Ways to Reduce Your Risk of Prostate Cancer

Prostate cancer is the most common cancer in men, with the American Cancer Society projecting 191,930 new cases and 33,330 deaths from prostate cancer in 2020. While the statistics are compelling, most men diagnosed with prostate cancer do not die from it. Currently, more than 3.1 million men in the U.S. are living with prostate cancer.

While prostate cancer is a significant concern for both patients and healthcare professionals, empowering yourself with knowledge can help you prevent it. The goal of this article is to highlight all aspects of prostate cancer, including lifestyle choices that will decrease your risk, men who are at an increased risk, different types of diagnoses and the number of prostate cancer treatment options.

What is prostate cancer?

The prostate is a walnut-sized gland found in the male pelvis under the bladder and surrounding the urethra. This spongy gland is regulated by the hormone testosterone and produces a milky fluid that is part of seminal fluid. The seminal fluid carries sperm through the urethra during ejaculation.

Prostate cancer, also known as prostatic carcinoma, occurs when malignant cells in the prostate grow abnormally and form a tumor. Even if cancer spreads to other places in the body, which is known as metastasis, it is still called prostate cancer.

More than 99% of prostate cancers are adenocarcinomas. However, there are several different types of carcinoma. The types of prostate cancer are:

• Adenocarcinomas (most common) develop from the gland cells that make the prostate fluid for semen
• Small cell carcinoma
• Neuroendocrine tumors (other than small cell carcinomas)
• Transitional cell carcinomas
• Sarcomas

What are the leading risk factors of prostate cancer?

While the word cancer instills fear in most, prostate cancer is actually a very common disease that affects many men. However, some people are at a higher risk than others. Prostate cancer risk factors include:

• Age: Risk directly increases with age. The average age of diagnosis is between age 66 and 67.
• Race: African American men are at a higher risk than men of other races.
• Family history: Those who have a first-degree relative, father or a brother, with prostate cancer are at greater risk. There is a genetic mutation that may make it more likely to occur among family members with breast or ovarian cancer, like in those who have Lynch syndrome or BRCA1 or BRCA2.
• Geographic location: Prostate cancer is more common in North America, northwest Europe, Australia and the Caribbean. It is unclear whether that is because these areas screen more frequently for prostate cancer.

What can you do to prevent prostate cancer?

When it comes to how to prevent prostate cancer, it is important to discuss any relevant family history with your healthcare provider. Beyond things you can’t change like family history or race, there are many lifestyle factors to consider.

While there is no specific prostate cancer prevention diet, there are steps you can take to improve your overall health. Focusing on your overall well-being may help you to reduce the risk of developing prostate cancer.

How do I keep my prostate healthy?

While there is no guarantee you can prevent prostate cancer, there are lifestyle changes you can make to prevent prostate cancer, such as:

• Choosing a nutritious and balanced diet
• Drinking more water
• Quitting smoking
• Exercising at least 3 times per week at a moderate pace for 30 minutes

What foods kill prostate cancer cells?

No food will directly kill prostate cancer cells. A healthy diet made up of specific superfoods will improve prostate health. Start by increasing your consumption of fruits and vegetables that contain antioxidants that fight cancer.

• Isoflavones are present in foods like soybeans, chickpeas, peanuts, alfalfa sprouts and lentils. Isoflavones are phytoestrogens that help regulate hormones and cause cell death. Consider adding foods like peanut butter, hummus and tofu to your diet to boost isoflavone consumption.
• Lycopene is an antioxidant that is in red foods like tomatoes. It is easiest for your body to break down if it is cooked or pureed like in marinara sauce, tomato paste, tomato juice or sundried tomatoes.
• Plant-based fats are the preferred dietary choice. Animal fats, like those found in lard, butter and cheese, cause an increase in the risk of prostate cancer. Choose instead olive oil, avocados, nuts and seeds for your fat consumption.
• Coffee also has benefits. A 2015 study found that coffee may have a beneficial effect related to coffee consumption.
• Green tea decreases the risk of prostate cancer according to multiple studies. Green tea supplements may help as well.

Is drinking a lot of water good for your prostate?

Drinking an appropriate amount of water is part of a healthy diet. We recommend between 8 and 12 glasses (8 ounces per glass) of water per day. Drinking more water will help your body flush toxins and make your urine less concentrated, meaning your bladder will be less irritated. It also allows your gastrointestinal tract to pull in more liquid, meaning you will have regular stools, which is ideal.

What vitamins or supplements help prevent prostate cancer?

There are some supplements that may help prevent prostate cancer, such as:

• Fatty acids, also known as omega-3s, which can help reduce your risk of prostate cancer. They are found in fish like sardines, tuna, mackerel, trout and salmon. However, the research on this is not conclusive. A study in 2013 suggested that increased fatty acids may lead to prostate cancer.
• Cranberry extract, which includes a flavonol that may inhibit prostate cell growth and decrease the PSA level.

What are the recommendations for prostate cancer screening?

