•  Colon and Rectal Cancer •  Prostate Health Center •  Prostatectomy, Transurethral •  Saw Palmetto: Uses and Safety

It's a walnut-size gland that lies at the base of the bladder and surrounds the urethra. In the United States prostate cancer is one of the two most frequently diagnosed cancers in men (the other is skin cancer), accounting for 10 percent of cancer-related deaths in men. The American Cancer Society estimates that one man in 6 will be diagnosed with prostate cancer during his lifetime. However, only about one in 35 will die from the disease.

Risk increases with age. Men 65 or older account for two-thirds of the cases diagnosed. African American men appear to be at greater risk than white men, and an individual's odds may be higher than average if the disease runs in his family.

For starters, load up on tomato sauce. Researchers at Harvard University found that men who ate cooked tomatoes or foods made with them (tomato sauce or ketchup, for instance) more than twice a week were less likely to develop prostate cancer. Tomatoes are particularly rich in the antioxidant lycopene. (An antioxidant is a substance that can neutralize unstable molecules which may trigger cancer.)

Lycopene may have particular power to stop healthy prostate cells from turning malignant. (Since cooking tomatoes releases lycopene more thoroughly, tomato sauce offers better protection than fresh tomatoes.) Eat lots of other fruits and vegetables as well; they contain other natural antioxidants thought to guard against many forms of cancer.

Cutting back on saturated fat -- the kind found in meat, dairy products, and most pastries -- is a good idea, too. A study funded by the National Cancer Institute showed that prostate cancer was linked to diets high in this type of fat. Some studies also suggest that regular physical activity may lower the risks of all types of cancer, including the kind that develops in the prostate.

In early stages, prostate cancer generally has no symptoms, so most cases are detected by screening tests. Some men do notice that they have to urinate more often or that their stream of urine is weaker. But those changes can also arise from a less serious condition like an enlarged prostate. Advanced prostate cancer may result in swollen lymph nodes in the groin, problems maintaining an erection, and pain in the groin area, spine, hips, or ribs. If you have any of these symptoms, see your doctor.

Yes. He or she will use two basic screening methods. Neither is perfect; both have high false-positive rates, meaning that they frequently indicate cancer when there is none. The tests may also detect slow-growing tumors that will never get large enough to harm you. But both tests can help doctors identify cancer early enough to save your life. One is known as a digital rectal examination (DRE), in which your doctor checks for lumps or other abnormalities by feeling your prostate with a gloved finger.

The other is a blood test called the prostate-specific antigen test (PSA) which measures a substance that typically increases in men when they have prostate cancer. If the PSA test is high (for a man over 50, a score of 4 or higher), or has risen compared with a previous test, your doctor may do a biopsy on your prostate tissue. The sample will then be examined for cancerous cells. Unfortunately, PSA levels can be misleading. According to a report in the May 2004 New England Journal of Medicine, 15 percent of a group of 2,950 men with normal PSA levels were still found to have prostate cancer.

Doctors use a method called the Gleason system to estimate how aggressive a prostate cancer may be. Malignant cells are examined under a microscope and graded on a scale of 1 to 10 according to how different they look from normal cells. The Gleason score is far from conclusive; still, the higher the score, the more likely the cancer will grow and spread rapidly. Doctors may also look at changes in your PSA level over time to gauge the cancer's aggressiveness.

Treatment depends on how far the cancer has advanced. If tumor cells are found only in the prostate itself, doctors may remove your prostate or use radiation therapy to kill the cells. A newer treatment involves embedding tiny radioactive seeds in the prostate. If the cancer has spilled out of the prostate gland into surrounding tissue, hormone therapy in the form of pills, shots, or both can slow the growth of malignant cells, sometimes dramatically so.

Some patients choose to do nothing, an approach called "watchful waiting." This may sound alarming, but it may make sense, particularly for older men whose tumors are most likely to be slow growing. The majority of men who reach age 85, in fact, have cancerous prostate cells, but the disease is developing so gradually that it never threatens their quality of life.

If conventional treatments aren't working, and you want to try herbs, talk to your doctor about your choices. In May 1999, researchers at the University of California at San Francisco released findings that indicated PC-SPES, a cocktail of eight traditional Chinese herbs that includes saw palmetto and licorice, retarded the growth of advanced prostate cancer.

But in February 2002, PC-SPES ran afoul of authorities after tests by the California Department of Health Services turned up traces of warfarin, a prescription blood thinner that can raise the risk of serious bleeding. Subsequent tests found that some batches of PC-SPES contained other prescription medicines as well. BotanicLab Inc., the company that made PC-SPES, voluntarily recalled the product nationwide and it is no longer being made. The National Center for Complementary and Alternative Medicine (NCCAM) announced plans to study PC-SPES and its effect on prostate cancer once a standard product is available.

The California Department of Health Services urged anyone using PC-SPES to stop taking the product immediately and seek medical advice.

The biggest worries men face are losing their ability to get an erection or to control their bladder. Unfortunately, surgery and radiation entail some danger of both. Your own odds are difficult to calculate precisely, since the risk of these side effects depends on your age, the extent of the disease, and the type of surgery performed. A surgical nerve-sparing technique, introduced in the 1980s, has reduced the incidence of impotence, but it's not appropriate for all men. And the troubling fact remains that between 65 and 90 percent of patients whose prostates are removed suffer some inability to maintain an erection. A smaller percentage lose some degree of bladder control. Others may experience occasional urinary dribbling when they exert themselves or cough. Talk to your doctor about the best ways to deal with these problems.

Plenty. The National Cancer Institute is funding studies on a wide variety of new treatments, including hormones that block the growth of tumor cells and substances that cut off a tumor's blood supply. Researchers are also looking for better ways to distinguish between slow-growing and fast-growing prostate cancers.

-- Kevin Boyd, formerly a freelance health reporter, now works in the communications department at UCSF Medical School in San Francisco, California.

Further Resources

National Cancer Institute

American Cancer Society

References

First published June 1, 1999
Last updated March 12, 2008
Copyright © 1999 Consumer Health Interactive

• If you're 50 or older, see your doctor for a prostate exam. • Eat a healthy diet. Cut back on saturated fat and eat lots of fruits and vegetables -- especially cooked tomatoes and tomato sauce. • Get moving. Studies suggest that regular exercise may lower the risks of all types of cancer. • Consider supplements. Some studies have shown that vitamin E, selenium, and saw palmetto may help keep your prostate healthy. Your doctor can help you decide which, if any, supplements are right for you.

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