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Microsoft word - prevention
The ultimate goal of prostate cancer prevention strategies is to prevent men from developing the disease. Unfortunately, despite significant progress in research over the past 16 years, this goal has not yet been achieved. Both genetic and environmental risk factors for prostate cancer have been identified, but the evidence is not yet strong enough to be helpful to men currently at risk for developing prostate cancer.
By contrast, some success has been seen with strategies that can delay the development and progression of prostate cancer. Studies with finasteride and dutasteride, which are typically used for men with the noncancerous condition BPH, have shown that they can reduce by about 25% the chances that a man will be diagnosed with prostate cancer. The Prostate Cancer Prevention Trial was one of the largest prostate cancer trials ever, and involved over 18,000 men over a decade. This study showed that finasteride was able to reduce the risk of being diagnosed by 25%, but initially found a slightly higher rate of aggressive prostate cancers in men who took finasteride. Later looks at this data have suggested that this may be an artifact or due to a greater ability to find more aggressive cancers due to a smaller gland size (ie a biopsy needle can more easily hit a cancer in a smaller gland than a larger gland). Given that this agent is well tolerated, current recommendations call for a discussion about the risks and benefits of these agents in the prevention of prostate cancer, and of the potential risks and benefits of using these agents for other conditions, such as BPH.
In the meantime, diet and lifestyle modifications have been shown to reduce the risk of prostate cancer development and progression, and can help men with prostate cancer live longer and better lives.
More information about how dietary and lifestyle changes can be incorporated into everyday life can be found in the Nutrition, Exercise and Prostate Cancer
Top 10 Considerations for Preventing Prostate Cancer
To understand how to prevent prostate cancer, one must first understand what causes it. There are four major factors that influence one's risk for developing prostate cancer, factors which unfortunately cannot be changed.
The average age at diagnosis of prostate cancer in the United States is 69 years
and after that age the chance of developing prostate cancer becomes more common
than any other cancer in men or women.
African Americans have a 40% greater chance of developing prostate cancer and
twice the risk of dying from it. Conversely, Asian men who live in Asia have the lowest
risk; however when they migrate to the west, their risk increases.
A man with a father or brother who developed prostate cancer has a
twofold-increased risk for developing it. This risk is further increased if the cancer was
diagnosed at a younger age (less than 55 years of age) or affected three or more family
Where you live :
The risk of developing prostate cancer for men who live in rural China
is 2% and for men in the United States 17%. When Chinese men move to the western
culture, their risk increases substantially; men who live north of 40 degrees latitude
(north of Philadelphia, Columbus, Ohio, and Provo, Utah) have the highest risk for dying
from prostate cancer of any men in the United States – this effect appears to be
mediated by inadequate sunlight during three months of the year which reduces vitamin
Given the facts above, which are difficult to change, there are many things that men can do, however, to reduce or delay their risk of developing prostate cancer. Why is prostate cancer so common in the Western culture and much less so in Asia, and why when Asian men migrate to western countries the risk of prostate cancer increases over time? We believe the major risk factor is diet – foods that produce oxidative damage to DNA. What can you do about it to prevent or delay the onset of the disease?
1. Eat fewer calories or exercise more so that you maintain a healthy weight. 2. Try to keep the amount of fat you get from red meat and dairy products to a
3. Watch your calcium intake. Do not take supplemental doses far above the
recommended daily allowance. Some calcium is OK, but avoid taking more than 1,500 mg of calcium a day.
4. Eat more fish – evidence from several studies suggest that fish can help protect
against prostate cancer because they have "good fat" particularly omega-3 fatty acids. Avoid trans fatty acids (found to margarine).
5. Try to incorporate cooked tomatoes that are cooked with olive oil, which has also
been shown to be beneficial, and cruciferous vegetables (like broccoli and cauliflower) into many of your weekly meals. Soy and green tea are also potential dietary components that may be helpful.
6. Avoid smoking for many reasons. Alcohol in moderation, if at all. 7. Seek medical treatment for stress, high blood pressure, high cholesterol, and
depression. Treating these conditions may save your life and will improve your survivorship with prostate cancer
8. What about supplements? Avoid over-supplementation with megavitamins. Too
many vitamins, especially folate, may “fuel the cancer”, and while a multivitamin is not likely to be harmful, if you follow a healthy diet with lots of fruits, vegetables, whole grains, fish, and healthy oils you likely do not even need a multivitamin.
9. Relax and enjoy life. Reducing stress in the workplace and home will improve
your survivorship and lead to a longer, happier life.
10. Finally, eating all the broccoli in the world, though it may make a difference in the long run, does not take away your risk of having prostate cancer right now. If you are age 50 or over, if you are age 40 or over and African-American or have a family history of prostate cancer, you need more than a good diet can guarantee. You should consider a yearly rectal examination and PSA test.
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Tillæg til Cardiologisk Forum Oktober 2002 Nye retningslinjer vedrørende diagnostik og behandling Olav W.Nielsen, Niels Gadsbøll, Lars Køber, Per Hildebrandt, Henrik Villadsen Fra Arbejdsgruppen om Hjerteinsufficiens under Dansk Cardiologisk Selskab Introduktion 2. Objektiv dokumentation for kardial dysfunktionI 2001 udkom en task-force rapport om diagnostik3. Ved tvivl kan diagnosen