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Prostate Cancer Archive
On call: Diet, testicular cancer, and prostate cancer
Q. I know a bad diet can increase prostate cancer risk, but what about testicular cancer?
A. Diet does appear to have an important influence on a man's risk of prostate cancer, but it's not as simple as good vs. bad. Saturated fats, particularly those from red meat and whole dairy products, are linked to an increased risk, and they are bad news for general health as well. But a few items typically considered healthful have been associated with an elevated risk of prostate cancer; they include a very high consumption of both calcium (which may lower osteoporosis risk) and alpha-linolenic acid (ALA), the omega-3 fatty acid in flaxseed and canola oil (which may reduce heart disease risk). It's wise for men to keep their saturated fat consumption down to less than 10% of their total calories, to limit calcium to less than 1,500 mg a day, and to count on fish or fish oil rather than ALA for heart-healthy omega-3s. And men should get lots of whole grains, tomatoes (especially cooked tomatoes) and other fruits and vegetables, fish, and soy products, all of which have been associated with a reduced risk of prostate cancer and many other woes.
Prostate cancer is about 25 times more common than testicular cancer, and we know much more about its risk factors. But testicular cancer is on the rise, and scientists are starting to ask if diet may have a role in the disease, which tends to strike white males between the ages of 20 and 35. One study evaluated the impact of diet on testicular cancer. Only dairy products were linked to an increased risk; cheese was a particular culprit.
Prostate help: A test that can help you avoid unnecessary prostate biopsies
When you've already had a biopsy and your PSA remains high, the PCA3 urine test can help you and your doctor to decide if another biopsy is really needed.
Prostate biopsy is not an experience you want to go through without a good reason. Although some men weather it with only moderate pain and discomfort, other men would prefer the first biopsy to be their last. Now, a urine test called PCA3 can help reduce unnecessary biopsies.
An option for low-risk prostate cancer
For some men, the smartest move after diagnosis may be to delay treatment and carefully watch the progression of the cancer.
After a prostate biopsy confirms cancer, the next step might seem obvious: get treatment as soon as possible, either by removing the prostate gland entirely (radical prostatectomy) or zapping it with radiation. But immediate treatment is not the only option or necessarily the best one. Treatment itself can cause more harm in the long run than the cancer. Some men with early low-risk prostate cancers can choose to hold off on the decision to treat until the disease presents a greater threat. Then the cancer can still be treated effectively. The approach is called active surveillance with delayed intention to treat.
Should you get a PSA test?
The latest thinking on this controversial screening.
If you're wondering whether to have your PSA tested, you're not alone. Some experts think you should have the test, but others disagree. In May 2012, the United States Preventive Services Task Force (USPSTF) issued its final report concerning screening for prostate cancer using the prostate-specific antigen (PSA) test. After weighing the best evidence, the expert panel concluded that PSA screening for prostate cancer should not be offered routinely to all men.
When used as a screening tool, the PSA test aims to check seemingly healthy men for hidden cancer at an early stage, when (hypothetically) it may be more curable. To date, the most positive research findings have shown that screening with PSA, at best, prevents about one death from cancer for every 1,000 men who have the test. This means many men are diagnosed and treated for cancers that would not have made them sick or shortened their lives. For such men, the treatment—which can produce side effects—is worse than the disease.
FDA approves new PSA test
The FDA has approved a new kind of PSA test for determining prostate cancer risk. The company that developed the test, Beckman Coulter, Inc., claims that it can help physicians to tell the difference between prostate cancer and benign prostate conditions.
The Prostate Health Index (PHI) test is approved for use in men 50 years and older with a total PSA between 4.0 and 10 nanograms per milliliter (ng/ml) and whose physical exam does not find signs of cancer. Making a diagnosis in this PSA range requires a biopsy, but it would find cancer only 25% of the time. The PHI test is intended to help doctors determine which men with a PSA between 4.0 and 10 are most likely to have prostate cancer, potentially reducing unnecessary biopsies.
Ask the doctor: BPH drugs for preventing prostate cancer
Q. I take Avodart for my enlarged prostate. But I heard that Avodart increases prostate cancer risk. Is that true? Should I quit taking Avodart?
A. You are on the right track about the cancer risk, but it's complicated.
Acetaminophen and prostate cancer
Q. I was very interested in your article on aspirin and cancer. You commented that aspirin may help prevent cancer, but I can't take aspirin, even in low doses. I use Tylenol for pain and fever — can it also help against cancer?
A. The aspirin story is encouraging, but it's a work in progress. Current evidence suggests that daily low-dose aspirin, such as 81 milligrams, may help reduce the risk of certain malignancies. The evidence is best for gastrointestinal cancers, including colon cancer, but research also offers hope that aspirin may help protect against other tumors, including prostate cancer. However, aspirin can produce gastrointestinal bleeding and other side effects, even in low doses. All in all, most experts think it's too early to recommend aspirin specifically for cancer prevention, except, perhaps, for some people who are at high risk for colon cancer and low risk of peptic ulcers and bleeding.
On call: Penile shortening post-prostatectomy
Q. I am trying to decide between a radical prostatectomy and radioactive seed therapy for my newly diagnosed prostate cancer. All the doctors I've consulted say I have very early disease (PSA 4.9, Gleason score 6) and that I should be cured either way. I'm basing my decision on side effects, but I need more information on one thing I learned about on the Internet, penile shortening.
A. I won't try to advise you about your choice of treatment, since there is no clear answer as to which is best. In addition to the options you're considering, many men would also consider external beam radiation therapy, and older men might consider deferred treatment or active surveillance.
10 diet & exercise tips for prostate health
"What can I eat to reduce my risk of developing prostate cancer?" This is one of the most common questions physicians hear from men concerned about prostate health. Undoubtedly, many hope that their doctor will rattle off a list of foods guaranteed to shield them from disease. Although some foods have been linked with reduced risk of prostate cancer, proof that they really work is lacking, at least for now.
Aim for a healthy eating pattern
Instead of focusing on specific foods, dietitians, physicians, and researchers tout an overall pattern of healthy eating — and healthy eating is easier than you might think. In a nutshell, here's what experts recommend:
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