Prostate Cancer (cont.)
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
- Prostate cancer facts*
- What is prostate cancer?
- What are the risk factors for prostate cancer?
- How is prostate cancer diagnosed?
- Prostate cancer biopsy results
- The accuracy of the PSA test
- What are the symptoms of prostate cancer?
- What are the stages of prostate cancer?
- What is the prognosis for prostate cancer?
- What are the treatment options for prostate cancer?
- Watchful waiting
- Radiation therapy
- Hormonal therapy
- Targeted therapy
- Monoclonal antibody therapy
- Research techniques
- Complementary and alternative care approaches
- Prostate cancer prevention
- Find a local Oncologist in your town
Prostate cancer prevention
For a disease as common as prostate cancer, a condition which one man in six will be diagnosed with in their lifetime, the ideal approach is to prevent men from getting prostate cancer.
Two clinical trials referred to as the Prostate Cancer Prevention Trial (PCPT) and the subsequent Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial were conducted over the past two decades. These studies demonstrated that both finasteride and dutasteride (Propecia and Avodart), when used in men between 50 and 75 years of age, reduced the incidence of prostate cancer by 28% and 23% respectively as compared to similar men taking a placebo.
The reduction in the overall incidence of prostate cancer was significant. The use of these drugs and their FDA-approval for prevention has been slow to come in part because of the lingering concern over the high-grade prostate cancer risk. Men in these trials got less prostate cancer if treated with these drugs, but the prostate cancers that they did get were more often high-grade (had higher Gleason scores) and thus appeared to be at risk for behaving more aggressively. Men with a family history of prostate cancer or other high risk factors, and in fact any man, should discuss the use of these drugs for this purpose.
Trials have been conducted on several vitamins and nutritional supplements and naturally-occurring compounds in an attempt to prevent prostate cancer.
- Vitamin E and selenium were not effective in the prevention of prostate cancer in the SELECT trial. Vitamin E supplementation may have increased the incidence of prostate cancer.
- Lycopene was also ineffective as a preventive agent.
- Pomegranate juice had no meaningful impact on prostate cancer prevention.
- Green tea had some early results suggestive of a possible protective effect, and a larger trial is under way.
- Vitamin D and its derivatives have been studied in prostate cancer. There is no evidence that vitamin D protects against prostate cancer. The vitamin D derivative, calcitriol, has some therapeutic utility against this disease, and is still under study.
Prostate cancer is the most common cancer in men (after skin cancer), and the second leading cause of death from cancer in men. The biology of prostate cancer is better understood today than it was in the past. The natural history of the disease and its staging have been well defined. There are numerous potentially curative approaches to prostate cancer treatment when the disease is localized. Treatment options also exist for prostate cancer that has spread. Ongoing research continues to search for treatments for metastatic prostate cancer.
Medically reviewed by Jay B. Zatzkin, MD; American Board of Internal Medicine with subspecialty in Medical Oncology
American Cancer Society (ACS).
The James Buchanan Brady Urological Institute. Johns Hopkins Medicine.
National Comprehensive Cancer Network.
Physician Data Query (PDQ). National Cancer Institute (NCI).
Byrd, E. S., et al. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2009.
"Prostate Cancer." Memorial Sloan Kettering Cancer Center.
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