Prostate cancer is the second most frequently diagnosed cancer and the fifth leading cause of cancer deaths in men globally. Within the United States, the American Cancer Society found that one in eight men are diagnosed with prostate cancer and one in forty-one men die from it. While prostate cancer mortality rates are high, the suffering that results from the symptoms and treatment of this disease are far more widespread. The good news is, the more we learn, the more the scientific community is beginning to view prostate cancer as preventable. How is it possible that the second most diagnosed cancer in American men could, to an extent, be avoided? To answer this question, let me tell you a story that spans decades of scientific discovery.
Understanding how prostate cancer became a topic of worldwide interest starts with the publication of two international research studies that found one very shocking statistic; over 70 percent of prostate cancer cases occur in high resource countries.
The first study, led by Dr. Ahmedin Jemal, a distinguished cancer epidemiologist, analyzed data from the World Health Organization on prostate cancer incidence across fifty-three countries. Findings showed that prostate cancer rates increased in thirty-two of the countries studied, with over 70 percent of cases occurring in high-resource countries, such as the U.S. Conversely, only 30 percent of cases occurred in lower-resource countries, such as those in Southeast Asia. This stark difference left the research community wondering what could be responsible for this disproportionate distribution.
Initially, scientists believed the higher percentage of cases observed was simply the result of more cases being diagnosed. Perhaps it wasn’t that more men had prostate cancer in higher resource countries, but that the advanced medical technology used in these countries detected more cases. This theory lost traction once scientists determined there was already a fifty-fold difference in prostate cancer rates between countries before advanced testing technology was developed. Furthermore, scientists found that as countries developed, their rates of prostate cancer increased, regardless of their diagnostic techniques.
Let’s look a little deeper into Dr. Jemal’s global study. Findings demonstrated that compared to the alarming 213,700 new prostate cancer cases diagnosed in North America in 2008, fewer than 20,000 new cases were recorded in Southeast Asia that same year. Adjusted for population size, that means twenty times more prostate cancer cases were recorded in North America than in Southeast Asia. South-Central Asia has an even more drastic difference, with nearly fifty times more cases of prostate cancer reported in North America than in South-Central Asia. How could it be that America’s second most diagnosed cancer is seemingly rare in parts of Asia?
In response to this query, scientists in Hawaii and California began exploring the role of ethnicity in prostate cancer incidence. These scientists looked at over 215,000 Japanese men of varying socioeconomic status who had migrated from Japan, a country with relatively low prostate cancer rates, to the U.S., a country with very high prostate cancer rates. What they discovered was extraordinary. Prostate cancer risk in participants within the same ethnic group was reflective of incidence rates in their country of residence, not their country of origin. In fact, within one generation of migration, after only four years of living in the U.S., Japanese study participants showed a 700 percent increase in their prostate cancer incidence rates. A second study continued this research, by demonstrating that Chinese men living in the U.S. had sixteen times more prostate cancer incidences than Chinese men living in China. Based on these studies, it does not appear that ethnicity protected these men from prostate cancer, because after living in the U.S., their incidence rates skyrocketed.
Ethnicity and diagnostic technology may play a smaller role in prostate cancer risk than previously believed, what about genetics? Dr. Lichtenstein, a renowned genetic epidemiologist, looked at data from 89,576 twin individuals in the Swedish Twin Registry to address this question. Results indicated that 42 percent of participant’s prostate cancer risk could be attributed to genetics. While 42 percent is undoubtedly a weighty statistic, it also implies that nearly 60 percent of risk is entirely unrelated to genetics. Based on these findings, Dr. Lichtenstein suggests that environment could be the primary contributor to prostate cancer risk, not genetics.
Around the world researchers are shifting to a new understanding of lifestyle choices as a major contributor to men’s individual risk for prostate cancer. Lifestyle choices are the daily practices we have, from our diets to our exercising patterns. After three decades of research, scientists today believe the seemingly small decisions we make every day may be the key to preventing prostate cancer.
Just how much of an effect can eating an extra daily serving of veggies actually have? Dr. Kenfield harnessed thirty years of data from over 60,000 men on their daily practices and bodily measurements, including diet, physical activity, and body mass index, to answer this very question. Of the men studied, those who followed the healthiest lifestyle practices had a 68 percent decrease in terminal prostate cancer incidence compared to men with the least healthy lifestyles. What’s more, Dr. Kenfield predicted that nearly half of lethal prostate cancer cases in the United States could be prevented if men followed a healthier lifestyle.
Like the men in Dr. Kenfield’s study, you have the power to make healthier choices to reduce your risk for prostate cancer. While things like genetics are out of your control, there is a wealth of research showing that there are simple ways to reduce your risk for prostate cancer that are within your control. Over the course of this book, we review healthy lifestyle choices, from diet to routine medical screenings, you can integrate into your daily practices to reduce your prostate cancer risk.
You have the power to possibly prevent prostate cancer and this power comes in the form of daily lifestyle choices. Use this information to take ownership of your health. Empower yourself. There is no time like the present.
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