OakLeaf Medical Network Healthy Viewpoints, Winter 2003
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Josiah Nelson, MD

Prostate Cancer: Can It Be Prevented?

Josiah Nelson, MD
Western Wisconsin Urology
Eau Claire

Almost everyone knows someone affected by prostate cancer. If it isn’t a close relative, then it’s often a close friend. It is estimated that one in every six men will develop prostate cancer in their lifetime, with a higher risk for African American men. Prostate cancer remains the fourth most common male malignancy worldwide. Despite thousands of man-hours and millions of dollars spent researching prostate cancer, screening for the disease continues to be very controversial.

“Prevention is so much better than cure, because it saves the labor of being sick.”  Thomas Adams, 1618

A diagnosis of prostate cancer can be overwhelming for many men. It can be psychologically devastating and is often the first time that they have had to face their own mortality. While prostate cancer is often curable, there are an abundance of therapeutic treatments all having significant and often permanent side effects. This leaves many men feeling they are stuck between the proverbial rock and a hard place, making decisions very difficult and emotional.

Urologists have known since the 1950’s that androgens (male hormones) are required to develop prostate cancer. In recent years, two large studies have evaluated the effect of certain androgens on the prostate and the formation of prostate cancer. In 2003 the results of The Prostate Cancer Prevention Trial were published. This trial found that there was a 25% risk reduction of prostate cancer in patients taking finasteride versus a placebo. A concerning finding was an increase in the grade of prostate cancer seen in patients who developed prostate cancer while taking finasteride. Use of this medication for prevention wasn’t widely adopted due to this finding. However, recent studies have refuted the finding of higher grade cancers in patients taking finasteride. In 2009 the Results of the REDUCE trial were published. This study evaluated the effect of dutasteride (Avodart®) on the risk of prostate cancer. It found that dutasteride reduced the risk of prostate cancer by 23%. In this study there wasn’t any risk of higher grade cancers seen.

Other studies have been done to look at vitamins, supplements and diet to examine their effect on prevention of prostate cancer. The SELECT trial or Selenium and Vitamin E Cancer Prevention Trial evaluated these substances to see if they would help prevent prostate cancer. The study found that selenium and vitamin E, taken either alone or together, did not prevent prostate cancer.

Vitamin D has also been evaluated with interest due to observations such as, men in northern climates have a higher mortality with prostate cancer, native Japanese men who have high Vitamin D intake have a low incidence of prostate cancer, and African American men whose skin melanin inhibits activation of Vitamin D have the highest incidence and mortality rates worldwide. Thus far, these studies have displayed conflicting results. Other compounds being evaluated include lycopene, green tea extract and soy.

Finally obesity has been suggested to influence prostate cancer risk. Obesity is suggested to cause increased oxidative stress on the body making it more susceptible to cancer. Whether or not new studies find a clear relationship between obesity and prostate cancer, it is clear that being obese is unhealthy.

Can prostate cancer be prevented? For some men, a combination of medication, diet and supplementation seems to help. It remains important to discuss your unique situation with your physician to see if this is right for you.

Dr. Nelson – Western Wisconsin Urology
For information or to schedule an appointment:
715-835-6548 | eauclaireurology.com
Dr. Nelson sees patients in Eau Claire, Black River Falls and Osceola.