How to Prevent Prostate Cancer

There's conflicting evidence about lycopene, but losing weight and considering finasteride are more promising options.

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The medical literature is loaded with tantalizing hints that various drugs, supplements, and foods may either encourage or inhibit the development of prostate cancer. Just a few of the strategies that have been bandied about: reducing saturated fat intake, taking selenium or vitamin E, eating more soy, drinking green tea, or taking statins. But despite many studies of some of those substances, there's a fairly narrow slice of practical advice that men can count on.

That's because many of the studies that support such options have only observed men, rather than actually testing treatments, or have had other weaknesses in their methodology. For example, consider the evidence on lycopene, an antioxidant that's generated buzz over the years for its supposed prostate-cancer-fighting prowess. Numerous observational studies, such as this one, have trumpeted tomatoes, in particular, for containing the antioxidant, and the media have played right along, writing countless headlines about the benefits of tomatoes and tomato sauce. The trouble is, convenient as slurping down spaghetti sauce might be, the tomato-a-day approach, at this point, doesn't stand up to scrutiny.

Nevertheless, there are two strategies that do seem to have legs—one that requires some willpower and the other that comes in pill form (with, of course, side effects included). The first you've probably heard before: Lose weight. "We know that obese men are 30 percent more likely to die of prostate cancer than thin men," says Stephen Freedland, a urologist at Duke University and the lead author of a recent paper in the American Journal of Men's Health that reviewed all of the prostate-cancer-prevention options currently being researched.

As for that pill I mentioned, scientists have known since the completion of the Prostate Cancer Prevention Trial in 2003 that daily doses of finasteride, a drug that diminishes levels of biochemical products of certain male hormones, reduce the risk of prostate cancer by at least 25 percent. That's a surprisingly high number. So high, in fact, that the researchers doing the study opted to halt it early to allay concerns that continuing to give placebos to some study volunteers would be unethical. Initially, there was controversy about finasteride as it also seemed to cause an increase in certain dangerous tumors, but research released this week here and here and an editorial here have started to put such worries to rest. This fact sheet from the National Cancer Institute thoroughly answers questions you might have about finasteride.

Men concerned about prostate cancer can determine their risk of developing the disease by using this helpful online risk calculator. The calculator looks at risk factors of prostate cancer—such as age, race, and family history—to determine a man's probability of getting the disease. If your score comes in too high for your liking and you're gung-ho to make changes, exercising regularly and eating a sound diet that keeps the weight down are good places to start. Urologists recommend this detailed advice from the American Heart Association.

If you're interested in finasteride, talk to your doctor. It's available as a generic drug and generally costs between $35 and $80 per month, though it hasn't been approved as a preventive treatment for prostate cancer. Be aware, however, that known side effects of the drug include diminished sexual desire, impotence, and decreased ejaculate volume, according to the National Cancer Institute. And the long-term effects of the drug, which alter hormone levels, are unknown. "The last thing I'd want to have is an overweight or obese patient take a pill and not worry about what he eats," says Freedland.

To prevent prostate cancer, are you more apt to get serious about losing weight or to take a pill such as finasteride?