Prostate Cancer

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Since the exact causes of prostate cancer are unknown, doctors can’t say for sure how to prevent it. However, studies have shown changing some lifestyle behaviors can lower the risk of developing prostate cancer.

Screening

Prostate cancer screening is a controversial topic. Screening tests include:

  • Digital rectal exam (DRE)
  • Prostate-specific antigen (PSA) blood test

While screening detects more cases of prostate cancer than waiting for symptoms to develop, only a small number of these cancers are harmful or life threatening. The overall chance of being harmed by prostate cancer is difficult to predict, and it depends on a man's age and health and the grade or stage of the cancer. Since prostate cancer grows slowly, the risks of treatment may outweigh the advantages, especially in older men and men with other health problems.

Also, prostate cancer screening is not perfect. Sometimes it may lead to more invasive tests that are not necessary. In some cases screening may be too late, and high-grade tumors may be found despite minimal abnormalities on screening exams.

Men older than 40 should educate themselves about the advantages and limitations of prostate cancer screening. Talk to your doctor about whether screening is right for you.

In general, prostate cancer screening should begin at age:

  • 50 for most men
  • 45 for African-American men or men with family histories (father, brother, son) of prostate cancer

Men older than 75 should consult their doctors about screening.

In many men, the PSA level slowly increases over time because of a condition called benign (non-cancerous) prostatic hyperplasia (BPH). It may be difficult to differentiate between BPH and prostate cancer. Sometimes, the threat of prostate cancer is evaluated based on the speed at which PSA increases over time.

While PSA and DRE are the best available screening tools, they have limitations. Researchers are working to develop better tools.

If you have regular PSA screening, keep track of your PSA values in a file or spreadsheet. This complete history of screening results will be helpful if you change doctors.

Read more about DRE and PSA in the section on Tests.

Other ways to prevent prostate cancer

You can take action to lower your chances of developing prostate cancer.

  • Eat at least five servings of fruits and vegetables daily and eat less red meat.
  • Tell your doctor about supplements you take. Vitamin A (beta-carotene) may increase risk. A recent large study found that selenium and vitamin E, once thought to decrease risk of prostate cancer, have no effect.
  • Exercise regularly
  • Maintain your ideal weight

In other words: Most recommendations for a healthy heart are also true for a healthy prostate.

Other ways to avoid prostate cancer are being investigated. These include:

  • Lycopenes. These substances found in tomatoes, pink grapefruit and watermelon may help prevent damage to cells.
  • Finasteride (Proscar®) or dutesteride (Avodart®). If you are at high risk for prostate cancer, talk to your urologist or other provider who is familiar with studies about these drugs.

Last reviewed on 5/27/10

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