Central  South  Dakota Medical News
The Clinical View
by P.E. Hoffsten, M.D.
13 March 2002

PROSTATE CANCER PREVENTION

     Five thousand years ago, a chinese proverb stated that preventive medical care is the superior method of practice.  It is less desirable to try and treat a disease already established.  Nowhere is this concept more true than for those that have had a cancer.  In my  experience, a lady diagnosed with breast cancer or a man diagnosed with prostate cancer dread the entire situation.

     Modern treatment for cancer of the prostate is very frequently medical.  For those individuals who are qualified for surgical consideration and elect the follow same, the potential complication of loss of sexual function or even loss of urinary continence is very unpleasant.  Thus anything that might prevent the problem would certainly be welcome.  This month in the Mayo Clinic proceedings, a study was published showing that the incidence of prostate cancer can be cut in half with the daily use of aspirin or any member of the aspirin family.  The study was carried on for 5 ½ years by which time there was a clear separation between a group of men using aspirin or aspirin like products and a group of men who did not.  There was only a 4% incidence of cancer of the prostate in the aspirin users but an 8 ½%  incidence of cancer of the prostate in the men not using these drugs.

    Previous studies have shown that the use of Vitamin E at about 1,000 units a day decreases the incidence of prostate cancer by 30%.  Another study showed that prostate cancer was decreased by 63% in men who took selenium as a supplement. Both of these products are available as non prescription medications.  Thus there are at least 3 different products that are now associated with a decreased incidence of cancer of the prostate.

    In as much as aspirin decreases the rate of heart attack by 50%, it would seem that the benefit of aspirin a day usage by men over age 50 is an established and highly recommended practice.  The use of higher doses of aspirin to treat arthritic symptoms carries a greater risk of stomach ulcers but is a calculated risk for those individuals with worse types of arthritic problems.  The side effects from a single aspirin per day are massively outweighed by the benefits of heart attack prevention and the decreased incidence of prostate cancer.

    Cancer of the prostate is the most common cancer in men and the third leading cause of death from cancer in men.  Fortunately, there are now relatively effective methods of dealing with the problem once it has occurred.  Since prostate cancer is invariably accelerated by the male hormone, cutting down the amount of male hormone will often put the cancer into remission so that it does not grow any further and ceases to be a clinical problem.

    The aggressiveness of prostate cancer is related to how young the condition begins.  The younger the person is when the diagnosis is made  the worse of the prognosis.  Prostate cancer diagnosed in men over age 70 has a much lower mortality than in men diagnosed in their 50’s.  Thus the medical community is much more aggressive in the treatment of prostate cancer diagnosed in younger men than in older men.  Depending upon the circumstances, surgical treatment is generally recommended for the younger men if the tumor is felt to be limited to the prostate gland itself.  If the tumor has already escaped from the prostate gland and moved into the boney areas of the spine, medical treatment with chemotherapy or radiation therapy is the appropriate intervention.

    As with most cancers, the earlier the diagnosis is made the better the chance to effectively treat the condition.  Beginning at age 50, yearly examinations of the prostate and monitoring of the blood test called PSA are recommended.  If suspicions arise, there may be a problem;  then biopsies of the prostate gland are relatively easy to perform and can either be diagnostic or reassuring regarding the situation.  It should be noted that simply having a high blood test for PSA does not mean that the person has a cancer of the prostate.  Elevations can occur from irritations to the prostate and infections.  Thus the blood test is merely a flag that suggests the possibility but is not diagnostic of a problem.

    As mentioned at the initiation of this article, the most effective step is prevention of the prostate cancer altogether.  The daily use of an aspirin or aspirin like product, daily Selenium intake, or daily Vitamin E intake or possibly even all three would be a recommended step for the prevention of the prostate cancer altogether.  Your local clinics are aware of problems of prostate cancer and are the appropriate place for screening procedures with physical exam and blood test to ensure that there is not a problem or else one that is dealt with at an early time.