Here in Canada:
- Prostate cancer is the most diagnosed cancer in men;
- Approximately 1 in 7 men will be diagnosed with prostate cancer;
- 23,300 men will be diagnosed with prostate cancer, representing 20% of all new cases of cancer in men in 2020;
- 4,200 men will die from prostate cancer, which represents 10% of all cancer deaths in men in 2020;
What it represents daily:
- On average, 64 Canadians will be diagnosed with prostate cancer every day;
- On average, 11 Canadians will die from prostate cancer every day.
Although it is a deadly cancer in men, the death rate from prostate cancer has declined significantly in recent decades thanks to the increase in early detection.
The 5 things you should know about prostate cancer:
- What is a tumor?
- Risk factors
- The evolution of prostate cancer
- The different types of treatment
- Risk reduction
1. What is a tumor?
Let’s define some terms. First the term tumor. A mole, cyst, or wart are tumors. A tumor is not necessarily cancer. A tumor is defined as an increase in the size of a tissue, part of the body, usually without inflammation, which is caused by abnormal growth of cells. It is therefore a cluster of cells. If the cells are cancerous, it is called cancer. If the cells are healthy, it is called a benign tumor. If they’re cancerous cells, it’s a malignant tumor.
Why does cancer develop?
To understand the reasons for the development of cancer, we must talk about cell differentiation. At the origin of life, the sperm meets the egg. The first cell thus formed, has the capacity to create all the cells within the human body: muscles, bones, neurons, connective tissues, etc. All cells in the human body have the necessary genetic makeup to make all types of cells. What makes you have teeth in your mouth instead of below your feet is the extraordinary capacity for cell differentiation. Depending on where they are and the type of nearby cells, they differentiate into specific cells that will have specific functions, such as kidney, liver or muscle cells. Cells sort of understand where they are in the human body and what their roles are.
Problems arise when cells no longer understand their role and decide to divide out of control. What (mainly) causes the cells to malfunction would include:
- Exposure to certain pesticides,
- DNA mutations,
- Certain viruses,
- The toxicity of certain chemicals or drugs,
- Metabolic problems that interfere with proper cell function,
- The inability of the immune system to destroy damaged cells, and
- Genetic predispositions.
We frequently fight cancers which are automatically eliminated by our surveillance systems. These cancer cells must escape the internal mechanisms that cause their death (apoptosis), or the immune system that can recognize damaged or abnormal cells. Thus, chemicals or poor lifestyle habits that can cause cells to function poorly, or the immune system to function poorly, can increase the risk of cancer and is categorized as carcinogens.
A final point is the spread. Cancer cells can grow in one place or travel through the blood or lymphatic circulation. The cells are then called metastases. The initial tumor is called the primary tumor, and new tumors that form at a distance as a result of cell displacement are secondary tumors.
2. Risk factors
Epidemiological studies, that is, studies that make links between the behaviors of populations and certain health problems, have made it possible to link the levels of prostate cancer and:
- Body weight
- Weight variations
- Physical activity
- Consumption of lycopene/tomatoes
- Vitamin D
- Calcium and
In general, here are the factors that increase the risks:
- Alcohol consumption;
- Physical inactivity;
- Sexually transmitted diseases;
- Vasectomy (small increase);
- Consumption of animal fat, red meat and dairy products.
And the factors that reduce the risks:
- Lycopene (the red pigment in tomatoes and watermelon);
- Crucifers (broccoli, cauliflower, Brussels sprouts, etc.);
- Fish and soy;
- Pumpkin seeds and flax seeds;
- Saw palmetto extracts;
- Coffee and green tea;
- Selenium and vitamin D;
- Physical activity;
- Pomegranate extracts.
