How Can I Improve My Prostate Health?

Prostate cancer occurs when the DNA in prostate cells mutates. Those cells divide and multiply and cancer cells form in the tissues of the prostate. The prostate is a walnut-sized gland located just below the bladder and in front of the rectum.

"The prostate gland is an important component of the male reproductive system that allows fertility," according to Andrew Seigel, M.D., a New Jersey-based urologist and author of the book, "Male Pelvic Fitness: Optimizing Sexual & Urinary Health."

"Prostate cancer is the most common cancer in men aside from skin cancer, afflicting 1 of 9 men in the United States," he said.

Research continues to ask questions about the risk factors for prostate cancer, but four primary ones stand out: age, race, family history and lifestyle.

Age

Aging is the greatest risk factor for prostate cancer.

"More than 60 percent of men are 65 years old or older at the time of prostate cancer diagnosis, with the average age at diagnosis in the late 60s," Seigel said. "Prostate cancer is rare in men under 40 years old."

"When guys get into their fifth, sixth, seventh decades, there's an increased chance that there'll be some growth in terms of cancerous cells in the prostate," Oliffe said.

The development of cancerous cells may be due to oxidative damage, or the literal "rusting" of prostate cells, Seigel said.

Race

"Men of African ancestry have the highest incidence of prostate cancer," Seigel said.

Black men in the U.S. are 1.6 times more likely to be diagnosed with prostate cancer than Caucasian men, and they are more likely to be diagnosed at a younger age, Seigel noted. In addition, the death rate for African American men is 2.4 times higher than that of Caucasian men.

"On a worldwide basis, the greatest occurrence of prostate cancer is in North America and Scandinavia, and the lowest in Asia," Seigel said. "Prostate cancer is approximately eight times more prevalent in Western countries than in Eastern countries."

Family history

Genetic predisposition is a third major risk factor for prostate cancer. A family history of prostate cancer puts you at greater risk of contracting the disease.

Risk increases according to the number of affected family members, their degree of relatedness and the age at which they were diagnosed.

"[For example], if you have three family members with prostate cancer, or if the disease occurs in three generations in your family, or if two of your first-degree relatives have been diagnosed at an age younger than 55 years, you have a good likelihood of having hereditary prostate cancer, which confers a 50 percent risk of developing the disease," Seigel said.

Lifestyle

The effects of a person's lifestyle—body weight, physical activity and nutrition—on prostate cancer risk aren't clear. However, a healthy lifestyle can help reduce your likelihood of developing chronic diseases overall.

This likely includes prostate cancer, as well as many other cancers.

"Asian men who reside in Asian countries have the lowest risk for prostate cancer. However, after migrating to Western countries, their risk increases substantially," Seigel noted. "This is highly suggestive that diet and other lifestyle and environmental factors play a strong role in the development of prostate cancer."

While there may be no known prevention for prostate cancer, there are ways to keep your prostate healthy and potentially reduce your risk. Here are five best practices for prostate health:

1. Maintain a healthy weight

"Obesity has been correlated with an increased risk of prostate cancer occurrence, recurrence, progression and death," Seigel said.

Seigel cited research suggesting a link between body mass index (BMI) and prostate cancer. The study found that the odds of metastasis and death are increased about 1.3 times in men with a BMI of 30 to 35, and about 1.5 times in men with a BMI greater than 35.

"Furthermore, carrying the burden of extra weight increases the complication rate following treatments for prostate cancer," Seigel added.

2. Eat a Mediterranean diet

Seigel and Oliff named a plant-based, Mediterranean diet as a possible way to reduce your chances of developing prostate cancer and improve your odds of surviving.

"An ideal diet that is both heart-healthy and prostate-healthy is the Mediterranean diet," Seigel said.

Prostate cancer has been linked to inflammation, and recent research suggests an anti-inflammatory diet, such as the Mediterranean diet, could contribute to prostate health.

According to Seigel, a healthy, anti-inflammatory diet includes the following:

• Fruits and vegetables. Vegetables and fruits are rich in antioxidants, vitamins, minerals and fiber.

  "Antioxidants help protect cells from damage caused by unstable molecules called free radicals, which can incur cellular damage and potentially cause cancer," Seigel said.

• Cruciferous vegetables, specifically. Virtually all vegetables are healthy, but Seigel listed broccoli, cauliflower, Brussels sprouts, kale and cabbage, and dark green, leafy vegetables as being particularly prostate-friendly.

  "These are fiber-rich and contain lutein, a carotenoid antioxidant pigment," Seigel said. Research has suggested lutein has an inverse relationship with prostate cancer.

