What precautions can be taken to prevent prostate cancer?

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Q: Prostate cancer runs in my father's side of the family. Is there anything he can do now to hopefully avoid it altogether?

A: While there is no easy way to guarantee your father will avoid the development of prostate cancer, there has been much research lately that--at the very least--can help the odds. On his side is what he knows of his family medical history, which is a significant safeguard. Prostate cancer, after all, sometimes doesn't show its hand until it has spread outside the prostate.

One line of defense is what your father already recognizes: the need to see his doctor at the first sign of symptoms. These, he likely has learned, include weak, frequent, painful or otherwise difficult urination; blood in the urine or in semen; and frequent stiffness or pain in the upper thighs, hips or lower back. He should understand, too, that several other disorders, not necessarily afflicting the prostate, can produce the same symptoms.

Even more vital than responding to symptoms, however, is for your father to visit his HMO for screening on a regular basis. HMOs, by and large, have a track record of encouraging their members to seek preventive care. An annual digital rectal examination (DRE), while unpleasant, is the minimum he should schedule. Another test, the PSA (for prostate-specific antigen) blood screening is recommended by the American Urological Association alongside the DRE for all males 50 or older--40 or older for black men and anyone with a family history of prostate cancer.

Other organizations suggest more or less conservative screening routines, but one fact is clear: Although both the DRE and the PSA tests can produce false readings, positive or negative, early detection and treatment of prostate cancer is a must. Check with the HMO for what it will permit, keeping the bottom line--your father's health--in mind should the two realities conflict. Remember, too, the goal of diagnosing any prostate cancer before any symptoms are evident.

In the meantime, research is increasingly showing that diet plays a great role in the prevention of prostate cancer--as with other diseases such as colon and lung cancer, diabetes and hypertension. One study, at Harvard University, evaluated the diets of 50,000 men and learned that those who ate the most fat were nearly twice as likely (as those at the other extreme of fat intake) to develop prostate cancer. Similarly comparing most and least, the men who ate the most beef, lamb and pork were 2.6 times more likely to develop prostate cancer.

Enough about what not to eat--what can you eat? For starters, think tomatoes, especially cooked as they are in tomato sauce. One particular nutrient in tomatoes, lycopene, is considered a potent fighter against so-called "free radicals" that contribute to heart disease as well as cancer. One study, in fact, has found that men who eat ten servings of cooked tomato products per week had the lowest risk of prostate cancer. (Consider a serving about a half-cup of sauce.) Uncooked tomatoes, however, offer only about a fifth of the lycopene available in cooked tomatoes. Ruby grapefruit, as red as you can find it, is the next-best source of lycopene.

A recent study conducted among 29,000 men in Finland also seems to suggest that taking Vitamin E supplements may help to avoid prostate cancer. Earlier research already shows that taking 100 milligrams a day helps the cardiovascular system, so until further research supports the Finnish study, the verdict is in--taking as much as 400 mg won't hurt, and it may help in preventing any small, latent prostate tumors (residing in perhaps 40% of men in their seventies) from becoming active.

With the American Cancer Society reporting 140,000 new cases diagnosed in the United States each year, prostate cancer is the second leading cause of cancer death among American males. Regular attention to your father's screenings and an eye on his diet can keep him from joining these frightening statistics.


John Connolly is President and CEO of Castle Connolly Medical Ltd., the trusted source for finding top doctors. Read his full biography

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