The best way to detect prostate cancer early is through a blood test called a prostate-specific antigen (PSA) test.

The American Cancer Society recommends starting prostate cancer screening at these ages:

• Starting at age 50: Routine screening with a PSA test so long as they are expected to live another 10 years or more.
• Starting at age 45: Screen if they are at a high risk of developing prostate cancer and have risk factors such as being African American or having a first-degree relative diagnosed with prostate cancer before age 65.
• Starting at age 40: Screen if at higher risk and have more than 1 first-degree relative with early-age prostate cancer.

Before undergoing any screening services for prostate cancer, talk to your doctor. The age for prostate cancer screening is based on health status and risk for prostate cancer. Overall health status is more important than age when making a decision about proceeding with prostate cancer screening.

The PSA blood test will return a number value.  There is no “one-size-fits-all” PSA value that is appropriate.  For example, the average PSA for men in their 40s is 0.7, while for a man between 55 and 59 the average is 1. As men age, their PSA increases.  It is important for you to have your PSA reviewed by a physician who is familiar with your personal health and family history to determine if your PSA is appropriate or not.  

What are the risks of screening for prostate cancer?

The risks of screening include a false positive test result, meaning an elevated PSA level without having prostate cancer. When the test results come back abnormal, you may feel anxious about your health and have an unnecessary biopsy. The risk of an elevated PSA level increases with age.

Screening can also detect prostate cancer in men who do not have symptoms and may have eventually died from another cause. These men are at risk for complications without the benefits of treatment.

However, for men with at least a 10-year life expectancy, on balance the benefits of prostate cancer screening outweigh these risks. Cancer screening has been shown to save lives.

How is prostate cancer diagnosed?

First, you may be found to have an elevated PSA level. However, other conditions can cause abnormal PSAs. Prostate cancer is actually diagnosed with a prostate biopsy, which involves removing small pieces of tissue from the prostate and examining them under a microscope for cancer cells. If the cancer cells are present, you will need to discuss your treatment options with your cancer care team.

Your follow-up care will depend on the extent of your cancer. Important considerations include the size of the tumor, whether it has spread to lymph nodes or other areas of the body, your PSA level and the Gleason grade group.

The pathologist who examines your biopsies will review the tissue and give a Gleason score grade groupthat is between 1 and 5. Grade group 1 is considered low grade (least aggressive), grades 2 and 3 intermediate, and 4 and 5 high grade (most aggressive).

How is prostate cancer treated?

With early treatment, most men will be cured of prostate cancer. However, seeking expert treatment is imperative to recovery.

• Active surveillance is considered for men with slow-growing cancer confined to the prostate, without symptoms and includes regular PSA screening and digital rectal exam. For many men with Gleason Grade group 1 prostate cancer, active surveillance is appropriate and no immediate treatment is needed.
  
• Surgery • Surgery involves removing the prostate and any other cancerous tissue. Most commonly this is done using a robot and is considered a surgery. There are many options for how surgery can be performed, and it is important to seek care from a high-volume surgeon to ensure all options are considered. 
• Radiation therapy comes in different forms:
  
  • Intensity-modulated radiation therapy
  • Brachytherapy (also called "seeds")
  • Stereotactic body radiation therapy
  • Proton therapy 

Can you fully recover from prostate cancer?

Yes, when diagnosed early and treated promptly, the chance of curing  prostate cancer can be almost 100%. However, when prostate cancer is metastatic, it is treatable, but cure is not possible.

For those who undergo a prostatectomy, the postoperative short-term recovery involves a night in the hospital and regaining your mobility. After you’re able to walk, you will return home to recuperate for a month before returning to work. You also cannot lift heavy objects for 6 weeks or drive for 7 to 10 days.

Long-term side effects of prostate cancer treatment include urinary dysfunction, erectile dysfunction, bowel issues, infertility and issues resulting from hormone therapy. However, with pelvic floor physical therapy and medications, long-term side effects can often be treated.

Where should you seek prostate cancer diagnosis and treatment?

One in 9 men will develop prostate cancer in his lifetime. If you or a loved one are diagnosed with prostate cancer, turn to the prostate cancer specialists at The University of Kansas Cancer Center. Our specialists offer advanced robotic surgery, known as the Retzius-sparing radical prostatectomy. We are the only team in the region to offer this less-invasive procedure, which approaches the prostate from below the bladder to reduce unwanted side effects. We also offer the most advanced forms of radiation treatment, including proton therapy – which will arrive in 2021. The physicians at the University of Kansas Cancer Center are nationally and internationally renowned experts in prostate cancer, and work together as a team to personalize treatment on an individual basis.

Patients who receive treatment at a National Cancer Institute-designated cancer center are 25% more likely to survive than compared to other centers. We are the only NCI-designated cancer center in the state and 1 of only 71 in the United States. Our patients have access to advanced cancer research and clinical trials. Our personalized care teams include highly trained physicians who provide a supportive experience and expert consultation every step of the way.