red meat — the longer meat is exposed to heat, the more carcinogens form.
2. Supplements: Be wary
If you still take vitamin E for prostate cancer, stop. There's no credible data that it or any other vitamin, mineral or medicinal herb prevents prostate cancer, says Moyad, an authority on supplements and prostate cancer. He's about to launch a study of red yeast rice supplements in high-risk men. Red yeast rice lowers cholesterol, which recent studies suggest may promote prostate tumor growth. Stay tuned.
3. Drugs: benefits and risks?
Some doctors give men at high risk for prostate cancer the drugs Proscar (finasteride) and Avodart (dutasteride), which reduce the threat by an estimated 23 percent. These drugs, known as 5-ARIs (shorthand for their chemical name), are normally prescribed for treating symptoms of an enlarged prostate and are not approved for cancer prevention by the U.S. Food and Drug Administration. The reason: Studies show that men taking 5-ARIs who do end up getting diagnosed with prostate cancer are more likely to have a highly lethal form of the disease.
But some physicians contend that increased risk may be a mirage. Instead of causing deadly cancer, 5-ARIs may simply make the disease easier to detect, says Neil Fleshner, M.D., a urologist at Princess Margaret Hospital in Toronto and a professor of surgery at the University of Toronto. These drugs shrink benign prostate tissue, Fleshner explains, which may improve the odds that a biopsy needle will find a small, but serious, tumor. Fleshner prescribes 5-ARIs to some men who have elevated PSA levels, a family history of the disease and other factors that increase their risk for prostate cancer.
4. Exercise: Just do it anyway
Although the general health benefits of exercise are beyond doubt, several large studies have failed to show that it lowers the risk for prostate cancer. One possible explanation: Healthy men who work out a lot may be more likely to get tested for prostate cancer. "Because they're more likely to get screened, they are more likely to be diagnosed with early-stage prostate cancer," says Steven C. Moore, a researcher at the National Cancer Institute. That could mask any potential protective effect of exercise. In fact, Moore says, other research suggests that exercise may guard against lethal forms of prostate cancer.
5. More sex … or masturbation
Finally, there's evidence that men who have frequent sexual intercourse or masturbate often may lower their risk for prostate cancer, possibly because ejaculation cleans out cancer-causing compounds that can accumulate in the gland. A study involving more than 29,000 male doctors and other health professionals found that men who ejaculated at least 21 times a month cut their risk for prostate cancer by up to 33 percent compared with men who reported an average of four to seven ejaculations per month.
Timothy Gower is a freelance journalist who lives on Cape Cod and writes about health and medicine.