Prostate Cancer, Prevention, Detection

Actor Jerry Orbach (search), most recently known for his role as Detective Lenny Briscoe on TV’s Law & Order, died Tuesday from prostate cancer. More than 30,000 men die from prostate cancer each year, but it’s almost always curable when caught early.

More than 180,000 men in the U.S. are diagnosed with prostate cancer each year. It’s the No. 2 cancer killer among men, following lung cancer.

So while the number of men diagnosed with prostate cancer remains high, survival is near 100 percent when prostate cancer is caught early. But the trick is getting men to the doctor to be checked.

What’s Your Risk?

All men are at risk for developing prostate cancer. A man has about a one in six chance of being diagnosed with prostate cancer during his lifetime.

Besides being male, other factors that may contribute are:

Age: Risk rises with age. More than 75 percent of all prostate cancers are diagnosed in men over 65. But there’s some evidence to show that men who get prostate cancer at an earlier age may have a more aggressive form of the disease.

Family history: Having a father or brother with the disease doubles your risk for prostate cancer. This is especially true if the relative was young when he got prostate cancer. Therefore, screening for prostate cancer should be started at age 40 in these men.

Race: Blacks have the highest rate of prostate cancer. They are 30-50 percent more likely to get prostate cancer than any other race in America and are more likely to die of it. Blacks are the second group of men for whom prostate cancer testing should begin at age 40.

Diet: A high-fat diet may increase risk. The disease is much more common in countries where meat and dairy products are dietary staples.

Sedentary lifestyle: You may be able to reduce your risk for prostate cancer by getting regular exercise and maintaining a healthy weight.

What Should Men Do?

Not all medical experts agree on when men should be routinely tested, or "screened," for prostate cancer. But early detection often means more treatment options are available and less extensive treatment is necessary.

There are two main tests that are used to help find prostate cancer early.

A digital rectal exam is used to detect prostate cancer in its early stages, when treatment is most successful. Because the prostate is an internal organ, your doctor cannot look at it directly. But since the prostate lies in front of the rectum, he or she can feel it by inserting a gloved, lubricated finger into your rectum. The test typically lasts less than a minute.

Prostate-specific antigen (PSA) testing is a blood test that helps in the detection of prostate cancer. PSA is a substance produced by the prostate gland. The screening test measures the amount of this substance in the bloodstream. Elevated PSA levels may indicate prostate cancer.

The PSA test is not perfect. Many healthy men have elevated PSA levels. Conversely, low levels of PSA in the bloodstream do not rule out the possibility of cancer. Still, most early cases of prostate cancer are detected with a PSA blood test.

Many doctors, including experts at The Cleveland Clinic and the American Cancer Society, recommend the following:

—Annual digital rectal exams and PSA testing for all men beginning at age 50

—Annual digital rectal exams and PSA testing beginning at age 40 for black men and those with a family history of prostate cancer.

Preventing Prostate Cancer

Diet: A low-fat diet that consists primarily of vegetables, fruits and grains may help reduce your risk for prostate cancer. The American Cancer Society recommends limiting high-fat foods from animal sources. Eat five or more servings of fruits and vegetables each day. Healthy food choices also include bread, cereals, rice, pasta, and beans.

Substances called antioxidants (search) help prevent damage to DNA and, as a result, may lower your risk of prostate cancer. Lycopenes (search), in particular, are antioxidants that have been linked to lower risk of prostate cancer. They are found in foods like tomatoes (raw or cooked), grapefruits, and watermelons.

Vitamin Supplements: Some studies have found that taking 50 mg (or 75 IU) of vitamin E each day can lower your risk, but other studies have found no benefit. Other studies suggest that taking vitamin A supplements may actually increase prostate cancer risk. The American Cancer Society recommends that vitamin supplements be used with caution, avoiding excessive doses.

By Michael W. Smith, MD, reviewed by Brunilda Nazario, MD

SOURCE: WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Your Guide to Prostate Cancer."