Prostate cancer is now the commonest cancer in men having replaced lung cancer. It is more common in the western world with 30,000 new cases per year and rising for unknown reasons.
It tends to affect men mainly older than 65 and is rare in those under 50 years of age.
The fact that the cancer is hormone dependent and prostate cancer is not seen in castrated men means that androgens play a role in its development.
There is an association with BRCA1 and BRCA2 but the main gene(s) associated with familial risk have not been identified to date. Heredity only plays a part in 5-10% of prostate cancers.
There appears to be an inverse relationship between the amount of sunlight one is exposed to during one’s life and the incidence of prostate cancer. This may be due to the prevention of minor infections of the prostate which long term can lead to chronic inflammation which in turn is associated with cancer. Ideally try and get at least 30 minute daily exposure at a minimum of your hands and face. If there is no natural sun then the careful use of a sunbed could be used but just enough to produce a light tan.Sunbed use that results in burning of the skin is a risk factor for skin cancer.
Diet and possibly the use of certain therapies that are available for an enlarged prostate may have a role. The use of the PSA test is controversial as the PSA can be raised in other prostate conditions besides cancer. However, if the PSA is found to be raised and continues to rise steadily upwards on repeat testing, then prostate cancer is likely and should be investigated for.
It should also be remembered that approximately 25% of prostate cancers will not have a raised PSA.
There is strong circumstantial evidence that diet plays a role in prostate cancer and based on this a diet sheet is available on the website which may help in the prevention and possible treatment in this disease.
The treatment of prostate cancer remains controversial with some specialists arguing that it is best to do nothing till symptoms occur while others prefer a more active approach.
The ideal situation is to accurately diagnose prostate cancer before it has spread outside its capsule and spread to other areas. At present, the main difficulty is pinpointing small prostate tumours so biopsies of the prostate gland are carried out ‘blind’ in the hope that the more biopsies you take the better the chance of finding the tumour.
Prostatectomy (removal of the prostate gland) can be performed in these cases but possible side effects such as impotence and incontinence have to be considered. Other treatments include radiotherapy or more localised treatments such as brachytherapy (local radiotherapy by implanting radioactive seeds into the cancerous areas) or cryotherapy (localised freezing of the tumour)
Hopefully as the different forms of imaging such as ultrasound, MRI and CT scanning continue to improve, the location of prostate tumours will be easier to detect.
In reality, many prostate tumours have spread at the time of diagnosis and treatment relies on the fact that these tumours are hormone dependent. That means if the growth hormone which the tumour relies on can be prevented from being produced or alternatively blocked, then the tumour will cease to grow or grow at a slow rate.