By Christopher P. Evans, MD, FACS
Misconceptions about prostate cancer abound. It’s not just a disease that affects older men, and it’s not always slow-growing. Despite some recent recommendations against getting PSA (prostate-specific antigen) screenings, the facts show otherwise. Prostate cancer is the most common non-skin cancer diagnosis in American men and is the second most common cause of cancer deaths of men in America.
One in six men in the U.S. risks getting prostate cancer during his lifetime. Why is this disease so prevalent today? We believe prostate cancer has always been widespread; however, before 1987, we didn’t screen for it. At that time, 40 percent of men diagnosed with prostate cancer had metastatic disease that had spread from the primary location to other parts of the body. Today, with screenings and early detection, that number has been drastically reduced to 2 percent.
Prostate cancer is linked to many variables, including age, ethnicity, family history and environmental factors. Based on annual cases diagnosed per 100,000 as reported by the National Cancer Institute:
• If you are black, you have the highest risk of developing prostate cancer (234 cases);
• If you are white, you have the second highest risk (150 cases);
• If you are Hispanic, the risk is 129 cases per 100,000; and
• If you Asian/Pacific Islander, you have a lower risk (88 cases).
According to the California Cancer Registry (CCR), the number of diagnosed cases in 2009 in Sacramento County for these ethnic groups included:
• For a population of 74,255 blacks – 115 cases;
• For a population of 360,107 whites – 512 cases;
• For a population of 147,585 Hispanics – 69 cases ; and
• For a population of 100,994 Asian/Pacific Islanders – 50 cases.
For 2012, CCR estimates Sacramento County will see 825 prostate cancer cases; Yolo County – 105 cases; El Dorado County – 145 cases; and Placer County – 255 cases.
The disparities among ethnic groups may be due to a variety of complex factors; however, evidence suggests that lack of health care coverage and socioeconomic status play a significant role.
What can you do? Challenge the myths and protect yourself against prostate cancer:
• Talk to your physician, and develop a screening plan that’s right for you.
• Get screened, especially if you are at increased risk. This may include regular digital prostate exams and PSA tests. Normal PSA values can vary with age.
• If your father or brother has had prostate cancer, you may be at an increased risk of getting the disease, and should get regular screenings.
• Although studies vary about the impact of foods on prostate cancer, such as those containing omega-3, lycopene and soy products, it’s important to maintain a healthy weight and lifestyle.
• Adopt a balanced diet that includes fruits and vegetables and is low in high-fat dairy products and barbequed red meats (especially charred meats).
• Avoid taking more than 1,500 mg. of calcium per day, and stay away from mega-doses of vitamins, especially E and folate.
• Exercise daily, and include strength training to avoid muscle loss as part of your regimen.
Educating yourself about prostate cancer and taking steps to reduce your risks is the best defense against this potentially deadly disease.
Dr. Evans is Professor and Chairman, Department of Urology, UC Davis School of Medicine, and is a member of the National Cancer Institute-designated UC Davis Comprehensive Cancer Center