World Cancer Day – Focus on prostate cancer

World Cancer Day is observed on February 4 every year. The day provides a chance to reflect on what we can do individually and collectively in our fight against cancer. For my part, I have decided to throw the spotlight on prostate cancer.

The prostate is a part of the male reproductive system. It is normally about three cm long and located at the neck of the urinary bladder and in front of the last part of the big intestines called rectum.

The prostate surrounds the conduit for passage of urine from the bladder called urethra and produces a milky fluid which adds to the semen mix.

Prostate cancer is the most common cancer in men. Like all cancers, normal prostate cells undergo a transformation in which they grow and multiply without normal controls to invade adjacent tissues.

Almost all prostate cancers arise from the part that secretes the prostatic fluid – the secretory glandular cells and about five per cent of all prostate cancers arise from other cells. Older men commonly have an enlarged prostate, a non- cancerous enlargement of the prostate called benign prostatic hyperplasia (BPH).

Prostate cancer has increased in frequency, due in part to the widespread availability of simple testing for its detection. However, the death rate from this disease has shown a steady decline due to improved treatment facilities.

The specific cause of prostate cancer remains unknown. However, hormonal, genetic, environmental, and dietary factors are thought to play various roles. Yet, the only well-established risk factors for prostate cancer are age, ethnicity, and heredity.

Age: There is a strong correlation between increasing age and developing prostate cancer. The incidence of prostate cancer increases a thousand fold from age 40 to 80 years of age.

Ethnic origin: In the U.S., African American men are 1.6 times more likely than Caucasian men to develop prostate cancer. They are also 2.4 times more likely to die from their disease compared to Caucasian men of similar ages. Asian Americans, on the other hand, have a much lower chance of getting prostate cancer as compared to Caucasians or African Americans.

Family history: Men with a family history of prostate cancer especially if it is a first-degree relative such as a father or brother, are at an increased risk of developing prostate cancer. If one first-degree relative has prostate cancer, the risk is at least doubled. If two or more first-degree relatives are affected, the risk increases by five- to 11-fold.

Diet: Dietary factors may influence the risk of developing prostate cancer. Specifically, total energy intake and dietary fat have been incriminated. In addition, there is some evidence to suggest that obesity leads to an increased risk of having a more aggressive, larger prostate cancer, which results in a poorer outcome after treatment.

Infection: the role of sexually transmitted infections has been investigated and recent evidence points to it as one of the causative factors for prostate cancer.

People who have had sexually transmitted infections are reported as having 1.4 times greater chance of developing the disease compared to the general population.

Chemicals: Exposure to certain chemicals such as cadmium has been implicated in the development of prostate cancer.

Certain vitamins like selenium and vitamin E intake was deemed to reduce the risk of prostate cancer however, a recent study found no reduction in risk of prostate cancer with either selenium or vitamin E supplements.

However, recent conclusions suggest that vitamin E does not only fail to prevent prostate cancer but actually increases the risk of development of prostate cancer.

Also vitamin C which was advocated as one of the preventive measures of this condition was found, in a recent study, not to reduce the incidence of prostate cancers.

Certain factors have been erroneously associated with prostate cancer. These include Benign prostatic hyperplasia (BPH) which is not related to prostate cancer.

The confusion appears to be from the fact that BPH leads to high markers in the screening test for prostate cancer.

Also vasectomy and an increased sexual activity are no risk factors for developing prostate cancer.

Recent studies have found that increasing the discharge from the prostae either through increased sexual activity or masturbation does reduce the incidence of prostate cancer.