As September is observed as Prostate Cancer Awareness Month, Dr SK Rawal explores how with increase in life expectancy the disease is on the rise in countries like India
Of the 7.6 million deaths due to cancer worldwide, one-sixth are caused by prostate cancer which is today the second most frequently diagnosed cancer after that of lung. A disease whose risk increases proportionately with age, prostate cancer is growing in incidence as life expectancy increases. Seventy per cent of all prostate cancers are diagnosed in men over the age of 65. It is still unclear why this increase with age occurs, but studies suggest that after 70, most men have some form of prostate cancer, though there may be no outward symptoms.
Prostate is an exocrine gland of the male reproductive system, and exists directly under the bladder. Roughly the size of a walnut, it is through the prostate that the urethra — the tube carrying urine and semen out of the body — goes through. Besides producing a fluid that forms part of the semen and protects the sperm, the prostate gland also plays a role in urine control.
Traditionally, the incidence of prostate cancer has been the highest in the United States and Europe. However, with increase in life expectancy, adoption of newer lifestyles and screening using prostate-specific antigen (PSA), the incidence of prostate cancer is on the rise in low- and middle-income countries like India. In India, where life expectancy increased from 61.97 in 2001 to 65.48 in 2011, prostate cancer incidence is growing by one per cent every year. However, not many people are aware of this problem and its treatment to prevent it from turning fatal. As we observe the Prostate Cancer Awareness Month in September, we need to up the ante against the disease by spreading awareness about prostate cancer, its risks and ways to curtail it.
Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
Before we discuss the prevention and treatment options, here is a quick look at some key facts about prostate cancer.
In the West, where a number of celebrities and high-profile people have spoken publicly about the disease, awareness has steadily risen. Hollywood stalwarts Robert De Niro and Michael Douglas have undergone treatment for prostate cancer, so has South Africa’s former President Nelson Mandela and former US Secretary of State Colin Powell.
Age, genetic predispositions and diet — all seem to have a direct correlation with the risk of prostate cancer. Some studies have also indicated that men with sexually transmitted diseases, too, have a higher chance of getting afflicted with prostate cancer. In India, however, the awareness about the disease remains low. It is important to note that there are no warning signs of early prostate cancer. Once a tumour causes the prostate gland to swell, or once cancer spreads beyond the prostate, the following symptoms may happen: A frequent need to urinate, especially at night; a weak or interrupted urinary stream; and, blood in urine or semen. Hence, it becomes important to immediately visit a doctor if any of these symptoms are observed. The good part is that prostate cancer is a relatively slow-growing cancer, and the survival rate is high.
While age is a factor that nobody can control, certain dietary modifications can certainly help you cut the risk of getting afflicted with the disease. Choosing a healthy diet is imperative in reducing the risk of this global killer. A low-fat diet that restricts red meat, oil and dairy products such as milk and cheese can be of great help. Men with higher consumption of fatty products have been found to be more prone to getting prostate cancer. However, consumption of fat from plants is generally preferable to that from animals. For instance, cook with olive oil rather than butter or sprinkle nuts, and seeds rather than cheese. An increased amount of fruits and vegetables that are full of vitamins and minerals can be beneficial. So will a diet that includes tofu — a product made from soybeans — which again has been linked to reduced prostate cancer risks. Studies of men who drink green tea have shown a reduced risk of prostate cancer.
There are several myths associated with the risk of prostate cancer, some may believe that too much sex, a vasectomy, masturbation, or enlarged prostate may put you at risk of the disease. However, these are all myths that should be best discarded. To keep prostate cancer at bay, make sure you adopt the following habits in your daily diet:
Eat a big bowl of cereal: There’s no arguing that frosted flakes taste great, but they are not exactly the healthiest breakfast. So, if you want to prevent prostate cancer, opt for a cereal that’s high in flax and try substituting cow’s milk with soy. Both flax and soy contain active ingredients that fight prostate cancer.
Have fish regularly: One finds omega-3 fatty acids in fish, especially oily varieties such as salmon and mackerel. It dampens inflammation, which appears to promote prostate tumours.
Go for leafy greens: Eating several servings of spinach and other leafy greens per week may cut the risk of prostate cancer, according to recent research by genetic epidemiologist John Witte and colleagues at the University of California in San Francisco.
At the same time, you must also restrict your intake of:
Carbohydrates: Sugary candy and soda, as well as starchy foods such as white bread and white rice are all high-glycemic carbs, which spark inflammation. A recent study found that men who ate the most sweet, starchy food were 64 per cent more likely to develop advanced prostate cancer.
Roasted red meat: The increased risk of prostate cancer is specifically tied to the time red meat is exposed to heat — the longer meat is exposed to heat, the more carcinogens are formed which is directly involved in causing cancer.
The writer is Urologist, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi