Is prostate cancer preventable? What is the benefit of early detection?
WHAT IS PROSTATE AND PROSTATE CANCER?
The prostate is a gland in male beings with the size of a walnut. The liquid formed by the prostate gland is intended to be used outside the body (the prostate is an exocrine gland).
This liquid give food to sperm and transports it on their way to meet with a female ovum (egg) during sexual intercourse and produce human life. The gland works by contracting during orgasm and forcing these fluids out.
Prostate gland controls urine
The urethra, the tube through which urine and sperm exit the body passes through the prostate can tighten by the
prostate using thousands of tiny muscle fibers and this may restrict the flow of urine.
The Prostate gland excrete a protein called “prostate-specific antigen” (PSA), which helps semen keep its fluid state. One of the first signs of prostate cancer is an excess in that protein.
Prostate cancer is one of the most common cancer in men and a major threat to Western world.
It stands also as one of the top causes of cancer death amongst males and the burden of the disease is rising globally.
The Center for Disease Control and Prevention (CDC) states that prostate cancer is the second most seen cancer amongst men in the United States.
Development of prostate cancer increases progressively with age.
Causes of prostate cancer are not known but researchers have found many risk factors that could trigger the condition.
Among these risk factors some are uncontrollable, and this includes age, race, and family history.
But other factors such as diet, medications, lifestyle and early detection (PSA screening) can be controlled and may play a significant role to lower the risk and mortality rate.
Symptoms of prostate cancer
Most of the times there is no symptoms at the early stages. Nevertheless, if symptoms appear, they generally comprise one or more of the following:
1. Difficulty beginning and maintaining urination
2. Blood passed in the urine
3. Regular urges to urinate
4. Painful urine
5. Difficulty reaching or sustaining an erection
In the advanced stage the following symptoms may be present:
1. Painful bones
2. Bone Fractures
3. Leg weakness
4. Urinary incontinence and / or Fecal incontinency
WHY EARLY DETECTION IS IMPORTANT?
Since someone having early prostate cancer will not show sign at the beginning and no cure is known up to now for the advanced, early detection (PSA screening) is the best way to lower the mortality rate and help men live longer (1)
What Tests help to detect prostate cancer early?
We discuss below some tests used to detect for warning signs of the disease. Nevertheless, these tests cannot really tell precisely if you have cancer.
If one of the tests shows an abnormal result, the clinician will possibly ask you to go for a prostate biopsy to confirm if you have cancer.
These tests are: Screening for Prostate-specific antigen (PSA) in the blood and a Digital Rectal Exam (DRE).
1. PROSTATE-SPECIFIC ANTIGEN (PSA)
Prostate cancer is often detected early with a simple blood test and Prostate-specific antigen (PSA) is a substance produced by cells inside the prostate gland by both normal and cancer cells.
The antigen (PSA) is released by the prostate into the semen where it acts to liquefy the semen following ejaculation.
It is therefore generally found in semen, but a slight quantity is also found in the blood.
The level of PSA can fluctuate and normal range still a debate. Nevertheless, in most case blood levels under 4 nanograms per milliliter (4.0 ng/mL) is the normal. Chance of developing prostate cancer are higher as the PSA level increases above that limit.
Levels lower than 4ng/mL is not a guarantee that you do not have cancer. Studies reveal that around some men with a PSA lower than 4ng/mL will develop prostate cancer on biopsy.
Men tested with a PSA between 4 and 10 present 25 percent or more chances of developing a cancer.
WHAT FACTORS MAY AFFECT PSA LEVELS?
PSA test has some limitations since besides prostate cancer, there are many factors that can raise or decrease PSA levels.
What increases PSA levels?
- Age: PSA levels may go up slightly as you advance in age, even with no prostate abnormality.
- Benign prostatic hyperplasia (BPH) on an enlarged prostate that affects several men as they get older, can affect PSA levels.
- Prostatitis or a Urinary Tract infection: can also increase PSA levels.
- Ejaculation: This can raise PSA levels for a short period of time and bring it down later. Reason why sometimes doctors recommend that men refrain from ejaculation at least for a day or two prior to testing.
- Urological procedures: such as prostate biopsy, cystoscopy or prostate surgery may rise PSA levels for a short period of time.
Since some studies have argued that a digital rectal exam (DRE) might affect PSA levels by rising it up, some doctors advise drawing blood for the PSA prior to performing a DRE.
- Medicines: such as male hormones like testosterone may cause a rise in PSA.
What decreases PSA levels?
- Group of medication known as 5-alpha reductase inhibitors: These are medications used to treat an enlarged prostate (Benign Prostatic Hyperplasia) male hair loss, such as finasteride or dutasteride, can lower PSA levels.
It is advisable to inform your doctor in case you are taking these medications since they can affect the outcome of the test.
Same applies for some Herbal mixtures because some of them may interact with the PSA levels reading and disguise a high level.
- Some other medication involved are Aspirin, Statins (used to treat high cholesterol) and Thiazide diuretics (used to treat Hypertension).
- Obesity: Men tend to show low levels of PSA when they are obese.
2. DIGITAL RECTAL EXAM (DRE)
A Digital Rectal Exam (DRE) is generally the first step in examining prostate well-being and most of the time is done as part of routine screening.
To perform a digital rectal exam (DRE), the clinician inserts a lubricated and gloved finger into the rectum to check if the prostate has proper shape, size and texture. If he or she feels anything suspicious, he or she may then recommend a diagnostic test.
During the exam the patient may feel uncomfortable particularly if he has some inflammations such as hemorrhoids.
Usually there is no pain on examination and it takes only few minutes.
HOW TO PREVENT PROSTATE CANCER?
In terms of prevention, a complete prostate cancer prevention is not possible, but research mentions that diet may play a key role.
1. Fruits and vegetables
Fruits and vegetables contain nutrients that may lower the risk of getting prostate cancer. In fact, most fruits contain vitamin C which is an antioxidant.
Although the use of high dose of Vitamin C in the treatment of cancer has not yet been approved, trials show an improvement in the quality of life. (2)
2. Tomatoes and other red foods
This includes tomatoes and other red fruits, such as watermelons, red carrots and papayas. Not counting strawberries or cherries.
They contain a substance named lycopene, an antioxidant that gives them the bright red color. Especially for tomatoes, besides lycopene, it is a good source of vitamin A and C.
Research show that men who eat more tomatoes, tomato-based products and these red fruits have less risk of developing prostate cancer.
Soybeans contain isoflavones, a nutrient associated to a to a lower risk of prostate cancer.
According to researches men who consume products containing soy isoflavones have less risk of prostate cancer.
Besides these foods, to prevent prostate cancer, it is advisable to keep a good lifestyle which includes:
- Staying physically active: Regular exercises such as walking, running, cycling, etc helps you stay fit and burn fat.
- Keeping the body at a healthy weight: With a good diet and regular exercise you can achieve an optimal weight loss
Early detection might present itself as a good choice toward lowering mortality related to prostate cancer. Do not wait too long to have yourself tested.
Once again, it is advisable to let your doctor know of any diet, medication or other condition you have. This will allow him or her to do proper examination.