In the United States, the most common tumor in men is prostate carcinoma. In 2007, it is anticipated that only about 30,000 men will die from this disease, despite the fact that almost a quarter of a million new cases are anticipated this year alone. The death rate is so low, compared to the number of diagnosed cases, because many of these cancers (but by no means all) have a relatively mild nature.

WHO IS AT RISK?

Obviously, since only men have a prostate gland, only men can get prostate cancer.

Age -The incidence of prostate cancer in men is extremely low under age 50, but increases rapidly in each succeeding decade until leveling off at about 40% of all men over age 75.

Family History - There appears to be an increased risk in men with a father or brother who has had prostate cancer. The inheritance appears to be quite complex, with no clear cut genetic explanation in the vast majority of cases.

Hormones - The amount of androgen (e.g., testosterone) in a man's body over his lifetime appears to be associated with the development of prostate cancer, with those experiencing higher cumulative androgen exposure having a greater risk of prostate cancer.

Dietary Fat - While the available scientific evidence is currently debatable, it appears to suggest that diets high in fat, especially animal fat, and saturated and monounsaturated fat, may increase one's risk of prostate cancer, while polyunsaturated fat may reduce one's risk.

Dairy and Calcium Intake - As in all studies of diet and prostate cancer, the evidence is only suggestive, there may be an increase of prostate cancer in men who consume large amounts of dairy products.

Cadmium Exposure - Cadmium is an industrial chemical with an uncertain (maybe, maybe not) relationship to increasing risk of prostate concer.

Dioxin Exposure - Dioxin (i.e., “Agent Orange”) is another “maybe, maybe not” increaser of prostate cancer risk.

PREVENTION

Finasteride - A prescription-only medication, finasteride reduces the incidence of prostate cancer, but the current scientific data is insufficient to know whether it has any effect on mortality. Furthermore, finasteride treatment can result in erectile dysfunction, loss of libido, and gynecomastia (enlarged male breasts).

Diet - Scientific studies suggest that certain dietary modifications could possibly reduce the risk or severity of prostate cancer: reducing dietary fat, increasing fruits and vegetables, and vitamin E (alpha-tocopherol), selenium, or lycopene supplementation. While tantalizing, the scientific evidence is currently inadequate to show that any dietary modification has any positive effect on prostate cancer. Since these dietary modifications do appear likely to improve other aspects of health (e.g., by reducing heart disease), there is certainly the “nothing to lose” argument for decreasing one's fat intake (especially animal, saturated, and monounsaturated fat), more fruits and vegetables, and (following approval of your health-care provider) reasonable vitamin/mineral supplementation.

EARLY DETECTION

The primary methods of early detection at the current time are manual rectal examination by the health-care practitioner in conjunction with the PSA blood test. There is strong scientific evidence that early detection routines for prostate cancer uncover cancers that would never have caused any significant problems. Unfortunately, at the time that treatment decisions need to be made, we are unable to tell those from the more deadly ones.

TREATMENT

Treatment options available for prostate cancer include radical prostatectomy (surgical removal of the entire prostate with a border of surrounding healthy tissue), external-beam radiation therapy (radiation directed into the body from a machine outside of the body), , brachytherapy (radiation from a radioactive object inserted into the body), cryotherapy (localized freezing of the tumor tissue), reducing the amount of male hormone in the man's body, chemotherapy, and merely watching and waiting.

Unfortunately, the behavior of any particular man's prostate cancer can be very difficult to predict. As a result, it is difficult to ascertain with reasonable accuracy the precise efficacy of different treatment options. It is vitally important that the patient discuss with his health-care provider the nature of his diagnosis and prognosis, as well as the risks and benefits of all possible treatment options.