Prostate Cancer Avoidance
November 27, 2002

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Longevity Index

    The following guidelines are derived from the Executive Summary delineating suggestions presented at a National Cancer Institute Division of Cancer Prevention workshop in June, 2000.
    I have begun with prostate cancer since it's the leading cause of cancer fatalities among U. S. men.
    I know this isn't fun to read. I don't enjoy it, either. Still, knowing what to embrace and what to avoid  earlier in life will, we hope, enable you to sidestep this deadly disease. 
    What is hard to grasp until it actually happens to you, or until you can vividly imagine it, are the terrifying realities of a positive cancer diagnosis, particularly if it's terminal (see  Patients Helping Patients:  Prostate Cancer From a Patient's Perspective.). It's as though you're on top of a high column of stone in a gathering wind, and knowing that the wind will increase until it blows you off to your death on the rocks below. It's worth a lot to avoid such a scenario. We function by pushing this likelihood out of our minds. After all, it hasn't happened yet. This is good because it allows us to be happy, and to enjoy the moment. The downside is that it can blind us to the dangers ahead.... dangers we may well avoid, given the right knowledge and actions today.
    [It's an interesting fact that cancer of the circulatory system never occurs. Cancer never develops in the epithelial tissues that line veins and arteries.]

Reducing the chances of prostate cancer:


    
The following discussions appear on the National Cancer Institute website:
Diet Has No Effect on Recurrence of Colorectal Polyps
Q&A- The Polyp Prevention Trial and the Wheat Bran Fiber Study
Questions and Answers About Beta Carotene Chemoprevention Trials
Selenium Supplements Lower Incidence of Lung, Colorectal, and Prostate Cancers
Study in Finland Suggests Vitamin E Prevents Prostate Cancer
Protein Patterns in Blood May Predict Prostate Cancer Diagnosis
Obesity and Cancer
Summary on cancer risk from alcohol
Summary on cancer risk from diet
Artificial Sweeteners
Coffee Decaffeination Process and Cancer
Deodorants and Breast Cancer
Heterocyclic Amines in Cooked Meats
Cancer.gov - Digest Page- The SELECT Prostate Cancer Prevention ...


The discussions below are found at "Patients Helping Patients:  Prostate Cancer From a Patient's Perspective" They contain a wealth of practical information from people whose lives depend upon getting correct answers.

Step by Step - Your Education
Watchful Waiting - When and Why

The Role of Diet, Vitamins & Supplements
Garlic - How to use it
Vit. E and Selenium by Dr. Myers
Antioxidants - what are they
Lycopene and Tomatoes
Genistein - Is it all its made out to be?
Fat - What kinds are good and bad
Dietary Inhibitors of Prostate Cancer
Modified Citrus Pectin - A Study
Saw Palmetto - Both Sides
Mis-information About Diet and Supplements
Soy and Tofu
Herbs And Drugs- Never Mix, Never Worry
Graphfruit Juice - Caution Please
Herb-Drug Interactions - Mayo
Diabetes- Beware Chinese herbs
Healthnotes Newswire- Does Selenium Ward off Prostate Cancer-
UIC News Tips-HOW DOES LYCOPENE REDUCE PROSTATE CANCER RISK-
WSJ Reverse Prostate Cancer
Rx.magazine | Prevention & Primary Care- Healthy Lifestyle, ...
Cancer Treatment Consultants
Cancer Information Network


    Below is the 11/6/2002 discussion of prostate cancer:

