I AM A CANCER DOCTOR, AND I WANT to share some ways that you can lower the chances we will ever meet.

First, a quick look at the scope of the problem. Worldwide, there are over 1.4 million men with prostate cancer. Prostate cancer represents about seven percent of all cancer cases.

Each year, over 375 000 will die from prostate cancer. This mortality number is nearly four percent of all deaths related to cancer.

Such statistics haunt me, driving me to continue to explore how we can work harder on the front end — risk-reduction — to reduce the probability of being diagnosed with, or dying from, prostate cancer.

Prostate cancer — risk factors (fixed)

Like all types of cancer, the exact cause of this male cancer isn’t easy to determine. Multiple factors may be involved in many cases, including genetics and exposure to environmental toxins, like certain chemicals or radiation.

Anything that can raise your risk of a disease (such as cancer) is a risk factor. Some of the risk factors for being diagnosed with prostate cancer include:

• Age. Prostate cancer risk rises with age. For whites with no family history of prostate cancer, the chances rise significantly after age 50. The risk increases for blacks or those with a close relative with prostate cancer at age 40. Approximately two-thirds of cases are among men 65 and older. However, the older a man with prostate cancer is, the less aggressive the disease tends to be, especially after age 70.
• Inherited genetics (family history). For most men with prostate cancer, the genetic changes associated with prostate cancer are acquired during life and are present only in specific prostate cells. These somatic variants are not inherited. The American Cancer Society offers that inherited mutations cause up to ten percent of prostate cancer cases.
• Race. The risk of prostate cancer is 1.8-times higher for African-American men (compared with white Americans). In addition, some studies indicate that prostate cancer tends to be more advanced among African-Americans. Interestingly, the risk is low in Africa and Japan but rises sharply for immigrants to higher-risk countries like the USA. We don’t know why.
• Geography. Prostate cancer is more common in the Caribbean, North America, northwestern Europe, and Australia. Rates are lower in Asia, Africa, Central America, and South America.

Prostate cancer — risk factors (changeable)

Here are some potentially modifiable risk factors:

• Vitamin D. Did you know that in the USA, men living north of 40 degrees latitude have a higher risk of dying from prostate cancer than those who live more south. The Prostate Cancer Foundation explains that this may be secondary to lower levels of sunlight (and therefore vitamin D). Whether getting more vitamin D reduces prostate cancer risk remains unknown.
• Smoking. Please don’t do it.
• Diet. Some studies suggest dietary fat is associated with prostate cancer. Those in countries with a high-fat diet also are more likely to eat fewer fruits and vegetables. There is speculation that meat and dietary products play a role, given places where people consume many of them have a higher risk (compared with places where diet centers on rice, vegetables, and soy products). Is there high-level evidence of a diet: prostate cancer relationship, in my view? In a word, no. Here are some thoughts from the University of California, San Francisco (USA).
• Obesity. While being obese may not raise one’s risk of prostate cancer, the extra pounds may increase your risk of getting more aggressive prostate cancer. That’s the conclusion of some, but not all, research.
• Sedentary behavior. Here’s the take of the Seattle Cancer Care Alliance: Studies have found that men who get regular physical activity have a slightly lower risk of prostate cancer. Vigorous activity may have a more significant effect, especially on the risk of advanced prostate cancer. Also, physical activity is associated with better survival in men with prostate cancer. About three hours a week of modestly vigorous activity may substantially improve prostate cancer survival.
• Ejaculate frequently. Men who ejaculate frequently have a lower chance of being diagnosed with prostate cancer. Perhaps they are clearing irritants out of the prostate.

Prostate cancer risk reduction — Action

Thank you for joining me today. The takeaway? Watch your weight, get some physical activity, and consider vitamin D (with K2). Frequent ejaculation may lower risk, too.

Thank you for joining me.