Chapter 4

Happy Friday #winelovers! Here’s a post regarding November being Prostate Cancer month. For short hand sake, I’m going to refer to Prostate Cancer as PCA though out this summary. How common you ask? Around 17% of US men will come down with PCA and that’s a lot!

PCA is the most common form of cancer found in American, Canadian, Australian and northwest European men. By contrast, the historical rate in China is only 2%. Some of that may change with longer life spans and the adoption of more western lifestyles in China.

“Profiling” on the basis of gender, age or race is considered taboo in many parts of the world, especially the western world. PCA is a master at profiling. As expected, only men get PCA because women do not have prostate glands. PCA affects men as they get older with 65% of cases being 65 years of age or older. That said, more than a third of cases happen to those under 65. PCA also profiles by race with African American/black men having 2.5 fold increased risk of dying from PCA which is a paradox as the disease is relatively uncommon in Africa. In the US, PCA also profiles on the basis of where one lives, with there being increased risks from more northern regions of the country, possibly caused by less sunshine and lower vitamin D levels. Vitamin D may also play a role in African Americans and Africans living in Canada, Australia and Europe.

PCA also tends to afflict some families more so than others. Those with a family history of PCA are at increased risk as are those with histories of inheritable breast and ovarian cancers, including those with the BRAC gene.

Being tall or having increased calcium intake may increase risk as well as does being sedentary. On the flip side, exercise and leading a more physically active life is protective. How about weight or smoking? Unlike breast cancer which is strongly correlated with increased weight and smoking, PCA does not seem to have those associations. There is some data that smokers don’t get PCA more frequently but are more apt to get aggressive forms of the disease.

How about diet? Higher fat diets may increase risk. Diets high in fruits and veggies may lower risks. Lycopene from tomatoes and some other red fruits/veg may significantly lower risks. Some evidence exists that green tea may be preventative, something that could partially explain lower rates in China.

Okay #winelovers, what about alcohol, you ask. Here the studies are not as clear as with breast cancer where rates are correlated with alcohol intake. Studies for PCA do not show a consistent correlation with alcohol intake though there is some evidence that drinking more than 2/3 a bottle of wine daily may increase the risk of more aggressive forms of PCA.

So, what should men do to decrease their risk of PCA. As a group, men are stuck with their parents, their race and their countries of origin. Exercise, more fruits and veggies daily (wine doesn’t count as a fruit here!), tomato sauce, green tea, lower fat intake and drinking less than 2/3 of a bottle of wine are the steps one should consider. Obviously, a family history changes the equation somewhat and one would then need to consult with local specialty doctors.

I hope that this helps. Research money and efforts for PCA have lagged behind breast cancer efforts for a range of reasons. More research is being done and I hope to update this annually. More to come and have a great weekend!

 

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Patrick Farrell, MD, MW