3. The evolution of prostate cancer
For a young man, the prostate is the size of a ping-pong ball. At 50, it is the same size as a lemon. At this age, one in two men are already at risk of developing prostate problems related to inflammation. At 60, it can be the size of an orange. The swelling of the prostate is believed to be due to hormonal changes, but also to the natural transformation of testosterone. As the prostate swells, it reduces the space available for the bladder and compresses the urethra, which causes difficulties in passing urine.
These inflamed prostate problems will not necessarily cause cancer, but all symptoms should be seen by a doctor to rule out the diagnosis. Here are the main symptoms:
- Frequent need to urinate, especially at night;
- Sudden or urgent need to urinate;
- Difficulty starting and straining to urinate;
- Weak, slow and/or interrupted urine stream;
- Inability to completely empty the bladder;
- Difficulty in controlling: incontinence/urinary leakage;
- Blood in the urine;
- Burning or pain when urinating;
- Blood in the semen;
- Pain during ejaculation;
- Erectile dysfunction;
- Pain or stiffness in the bones of the hips, chest or back;
- Weakness/numbness in the legs and/or feet;
- Loss of bowel control;
- Shortness of breath or cough that does not go away.
Now, here are some terms to discuss for the evolution of cancer. If there is a single cluster of cancer cells in the prostate, it is called stage I. If there are several foci of development, in the prostate, it is called stage II. If there are foci of development outside of the prostate, but nearby, it is called stage III. If it has spread to more distant areas like the lymph nodes, lungs or liver, it is called stage 4.
The stage of development guides the type of treatment that will be offered.
4. The different types of treatment
As mentioned previously, in case of symptoms or in doubt, it is important to consult your doctor. In some provinces in Canada, 3 out of 4 prostate cancers are simply followed by active surveillance which includes rectal examinations, biopsies and the level of prostate specific antigen (PSA) in the blood. It is common for the development to be so slow that there is no need for surgery, radiation therapy, chemotherapy, or laser surgery. These 4 types of procedures are not always offered and depend on the stage of the cancer and its speed of development. Laser treatment is relatively new, minimally invasive, and usually without hospitalization. Ask your urologist or oncologist for more information.
5. Risk reduction
Body weight is one of the factors strongly correlated with the development of prostate cancer. Thus, in addition to the factors mentioned above, maintaining a healthy weight should be one of the first preventive approaches considered. Another preventative factor that is not mentioned is how often you have sex. And yes, men who have sex more often have a lower risk of developing prostate cancer. Apart from these two lifestyle habits, pay attention to the reduction of other risk factors such as alcohol consumption and smoking, and eating habits which are part of the preventive factors such as the consumption of lycopene, crucifers, soy, vitamin D, coffee, tea and selenium. The Vitoli blog contains a number of articles that can guide you in increasing the consumption of these nutrients.
Hopefully these tips will keep you healthy, longer.
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- Fujita K, Hayashi T, Matsushita M, Uemura M, Nonomura N. Obesity, Inflammation, and Prostate Cancer. J Clin Med. 2019 Feb 6;8(2):201. doi: 10.3390/jcm8020201. PMID: 30736371; PMCID: PMC6406330.
- Hatano K, Fujita K, Nonomura N. Application of Anti-Inflammatory Agents in Prostate Cancer. J Clin Med. 2020 Aug 18;9(8):2680. doi: 10.3390/jcm9082680. PMID: 32824865; PMCID: PMC7464558.
- Perdana NR, Mochtar CA, Umbas R, Hamid AR. The Risk Factors of Prostate Cancer and Its Prevention: A Literature Review. Acta Med Indones. 2016 Jul;48(3):228-238. PMID: 27840359.
- Pernar CH, Ebot EM, Wilson KM, Mucci LA. The Epidemiology of Prostate Cancer. Cold Spring Harb Perspect Med. 2018 Dec 3;8(12):a030361. doi: 10.1101/cshperspect.a030361. PMID: 29311132; PMCID: PMC6280714.
- The Quebec Cancer Foundation website: www.fqc.qc.ca
- Canadian Cancer Society website: www.cancer.ca