Dr. Keith Roach: How does one reduce prostate cancer threat?
Dear Dr. Roach: My brother started having pains in his body and swelling in his shoulder/collarbone area and feeling quite bad when he was 49. Doctors puzzled over what might be wrong for several months before my brother decided to go to his urologist. The urologist gave him a digital rectal exam that revealed no issues, but when the PSA came back it was 400. The prostate cancer had spread to his bones and other organs. He was dead about nine months after his diagnosis, just after his 50th birthday. My father also died from prostate cancer.
When I went to my urologist to ask how I can avoid prostate cancer, he suggested cruciferous vegetables. I think you’ve had similar recommendations. But I went to PubMed and found more helpful recommendations in the “Risk factors for prostate cancer incidence and progression in the health professionals follow-up study.” The study has been following over 50,000 men since 1986 with detailed questions annually about what they eat, how they exercise, how much they weigh, etc.
What I found suggested that increased calcium intake is associated with an almost doubling of the risk of fatal prostate cancer. Being tall also may double your risk (like me, my brothers and my father). Maybe this research isn’t bullet-proof, but it’s a lot more guidance than I’m finding in traditional consumer media. It seems good enough that every urologist and even family doctor should have a trifold pamphlet based on this research available to any patient who asks how he can reduce his risk of prostate cancer.
The study seems to suggest the following: Don’t consume excessive amounts of foods that are high in calcium; keep your calorie intake at a reasonable level; avoid high alpha-linolenic acid foods; keep your BMI at a good level; and don’t smoke.
Positive things you can do to avoid prostate cancer include participating in a lot of physical activity and eating a decent amount of tomato sauce.
I’m writing because it would be nice to see this in the newspaper where a lot of people like me and my brother could learn from it. I hope you will publish this information.
Dear A.: Prostate cancer remains a large cause of morbidity and mortality in North America, and I certainly can understand why men with a strong family history would want to do whatever they could to reduce their risk.
The connection between calcium and prostate cancer is controversial; however, it is likely to be complicated by and possibly related to vitamin D, which affects calcium and may protect against prostate cancer. Animal fats are more clearly associated with increased risk of prostate cancer (and are high in alpha-linolenic acid and low in the possibly protective linoleic acid).
Some studies have shown a reduction in prostate cancer risk with vegetables and legumes. Some studies, but not all, on omega-3 fatty acids show an increased risk for prostate cancer; these are taken by many to protect the heart. Coffee appears to be protective against prostate cancer, while smoking, as you note, is clearly a risk factor. Obesity is a very modest risk factor.
Other protective activities against prostate cancer are the exercise you mention, which is particularly important as men get older.
Email questions to ToYourGoodHealth@med.cornell.edu.