Prostate Cancer
Prostate cancer is the second most common cancer in men, with one in seven men diagnosed with prostate cancer in their lifetime. Another common prostate condition in men as they get older is Benign Prostatic Hyperplasia (BPH) or an enlarged prostate. Research indicates that an enlarged prostate does not increase your risk of prostate cancer (Osiecki, 2012, p494).
The aggressiveness of this type of cancer can vary between patients, and different treatment options are available depending on the speed of progression, usually determined by checking the patient's prostate specific antigen (PSA) levels (Telang, Lane, Cher, Miller & Dupree, 2017). The use of the PSA test is controversial, as many studies show inconclusive results based on PSA levels, as it can be an imprecise marker of cancer risk (NCBI, 2017).
The prostate is a gland that produces secretions which contributes to the bulk of semen, and provides an appropriate environment for sperm. The prostate also produces the PSA enzyme. The prostate gland sits under the urinary bladder and completely surrounds the urinary tract, which can explain some of the urinary tract symptoms associated with prostate cancer or BPH (Sherwood, 2013).
Symptoms
The symptoms of prostate cancer are non-specific (meaning that they can be a result of other conditions such as BPH) and can include the following:
Risk factors/Causes
The risk factors of prostate cancer include the following:
The aggressiveness of this type of cancer can vary between patients, and different treatment options are available depending on the speed of progression, usually determined by checking the patient's prostate specific antigen (PSA) levels (Telang, Lane, Cher, Miller & Dupree, 2017). The use of the PSA test is controversial, as many studies show inconclusive results based on PSA levels, as it can be an imprecise marker of cancer risk (NCBI, 2017).
The prostate is a gland that produces secretions which contributes to the bulk of semen, and provides an appropriate environment for sperm. The prostate also produces the PSA enzyme. The prostate gland sits under the urinary bladder and completely surrounds the urinary tract, which can explain some of the urinary tract symptoms associated with prostate cancer or BPH (Sherwood, 2013).
Symptoms
The symptoms of prostate cancer are non-specific (meaning that they can be a result of other conditions such as BPH) and can include the following:
- Decreased strength of urination
- Increased urgency of urination
- Difficulty starting urination
- Increased urination at night, thus interrupting sleep
- Incomplete emptying of the bladder
- Blood in the urine or semen
- Pain during urination or ejaculation, or in the lower back or pelvic area (NCBI, 2017; Osiecki, 2012, p494).
Risk factors/Causes
The risk factors of prostate cancer include the following:
- Age - an increasing age, with the median age of prostate cancer diagnosis being 66 years (NCBI, 2017).
- Family history - this has been suggested as a risk factor in some studies, but there appears to be no link between family history of prostate cancer and progression or severity of the condition (Telang, Lane, Cher, Miller & Dupree, 2017).
- Ethnicity - Epidemiological studies suggest that Caucasian men in Western countries (Europe and America etc) have a 15 times greater risk of this condition than men in other regions, such as in Asia (Quagliariello et al., 2017). Darker skinned men have an even higher rate of prostate cancer, at a younger age and a more aggressive form (Osiecki, 2012, p494).
- Diet – a diet high in processed foods, additives, preservatives, dairy and oxidised omega-6 fats, which is common in the Western diet (Quagliariello et al., 2017).
- Heavy metals - exposure to cadmium, a heavy metal, from plastics, smoking, mining and smelting industries, some foods, and other environmental sources can cause toxicity to the prostate (ATSDR, 2017). Cadmium is also a known carcinogen (Osiecki, 2012, p494).
- Infections - men who have a history of exposure to certain chronic infections such as mycoplasma, HPV and other sexually-transmitted diseases (Osiecki, 2012, pp494-495).
- Smoking and alcohol consumption - smoking is associated with an increased PSA level, metastasis (spreading to other body areas), increased cancer aggressiveness, and a decreased rate of survival (Curtis, Ondracek, Murekeyisoni, Kauffman, Mohler & Marshall, 2017). High intakes of alcohol of over 4 drinks per day or heavy consumption in the past, increase the risk of prostate cancer by about 21% (Lassed, Deus, Lourenço, Dahdouh, Rizvanov, Oliveira & Zama, 2016).
- Low vitamin D – Our bodies make vitamin D from direct sun exposure on our skin. However getting sufficient exposures can be difficult in our busy lives or where you might live in relation to the equator – as further away means less vitamin D can be made. Having low levels of vitamin D has been shown in research to increase prostate cancer risk and a more aggressive form (Quagliariello et al., 2017).
- Hormones - prostate cancer is initially dependent on the male hormones (also called androgens), but an imbalance between testosterone and the female hormone oestrogen can also play a part in the progression of prostate cancer (Osiecki, 2012, pp496-499).
- Environmental chemicals – many chemicals in foods, the environment, homes or workplaces can contribute to high levels of these chemicals in your body, some of which can disrupt your normal hormone balance and function, and contribute to prostate cancer. Some such products include bisphenol-A (BPA), more commonly found in plastics such as water bottles, and food packaging, and phthalates, often found in shampoos, conditioners, perfumes, washing and cleaning products. Other hormone-disrupting chemicals include pesticides and insecticides, chemicals in sunscreens, some medications and other sources (Quagliariello et al., 2017).
- Increased weight and metabolic changes – Weight gain, increasing Body Mass Index or waist to hip ratio, insulin resistance, and metabolic syndrome (a multifactorial condition comprising weight gain, insulin resistance, high blood pressure and high cholesterol) and increased inflammation (Quagliariello et al., 2017).
- Genetics – in addition to the inherited genetic factors associated with family history of prostate cancer, there are also epigenetic factors involved. Epigenetics suggests that the expression of genes (ie, the “turning on” of pro-cancer genes, and the “turning off” of cancer-inhibiting genes) to cause changes in the body is caused by environmental factors, such as our diet, stresses, infections, chemical exposure and other environmental stimuli, most of which are the risk factors listed here (Osiecki, 2012, pp495-499).
- Stress - psychological distress can affect physical and mental health (including depression and anxiety), leading to an increased mortality rate from certain types of cancer, including prostate cancer (Batty, Russ, MacBeath, Stamatakis & Kivimäki, 2017).