3 Ways to Discuss Prostate Cancer with Your Man

Just like a guy might want to avoid discussing an epic fail and their feelings, prostate cancer is just one of those topics most guys don’t want to talk about. Yet prostate cancer, a disease that originates in the small gland that produces fluid for semen, is the most frequently diagnosed cancer in men aside from skin cancer.

What’s more it strikes African American men hardest with an estimated risk of 1 in 5 developing prostate cancer during their lifetime, according to U.S. Centers for Disease Control and Prevention.

You can call it a guy thing, but be aware ladies, prostate cancer is one tough subject for men. In general, any topic that focuses on their sex life or sensitive parts of their bodies qualifies, and it doesn’t get more sensitive than one’s prostate.

That may explain one reason why men put off going to the doctor as long as possible, and tend to be more resistant to making an appointment when they do develop symptoms.

Bringing up prostate cancer as a topic can be difficult to do too, so here are three new conversation starters for you:

Keep a healthy weight
Obese men are more likely to have precancerous lesions and are at a 57 percent greater risk of developing subsequent prostate cancer than their thinner counterparts, even if their current biopsies are determined to be benign.

Columbia University researchers conducted a case-control study among 494 of these patients and 494 matched controls. Precancerous abnormalities were found in 11 percent of the benign specimens from men who were obese at the time of the procedure.

The researchers accounted for several factors — a family history of prostate cancer, prostate-specific antigen (PSA) levels during the initial procedure, and the number of PSA tests and digital rectal exams during follow-up.

After doing so, they found body size and associated prostate cancer risk is higher than that seen in prior studies, said Dr. Andrew Rundle, associate professor of epidemiology at Columbia University Mailman School of Public Health in New York City.

“In some ways, this reflects the association between the body size and larger prostate size, which is thought to reduce the sensitivity of the needle biopsy," he said in a statement. He added that it's possible that tumors which had been missed during the initial biopsy had grown enough to be detected later in a follow-up biopsy.

Lifestyle changes can stave off aggressive tumors
Following eight new lifestyle recommendations recently released by the World Cancer Research Fund (WCRF )significantly reduces the risk of developing aggressive prostate cancer, a study by UCLA's Jonsson Comprehensive Cancer Center (JCCC) found.

The eight recommendations encourage men to:

• Be as lean as possible without becoming underweight.

• Be physically active for at least 30 minutes every day.

• Avoid sugary drinks. Limit consumption of energy-dense foods.

• Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.

• Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats (such as bacon, lunch meats and hot dogs).

• If consumed at all, limit alcoholic drinks to two for men (one for women) a day.

• Limit consumption of salty foods and foods processed with salt (sodium).

• Don't use supplements to protect against cancer.

The study, led by Dr. Lenore Arab , a JCCC member and UCLA professor in the departments of medicine and biological chemistry, looked at 2,212 white and African American men between ages 40-70 with newly diagnosed prostate cancer.

Each man in the study was enrolled in the North Carolina-Louisiana Prostate Cancer Project. Men who adopted fewer than four of the lifestyle recommendations were at a much higher risk (38 percent) of developing aggressive tumors than those who stuck to more than four.

According to the study, men’s risk of developing aggressive cancer decreased by 13 percent for each additional lifestyle recommendation they adhered to after four.

Arab said in a statement, "Most men are at risk of prostate cancer, but it is the level of aggressiveness of disease that is most clinically relevant. These findings suggest that even men with prostate cancer can take control of their disease and moderate its aggressiveness through diet and lifestyle choices."

Several previous studies have shown exercise is associated with a lower prostate cancer risk, particularly in older white men.

Consider treatment carefully
Not every man with prostate cancer should undergo treatment, according to a new study published in peer-review journal Annals of Internal Medicine.

The study looked at 14-year survival outcomes of 3,000 men diagnosed with prostate cancer between 1994 and 1995 and found older men with underlying health conditions should think twice before committing to aggressive prostate cancer treatments.

Older patients with low to intermediate risk for prostate cancer — which is often slow growing and poses no symptoms — and who also have at least three underlying health problems, were much more likely to die of something other than their cancer, the study found.

Weighing your treatment options carefully is important because treatment comes at a price.

Aggressive treatments for prostate cancer, including surgery, external radiation and radioactive seed implants, can result in major side effects, including erectile dysfunction, urinary incontinence and bowel problems, said Timothy Daskivich , an Urologist, UCLA Robert Wood Johnson fellow and the study’s first author.

Daskivich said in a press release that any survival advantage gained by undergoing these treatments isn’t realized for approximately 8-10 years after treatment.

“In many cases monitoring the patient's cancer very closely with regular biopsies and intervening with surgery or radiation if the disease progresses is better than hitting the disease with everything in the treatment arsenal,” he said.

Sources:

Effect of Age, Tumor Risk, and Comorbidity on Competing Risks for Surivial in a U.S. Population-Based Cohort of Men With Prostate Cancer. Timothy J. Daskivich, MD; Kang-Hsien Fan, MS; Tatsuki Koyama, PhD; Peter C. Albertsen, MD; Michael Goodman, MD, MPH; Ann S. Hamilton, PhD; Richard M. Hoffman, MD, MPH; Janet L. Stanford, PhD, MPH; Antoinette M. Stroup, PhD; Mark S. Litwin, MD, MPH; and David F. Penson, MD, MPH. Ann Intern Med. 2013;158(10):709-717.
http://annals.org/article.aspx?doi=10.7326/0003-4819-158-10-201305210-00005&an_fo_ed

Eating Right, Exercise May Help Prostate Cancer Patients Reduce Risk of Aggressive Tumors. Shaun Mason, UCLA JCCC. 28 June 2013.
http://www.newswise.com/articles/eating-right-exercise-may-help-prostate-cancer-patients-reduce-risk-of-aggressive-tumors

Study shows regular exercise benefits prostate cancer survivors. American Cancer Society. Rebecca V. Snowden. 7 Jan. 2010.
http://www.cancer.org/cancer/news/study-shows-regular-exercise-benefits-prostate-cancer-survivors and http://www.wiley.com/WileyCDA/PressRelease/pressReleaseId-107268.html

Obese Men With Benign Biopsy at High Risk for Prostate Cancer. American Association of Cancer Research press release. Jeremy Moore. 23 Apr. 2013.
http://www.aacr.org/home/public--media/aacr-in-the-news.aspx?d=3106

Obesity and Future Prostate Cancer Risk among Men after an Initial Benign Biospy of the Prostate. A. Rundle, M. Jankowski, O.N.Kyrvenko, D. Tang, B.A. Rybicki. Published OnlineFirst April 23, 2013; doi: 10.1158/1055-9965.EPI-12-0965 Cancer Epidemiol Biomarkers Prev May 2013 22; 898.
http://cebp.aacrjournals.org/content/22/5/898.abstract?sid=1f7dbec0-d53c-4862-953a-02f6ed1ab8cd

Cancer Facts & Figures for African Americans 2013-2014. Cancer.org. Retrieved July 8, 2013.
http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036921.pdf

Reviewed July 9, 2013
by Michele Blacksberg RN
Edited by Jody Smith

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