Prevention: What It Can and Can’t Do For Your Prostate

As we learned in the first installment of this series, the most significant risk factors for prostate cancer are family history, genetic background and age. Any discussion of prostate cancer and who is susceptible begins with this trio.

While no one is certain to get prostate cancer, you are certainly at higher risk if any of the following are true:

• You have one or more close relatives who have had prostate cancer.
• You are African American.
• You are older than age 50.

Where that clarity begins to blur is when we try to break down all the other factors typically used to assess someone's risk for cancer: lifestyle choices, environment, diet, medication, prior illness and prior treatments.

"Unfortunately, prevention of prostate cancer is something that's very difficult to study," said Petar Bajic, M.D., a urologic specialist with the Cleveland Clinic. "Prostate cancer generally forms and evolves and changes very slowly, on the order of many, many years, sometimes even 10 or more years. Over that time, a man has many, many things that he might be exposed to: environmental things, dietary things and other medical conditions."

Imagine trying to catalog your diet over the past decade, listing places where you might have been exposed to toxic chemicals, or even assessing changes in your weight or activity level. It makes pinning down a single smoking-gun cause for prostate cancer nearly impossible.

However, making some broad changes, mostly having to do with diet and lifestyle, can help improve your odds and prevent the worst of outcomes.

"We know that there are two separate things that affect our bodies," said Jayram Krishnan, D.O., a urologist who specializes in surgical oncology with the Cleveland Clinic. "First is what we're born with, our genetic identity. The second thing is environmental factors, the things we can manipulate, that we can control."

That includes what we put into our bodies.

For some people, hearing a constant drumbeat about eating healthier foods can get old. We all know we should choose an orange over a handful of Cheetos, right? But come on, they're both, you know, orange(ish).

Another way to think about how our choices can directly affect our health is to flip the script: Imagine you already have cancer, and the choices you make either help your body combat it or they don't.

"There's this discussion about how everybody has cancer all the time," Krishnan said. "Our bodies are constantly fighting these cells and getting rid of them, causing them to have cell death and removing them from our bodies. There are a lot of checkpoints in our bodies to get rid of bad cells. So we can boost that by eating healthy."

Researchers have made great strides in recent years in looking at particular foods and general food categories that can help prevent prostate cancer and cancer of all types. Here are a few:

Antioxidants

Antioxidants are substances found primarily in fruits and vegetables that help prevent or at least slow cell damage. They fight unstable molecules called free radicals that damage DNA and other cells, and they also provide protection against heart disease, cancer and other conditions.

"There's a lot of discussion around vitamin C, antioxidants, turmeric and curcumin," Krishnan said.

Some foods high in antioxidants include dark chocolate, blueberries, strawberries, spinach, kale, artichokes and pecans.

Of particular interest is lycopene, a carotenoid antioxidant found in tomatoes. While there is some controversy over study quality and inconsistent results from some of the research, one review of 66 lycopene-prostate cancer studies conducted by researchers at the University of Illinois suggested men who ate more lycopene in foods (not supplements) had an 11 percent lower risk of developing prostate cancer.

They even found that for each milligram of lycopene consumed per day, there was a 1 percent reduced chance of prostate cancer. For reference, a typical tomato contains about 3 milligrams of lycopene.

Other food considerations

Plenty of research touts foods that may have an impact on prostate cancer, but much of it involves one-off studies that haven't been replicated or smaller studies that require further research before their findings become part of the official literature.

However, here's a brief list of other dietary choices researchers suggest could potentially have an impact on prostate cancer:

Coffee: Drinking four to five cups of coffee per day may be associated with a lower risk of prostate cancer, a 2014 meta-analysis suggested.

Green tea and tofu: Another 2014 meta-study suggested nutrients called isoflavones may play a role in reducing prostate cancer risk. They can be found in green tea, tofu and other soy products, chickpeas, lentils and alfalfa sprouts.

Fruits and vegetables: Healthcare providers such as the Mayo Clinic agree that eating more vitamin- and mineral-rich fresh fruits and vegetables is likely to help reduce your risk of prostate cancer.

Avoid animal fats: It's long been suspected that a fatty, meat-heavy diet raises the chances of getting prostate cancer. A 2014 study published in the journal Nutrients supports this possible association. If you do eat meat, stick to occasional, small amounts and avoid meat that's been charred, because it contains a carcinogen that's known to cause prostate cancer in rats.

Avoid too much dairy: A 2015 meta-analysis found a high intake of dairy products and dairy calcium may increase prostate cancer risk.

Okay, you had to know this was coming, right? Lifestyle choices could play a big role in prostate cancer prevention (along with about every other health-related issue). This isn't difficult, but maybe you need to read about it again.

Lose weight

There seems to be a link between obesity, contracting prostate cancer and the type of prostate cancer a man gets.

A 2012 review looked at more than 20 years of prostate cancer studies and examined the risk for prostate cancer among men who were obese and overweight. Researchers found obese men have a tendency to get more aggressive kinds of cancer and suggested there are molecular mechanisms specific to obese men that may be at work.

Of course, keeping your weight under control is the keystone to maintaining good health in general.

"Anything that makes you healthier is likely to have some benefit as to both your overall health and longevity, and for preventing disease," Bajic said. "Having a healthy diet, keeping your blood pressure and cholesterol under control, getting regular exercise—all those kinds of things are beneficial to your overall health."

Quit smoking

Smoking isn't good for any of your bodily systems. Although smoking doesn't appear to be directly related to prostate cancer in quite the same way it is to lung cancer, some studies suggest a solid link.

One meta-study looked at a 10-year period of peer-reviewed literature studying the decline of prostate cancer mortality rates in four states and found a statistically significant link to a concurrent decline in smoking rates.

Another systematic review suggested an association between smoking and aggressive types of prostate cancer and higher mortality rates. Researchers also noted a correlation between how much men smoke and how deadly their prostate cancer is.

A 2011 Harvard study found smokers who had prostate cancer were 61 percent more likely to die from it. If they survived, they were also 61 percent more likely to have a recurrence of the disease compared with men who never smoked.

Ejaculate early and often

Some research suggests that men who ejaculate more frequently may have a reduced risk of developing prostate cancer.

One theory is that ejaculating clears the prostate of toxins. Another suggests that suppressing the sympathetic nervous system and relieving tension, as occurs during orgasm, may slow the stimulation of prostate epithelial cell division, according to the National Foundation for Cancer Research.

However, there is quite a bit of disagreement with regard to these findings, so don't sprain your wrist in an attempt to ward off prostate cancer just yet.

Finasteride and dutasteride

Certain drugs used to treat benign prostatic hyperplasia (BPH), or enlarged prostate, are called 5-alpha reductase inhibitors. This class includes finasteride and dutasteride. They may help reduce the likelihood of low-grade prostate cancer. However, they may increase the risk of high-grade prostate cancer, so the jury is still out on this one.

Drink less booze

While alcohol isn't considered an established risk factor for getting prostate cancer specifically, it is a known carcinogen, and heavy drinking could cause a small increased risk of more aggressive forms of the disease.

At the end of the day, the best way you can help prevent the worst outcomes of prostate cancer is to get screened.

"One of the most important ways that we can help identify it early, which is very important, is for men to undergo their routine, recommended healthcare screenings, which includes screening for men in the populations that we discussed," Bajic said.

Stay healthier longer and reduce your chances of getting prostate cancer by eating a healthy diet, including plenty of antioxidants, exercising regularly, not smoking and, above all, getting regular screenings according to the guidelines for age, race and family history.