Avoiding Prostate Cancer

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Longevity Index

Prostate Cancer   
    The causes of prostate cancer are unknown. It has been estimated that just about every man over 70 has at least microscopic pockets of malignancy in his prostate.
    About 200,000 men a year are diagnosed with prostate cancer in the United States, and about 40,000 men a year, die from it, out of, perhaps, 185,000,000 U. S. males. This gives a male about a 1-in-60 chance of dying from prostate cancer over the course of a lifetime. The odds of getting prostate cancer and of either being cured of it, or of dying of something else first are about 4 out 5. Prostate cancer is the second leading cause ( behind lung cancer) of cancer deaths in men in the U. S.
    It's significant that Asian men have prostate cancer rates that are 10 to 20 times lower than those of U. S. males. Furthermore, when Asian males emigrate to North America and adopt North American diets and lifestyles, their prostate cancer rates rise significantly.
    It tends to be a slow-growing disease. Like other cancers, it can be surgically cured if it's caught while tumor cells are still encapsulated within the prostate gland. 
    The current method of detecting prostate cancer is still a digital rectal exam, combined with the Prostate-Specific Antigen (PSA) test. The PSA test may give false positives (high readings indicative of cancer when cancer isn't present), but it rarely misses cancer when cancer is present. PSA readings between 4.0 and 8.0 are suggestive that cancer may be present.
    The question of what to do when PSA levels exceed 4.0 depends upon the age of the patient, and upon how fast the PSA level has risen. If it's detected in someone over 70, and if it's slow-growing, it will usually be left alone, since the trauma of removing the prostate is major. If it's found in someone over 80, it will almost certainly be left alone. (The older the patient, the slower cancers tend to grow.) To give an example, if you were found to have a PSA level of 2 when you were 75, a PSA level of 4 when you were 80 (indicating a 5-year doubling time), a PSA level of 8 when you were 85, and a PSA level of 16 at 90, there wouldn't be any need or purpose of treating your prostate cancer because you would almost certainly die of something else before you would know that you had prostate cancer.
    The Gleason index is an index of the fraction of needle biopsies that contain neoplastic growth.. It ranges from 1 to 10, with 7 being the borderline into extensive prostate cancer. 
    As one patient puts it,
    "It seems to me that anyone under the age of 60 might move toward a definitive treatment. You have many years ahead of you and it may not be worth the gamble of not getting treatment at an early stage. From 60 to 70, I think that Watchful Waiting is a possibility and should be considered. At ages from 70 to 80, Watchful Waiting would be considered as your first treatment. The side effects of the other treatments may be worse than the disease. If you are over 80 I think that your only choice would be Watchful Waiting. The chances of the cancer killing you are very remote. You will die of another condition first."
    Almost all diagnosed with early-stage cancer are alive after five years.
    Of course, there are various treatments that can delay the inevitable.
   
It's very important to distinguish between prostate cancer, and the prevention of prostate cancer. Diets that may protect against the development of prostate cancer may have little or no effect upon existing prostate cancers
    