• Red fruits and vegetables. "Berries such as strawberries, blackberries, blueberries and raspberries, and red cabbage and eggplant, contain abundant anthocyanins," Seigel said. "[Anthocyanins are] antioxidant pigments that give red, blue and purple plants their vibrant coloring."

  Prior research has linked anthocyanins to various health benefits, including longevity and cancer prevention.

• Fish, lean poultry and plant-based protein. Seigel advises men to skip charred and processed meats and focus instead on fish, lean poultry and plant-based proteins. Fish such as salmon, sardines and trout contain anti-inflammatory omega-3 fatty acids.
• Healthy fats. Seigel tells men to focus on healthy fats of plant origin. Olives, avocados, seeds and nuts have healthy fats.
• Coffee. "Coffee has antioxidant and anti-inflammatory effects and has been associated with a decreased risk of developing prostate cancer," Seigel said.

3. Quit smoking

"Tobacco use has been associated with more aggressive prostate cancers and a higher risk of prostate cancer progression, recurrence and death," Seigel said.

A large-scale 2016 study found that as the prevalence of smoking declined in certain states, prostate cancer death rates declined in parallel. Prior research posits that cigarette smoking might increase prostate cancer risk because, when burned, cigarettes are carcinogens, or cancer-causing agents.

4. Drink less alcohol

"Prostate cancer risk rises with heavy alcohol use, so moderation is recommended," Seigel said.

Past studies have linked alcohol consumption to increased prostate cancer risk. However, in a majority of cases, the study authors emphasized the need for further investigation into the connection between alcohol consumption and prostate cancer risk.

The American Cancer Society (ACS) does not list alcohol as a risk factor for prostate cancer. The Prostate Cancer Foundation (PCF) notes there is no link between alcohol use and prostate cancer risk, but that comes with a cautionary statement: "It is important to note that alcohol is a risk factor for many other types of cancers. So nondrinkers must not start drinking alcohol, and it will be beneficial for drinkers to reduce consumption."

5. Stay active

"Exercise positively influences energy metabolism, oxidative stress, inflammatory pathways and the immune system," Seigel said.

A growing body of research suggests that people with prostates who exercise regularly are less likely to die from prostate cancer.

"If one does develop prostate cancer, he will be in better physical shape and have an easier recovery from any intervention necessary to treat the disease," Seigel said. "Exercise is capable of offsetting the negative effects of androgen deprivation therapy on lean muscle and bone mass."

Seigel recommends getting aerobic exercise at least every other day and resistance exercise two to three times weekly. He specifically recommends pelvic floor exercises or Kegels as being beneficial to the prostate.

"Pelvic floor muscle exercises benefit prostate health by increasing pelvic blood flow and lessening the tone of the sympathetic nervous system, which can aggravate lower urinary tract symptoms," Seigel said. "Additionally, pelvic floor muscle exercises strengthen the muscles surrounding the prostate so that if one develops prostate cancer and requires treatment, he will experience an expedited recovery of urinary control and sexual function."

6. Consider finasteride or dutasteride

Finasteride (brand name Propecia) or dutasteride (brand name Avodart) are medications commonly used to treat benign prostate hyperplasia (BPH). These drugs may also reduce the risk of prostate cancer, Seigel said.

"Finasteride or dutasteride block the conversion of testosterone to its activated form—dihydrotestosterone (DHT)—that is responsible for prostate growth and male-pattern baldness," Seigel said.

He cited the Prostate Cancer Prevention Trial from 2003. It followed men for 10 years and found that those men who took finasteride were 25 percent less likely to develop prostate cancer. A further 10 years of follow-up put that number at 30 percent.

Previous research into dutasteride found the medication improved BPH outcomes and reduced the incidence of prostate cancer.

7. Get screened regularly

"Be proactive and see your doctor annually for a digital rectal exam (DRE) and prostate-specific antigen (PSA) blood test," said Seigel. "The PSA test does not replace the DRE—both need to be done."

Guidelines for screening from major organizations such as the American Urological Association, the American Cancer Society and the U.S. Preventive Services Task Force can vary, Seigel said.

"I believe in initiating screening at age 40 with DRE and PSA and repeating this regimen annually," Seigel said. "Pursuing an annual testing regimen and reacting to a change in DRE and/or an acceleration in PSA allows for the timely identification of men with aggressive, or potentially aggressive, localized prostate cancer that can be successfully treated to prevent the morbidity and mortality associated with advanced or metastatic prostate cancer."

Oliffe agreed, adding that your frequency of cancer screening might vary depending on your risk level. He suggests talking to your general practitioner to determine a testing frequency that's right for you.