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Modifiable Factors for Prevention of Prostate Cancer …… 3

Dr. Ulhas Ganu / April 19, 2016 /

A risk factor is  anything that affects ones chance of getting a disease, be it diabetes, cardiac  problems or cancer. Different cancers have different risk factors. Risk factors  are of two kinds: Genetic, related to family history which cannot be changed  and Lifestyle related, like eating habits or smoking, which can be changed.

Yet we also  observe that many people with one or even multiple risk factors may not get  cancer, while others who get cancer may have had few or no known risk factors. Although  the exact causes of Prostate Cancer have not been understood as yet,  researchers have found several factors that might affect a man’s risk of  getting it.

Age

Prostate  Cancer is essentially the disease of the old. Very  rarely found in men younger than 40, the chance of having Prostate Cancer rises rapidly after age 50. In the US, about 6 in 10 cases of Prostate  Cancer are found in men over the age of 65.

Race/ethnicity

Prostate  Cancer occurs more often in African-American men and in Caribbean men of African ancestry than in men of other races.  African-American men are also more than twice as likely to die of prostate  cancer as white men. Asian-American and Hispanic/Latino men are less  likely to get Prostate cancer than non-Hispanic whites, the reasons for such  racial and ethnic differences as well as for geographic differentiation are not  clear.

Lifestyle  differences such as diet are likely to be important as well. Men of Asian  descent living in the United States continue to have a lower risk of Prostate  Cancer than white Americans, but their risk is higher than that of men  of similar backgrounds living in Asia. Prostate cancer seems to run  in some families, which is suggestive of an inherited or genetic factor. Having  a father or brother with prostate cancer more than doubles a man’s risk of  developing this disease. The risk is higher for men who have a brother with the  disease than for those with an affected father.

Gene  changes

Although several inherited gene changes have  been shown to be associated with increased Prostate Cancer risk, they  account for only a small percentage of cases overall. For example mutation in BRCA1  or BRCA2 genes (associated with increased risk of breast and ovarian cancers in  women in some families) may also increase Prostate Cancer risk in some  men.

Men with Lynch  syndrome (also known as hereditary non-polyposis colorectal cancer), a  condition caused by inherited gene changes, have an increased risk for a number  of cancers, including Prostate Cancer. Other inherited gene changes can  also raise a man’s risk of prostate cancer. Recently, some common gene  variations have been linked to a higher risk of prostate cancer. Studies to  confirm this are needed to see if testing for the gene variants will be useful  in predicting prostate cancer risk.

Diet

The exact role  diet in Prostate Cancer has not been established. Several factors such as eating  a lot of red meat or high-fat dairy products along with lower consumption of  fruits and vegetables appears to increase chances of getting prostate cancer,  albeit slightly. Thus experts advise avoiding beef, pork and lamb and shifting  to fish and poultry.  Consuming fruits  and vegetables regularly also makes lot of sense.

There are  conflicting reports about calcium intake with no concrete evidence to implicate  calcium. Calcium, no doubt, is important for bone health and of immense value  in preventing osteoporosis for the elderly. Some studies have suggested that  men who consume a lot of calcium (through food or supplements) may have a  higher risk of developing Prostate Cancer. Most studies have not found  such a link with the levels of calcium found in the average diet. Your doctor  is the best judge on daily quantity of supplementary calcium as it is important  to note that calcium is known to have many important health benefits.

Obesity  & Smoking

Some studies  have found that obese men may be at greater risk for having more advanced  prostate cancer and of dying from prostate cancer. However, most of the studies  do not report such a correlation. There is no conclusive proof of obesity being  a cause of Prostate Cancer.

Although a small  possible risk between smoking and Prostate Cancer is proposed by some  research workers, as such no direct link has been established between smoking  and enhanced risk for Prostate Cancer. Anyway it helps to keep better  health by quitting smoking.

Workplace  exposures

There is some  evidence that firefighters are exposed to substances (toxic combustion  products) that may increase their risk of prostate cancer.

Inflammation  of the prostate

According to some  researchers Prostatitis (inflammation of the prostate gland) may be linked to  an increased risk of Prostate Cancer. Though inflammation is often seen  in samples of prostate tissue that also contains cancer, direct link between  inflammation and Prostate Cancer appears to be weak as many other  researchers could not corroborate the theory.

The evidence to correlate Vasectomy and Sexually  transmitted infections to Prostate Cancer is also very weak and nothing  conclusive can be stated in the matter.

Although we do  not know exactly as to what causes prostate cancer, we do know that on a basic  level, Prostate Cancer is caused by changes in the DNA of a prostate  cell. Growth, division and death of our body cells (apoptosis – programmed cell  death) are decided by the genes. Oncogenes are the Genes that help cells grow,  divide, and stay alive. On the contrary there are (Tumor) Suppressor Genes  which (normally) slow down cell division, repair mistakes in DNA, or cause  cells to die at the right time.

DNA changes can  either be inherited from a parent or can be acquired during a person’s  lifetime. DNA changes (mutations) may turn on Oncogenes or turn off Tumor Suppressor  Genes, which may lead to cancer. Inherited DNA changes in certain genes seem to  cause only about 5% to 10% of prostate cancers. Several mutated genes have been  linked to a man’s inherited tendency to develop prostate cancer, including  RNASEL (formerly HPC1). The normal function of this tumor suppressor gene is to  help cells die when something goes wrong inside them. Inherited mutations in  this gene might let abnormal cells live longer than they should, which can lead  to an increased risk of prostate cancer.

Tumor suppressor  genes BRCA1 and BRCA2 normally help repair mistakes in a cell’s DNA or cause  the cell death in case the mistake is irreparable. Inherited mutations BRCA1  and BRCA2 commonly cause breast and ovarian cancer in women. In a very small  number of men, inherited BRCA changes may account for Prostate Cancers.  DNA mismatch repair genes such as MSH2 and MLH1 normally help rectify  mismatches in DNA during cell division. Men with inherited mutations in these  genes have a condition known as Lynch syndrome, which puts them at increased  risk of Colorectal and Prostate Cancers.

Most DNA mutations  related to prostate cancer seem to develop during a man’s life rather than  having been inherited.

Can  prostate cancer be prevented?

Since diverse  risk factors are involved from genetic to age, race and demography which cannot  be controlled the exact cause of Prostate Cancer cannot be pinpointed.  Naturally it is not possible to lay down an algorithmic path for prevention  either.

Body  weight, physical activity, and diet

The effects of  body weight, physical activity, and diet on prostate cancer risk are not clear,  but there are things one can do that might lower ones risk, such as: Eating at  least 2½ cups of a wide variety of vegetables and fruits each day, being  physically active and maintaining a healthy weight.

     
  • American Cancer Society  Guidelines on Nutrition and Physical Activity for Cancer Prevention.

American Cancer Society: http://www.cancer.org/acs/groups/cid/documents/webcontent/003134-pdf.pdf

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