Dietary Interventions Once Prostate Cancer Has Been Diagnosed
    A recently completed study has shown that eating a low-fat (no more than 30% of calories), high-fiber diet rich in fruits and vegetables had no effect upon rising PSA levels, and the frequency of diagnosed prostate cancer cases:  Healthy Diet May Not Prevent Prostate Cancer
  - ABC. However, this study only lasted four years. In probably every prostate cancer case detected during the four years of the study, microscopic cancer had started in the prostate before the study began. Consequently, the study probably wasn't about preventing prostate cancer as much as it was about trying to slow it down with diet.
    Another recent study showed that Dietary Change May Prevent Prostate Cancer
  - ABC. Actually, the title is misleading. What the study purports to show is that dietary intervention can help slow the rate of progression of advanced prostate cancer  The consumption of saturated fats, and of monounsaturated fats such as olive oil increased the risk of developing advanced prostate cancer. Polyunsaturated fats and the omega-3 fatty acids produced no accelerating effect (but the omega-3 fatty acids didn't slow the progression, either).
    "One reason that low-fat diets could reduce the risk of prostate cancer is because they reduce blood levels of circulating male hormones such as testosterone. Growth of the prostate, and perhaps growth of prostate cancer, is fueled by male hormones.
    "The researchers also found the risk of advanced prostate cancer was 112 percent higher - more than double - among men who consumed the most calcium (more than 1,200 mg per day, equivalent to four or more glasses of milk) as compared to those who got the least (fewer than 500 mg). It didn't matter whether the calcium came from food or supplements. "For regional/distant disease, there were consistent trends for increased, independent risks from both dietary and supplemental calcium," the researchers wrote.
    "The mechanism underlying the effect of calcium on prostate-cancer risk isn't clear, although there are relatively consistent findings from previous studies suggesting that dairy products or calcium-supplement intake are associated with risk. Some scientists hypothesize that a high intake of calcium may suppress blood levels of the active form of vitamin D, a hormone that may protect against prostate cancer by preventing the development of cancerous cells.
    "The only dietary risk factor that appeared to carry equal weight among men with both early and advanced prostate cancer was the amount of total calories consumed, regardless of fat. "Total energy intake was significantly associated with risk for both localized and advanced disease," Kristal said. Men who ingested the most calories each day more than doubled their risk of localized prostate cancer (a 115 percent increased risk) and nearly doubled their risk of advanced prostate cancer (a 96 percent increased risk) compared to men who ate the fewest.
    "Specific recommendations for calcium consumption are more complex, because calcium also helps prevent osteoporosis and colon cancer.
    "The U.S. Recommended Daily Intake of calcium for men over age 50 is 1,200 mg. While the most well-known dietary sources of calcium include milk, dairy products, salmon and dark, leafy greens, men - particularly those taking calcium supplements - also should be aware of the additional calcium content in fortified foods, from cereals to juices. A small bowl of fortified cereal, for example, can contain up to 1,000 mg of calcium."
    All of the above discussions are, in my opinion, about what happens after prostate cancer is present.
Avoidance Has to Start Young
    Prostate cancer starts early, so its avoidance must also start early. 
    The one dietary ingredient that is endorsed by the National Cancer Institute is a diet rich in
tomato sauce (lycopene). Individuals who ate two servings of pasta a week saw their incidence of prostate cancer decline by 20% from that of a control group. That's significant for only two servings a week. Prostate cancer patients are beginning to eat tomato sauces at ever meal. (There is some suggestion that lycopene may even combat existing prostate cancer.)
    Among other ingredients,
red wine (Red Wine May Combat Prostate Cancer - Cosmiverse) contains polyphenols--gallic acid, tannic acid, morin, quercetin, and rutin--that, in vitro,  dramatically inhibited cell proliferation and apoptosis.
   
Soy (OSU scientists study soy and tomato diet in prostate cancer) has been shown to slow the growth of prostate cancer in laboratory animals. Also, Asian men, who eat diets low in fat, red meat, and calories have prostate cancer rates that are 10 to 20 times lower than their American counterparts. The authors recommend a diet high in fiber, fruits, vegetables, and whole grains, and low in fat and calories. The article mentions that,
    "Some studies suggest that men who consistently eat at least five servings of tomatoes or tomato products each week over the decades it takes for a prostate tumor to develop may experience a 30 to 40% lower risk of prostate cancer."
    30% to 40% isn't a guarantee that you won't get prostate cancer, but that plus other changes might lead one to the 10- to 20-fold reductions in prostate cancer found in Asiatic men.
    Citrus pectin, found in the whole fruit, may help prevent prostate cancer:  Citrus Product May Help Prevent Prostate Cancer. The authors even speculate that citrus pectin might help reverse prostate cancer.
    The Chinese herb PC-SPES appears to lower PSA levels in prostate cancer patients. 
    For those patients (33) who had hormone-dependent prostate cancer, PSA levels were lowered more than 80%, with a median duration of decline of 57 weeks (13 months). 
    19 out of 37 of those patients with hormone independent disease had PSA declines above 50%, with a median duration of 16 weeks (4 months). 
    The next step is to see if PC-SPES is any different from estrogen. (PC-SPES causes side effects similar to those generated by estrogen.) However, the fact that PC-SPES is effective against hormone-independent prostate cancer suggests that there are other factors in PC-SPES that may affect  prostate cancer in non-hormonal ways.
    One important thing to understand is that something like estrogen will kill all those cancer cells that are still responsive to estrogen. The cells that remain are the hormone-independent cells that don't respond to estrogen, and these are the ones that are hardest to treat. Clearly, in the above cases, it didn't take these cells long to grow back to the point where they have replaced the ones that responded to estrogen.
    Hormone therapy and chemotherapy buy you a little time.
    Among the substances that prostate cancer patients caution against using is chondroitin.
    Here is what appears to be an excellent, practical discussion of prostate cancer.

    I will probably expand this page somewhat over time.