Cancer-Proof Your Prostate

By: Matt Bean

It's one of those weird anatomical-arboreal coincidences: the human prostate is about the size and shape of a walnut. But what if it really were a walnut? For one thing, you’d never get prostate cancer. Which sounds great, until you realise that you could get “walnut curculio” or “walnut-husk maggot” instead. Better to deal with the devil you know. And what a devil it is. Around 20,000 Australian men will be diagnosed with prostate cancer in 2010 and more than 3300 of them will die from it.

These are grim statistics, but there’s reason to be optimistic. Make that eight reasons. What follows is the latest, hot-out-of-the-lab research on how you can prevent, detect and treat the disease.

Putting this science into action won’t confer absolute immunity, but it will make your prostate one tough nut to crack.

PREVENTION

LOVE THYSELF
As if masturbation didn’t already provide enough of a pay-off, a recent Australian study found that DIY sex may also help prevent prostate cancer. The study of 2338 men showed that the blokes who masturbated five or more times a week were 34 per cent less likely to develop prostate cancer by the age of 70 than those who handled matters less often.

“Seminal fluid contains substances that are carcinogenic,” reveals Dr Graham Giles, the lead study author. “Regular ejaculation may help flush them out.”

And in case you’re wondering, no, masturbating more than once a day won’t offer more protection and, yes, straight-up sex works just fine as well.

But a word of warning: before you have unprotected nookie with your partner, make sure she’s been tested for cytomegalo-virus, a type of herpes found in cancerous prostate tissue.

BE HAPPY YOU’RE GOING BALD
Turns out the hair-loss drug Propecia has one impressive side effect. In a National Cancer Institute (NCI) study in the US of 18,882 men, researchers found that the men who took five milligrams of Propecia, aka finasteride, daily for seven years had a 25 per cent lower risk of prostate cancer than those taking a placebo. Finasteride blocks production of dihydro¬testosterone, a hormone that triggers hair loss and prostate growth.

“It’s the first study to prove that prostate cancer is preventable,” advises Dr Peter Greenwald, the NCI’s Director of Cancer Prevention – and one of those 18,882 men. “My prostate’s normal,” he adds.

One caution: men on finasteride had a slightly greater chance of being diagnosed with a more aggressive form of the disease than the placebo takers.

More research on the drug is needed, but if you’re concerned about prostate cancer, discuss these findings with your doctor.

WINE AND DINE
There’s a good reason Western European men have lower prostate-cancer rates than we do – and it has nothing to do with Speedos. New research suggests that certain staples of the Mediterranean diet have prostate-cancer-fighting properties.

For starters, a recent study published in the Journal of the National Cancer Institute revealed that men who consume more than 10 grams of garlic or spring onions (about three cloves of garlic or two tablespoons of spring onions) daily have a 50 per cent lower risk of prostate cancer than those who eat less than 2g.(The cancer-fighting credit here goes to the organosulfur compounds, which are common to both vegetables.)

Then there’s one of our all-time favourites, red wine. Its grapes are flush with resveratrol, an antioxidant found in some plants that may help inhibit the growth of prostate cancer, claims a report from the MD Anderson Cancer Centre at the University of Texas in the US.

A glass or two of red wine daily should suffice. “If you drink too much,” cautions Dr Catherine O’Brian, the lead study author, “you can neutralise the beneficial effects.”

DETECTION

LOWER THE BAR
Here’s an important PSA (public-service announcement) regarding your PSA (prostate-specific antigen): using a score of 4.1 or greater as the alarm for prostate cancer could prove fatal. A recent study of 6691 men, published in the New England Journal of Medicine (NEJM), showed that this traditional threshold for ordering a follow-up biopsy may be missing 82 per cent of prostate-cancer diagnoses in men under 60.

“The threshold of 4.1 that’s being used has never been rigorously studied,” says Dr Karen Kuntz, one of the study’s authors. And while critics say a lower threshold will lead to unnecessary biopsies, Dr Rinaa Punglia, another of the study authors, believes that it could be worth it. “It’s a trade-off,” she admits. “But it could save lives.”

So how low should you go? Punglia recommends that when you have your PSA level checked (annually from the age of 50 – or 45 if you have a family history), you observe a threshold of 2.6, especially if you’re under 60. According to the NEJM study, using this guideline doubled the cancer-detection rate, from 18 per cent to 36 per cent.

CALCULATE YOUR RISK
Let’s say your PSA is 2.6; you still may not need a biopsy. Instead, ask your GP to use a nomogram. This needle-free analysis turns a patient’s age, PSA density (PSA divided by the volume of the prostate), digital-rectal-exam result and transrectal-ultrasound result into a score that helps establish if a biopsy is really warranted.

“We can say whether or not, for your prostate, that’s a high PSA,” reveals Dr Mark Garzotto, Director of Urologic Oncology at the Portland VA Medical Centre in the US. In a study of 1200 men, Garzotto found that if a nomogram had been used in every case, it would have spared 24 per cent of the men from unnecessary biopsies.

For further information talk to your doctor or contact PCFA by phoning toll free 1800 22 00 99 or visit www.prostate.org.au

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