A Holistic Approach to Prostate Cancer

By Kenneth Koeneman, M.D.
(July 5, 2005)

Among American men, prostate cancer is the most common cancer and the second leading cause of cancer deaths. Nearly 200,000 men in the United States each year are diagnosed with prostate cancer, nearly 40,000 of whom die from the disease.

While the cause of prostate cancer is not known, there is increasing evidence that various dietary and lifestyle factors are involved.

Studies have shown that, among all solid tumor cancers, prostate cancer has the largest genetic component. About 35 percent of prostate cancers are due to certain, inherited genetic patterns. Certain types of people have a higher risk compared with the general population.

Scandinavian men, for example, have a higher incidence of prostate cancer and a higher death rate. African-Americans have twice the incidence and 2.5 times the death rate (although some of the difference may be related to health-care access).

Can prostate cancer be prevented? One aspect of prevention is assessment and knowledge of risk. Men whose father, uncle, or brothers had prostate cancer should be checked and screened starting at age 40, rather than the usual age of 50 years.

Proper diet may also play a role. In Eastern countries such as Japan and China, where diets are typically lower in saturated fat, meat, and cholesterol and higher in plants and fruits, the incidence of clinical prostate cancer is one-tenth of that in the United States. When people from those countries emigrate to the United States as children or young adults and adopt the Western diet, their risk has been found to be the same as among American men. So it may be helpful to follow a heart-healthy diet, low in saturated fats and cholesterol, and high in whole grain foods.

Early detection is very important. When diagnosed early, prostate cancer is highly treatable; 97 percent of the men who develop it survive at least five years after diagnosis.

The best tool available to detect prostate cancer is the blood test for higher-than-normal PSA (prostate-specific antigen) levels. Research shows that the PSA test helps to detect prostate cancer much earlier. In conjunction with a digital rectal exam, studies have shown it finds smaller-volume cancers and lower-grade cancers than other methods.

Prevention and early diagnosis of prostate cancer also is very important from a public-health perspective. Experts expect an explosion in the disease in the United States in the next 10 years, as the baby-boomer demographic group reaches the 55 to 65 age group. It is estimated that the current 1.8 to 2 million men with prostate cancer will increase to 5 to 10 million in the next decade.

Prostate cancer is a treatable disease but its management can be complex. It is important that patients are offered various treatment options and that individuals play a role in the decision-making process.

For the best care, the team of health care providers should take a holistic, comprehensive, personalized approach to treating the patient's disease, including educating the patient's spouse and family. I believe this is the prostate-cancer treatment model for the future.

Kenneth Koeneman is a professor at the University of Minnesota Medical School, director of the Prostate Cancer Center, and a member of the Cancer Center. This column is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu/.