RODALE NEWS, EMMAUS, PA—Most men over the age of 75 probably don’t need to continue getting screened for prostate cancer if they have a lower reading on a routine blood screening test, according to a study that will appear The Journal of Urology next month.
THE DETAILS: Researchers studied 849 men (122 with, and 727 without prostate cancer) and found that none of the men between 75 and 80 years old with a prostate specific antigen (PSA) score lower than 3 developed an aggressive form of prostate cancer. “It is thought that with PSA testing, it takes between 13 to 17 years for a less aggressive cancer to become problematic,” explains study author Edward Schaeffer, MD, PhD, assistant professor of urology at The Johns Hopkins University School of Medicine in Baltimore, MD. Two-thirds of men older than 75 years old have PSA values below 3, so that cuts out seemingly unnecessary testing, and perhaps unneeded treatment, for many seniors. Researchers concluded these men were unlikely to experience aggressive prostate cancer, or die from the cancer, during their remaining lives.
WHAT IT MEANS: Widespread testing for this type of cancer has been credited with a 30 percent decrease in prostate cancer deaths. But some researchers believe testing could prompt treatment in 30 percent of people whose prostate cancer would remain asymptomatic throughout their lives. “The question of who needs treatment depends not only on the type of cancer—low, intermediate, or high grade—but also on the volume of cancer in the prostate and the age of the patient,” explains Schaeffer. “There is probably no cancer in a 40- or 50-year-old man that is safe to just watch. Conversely, in men who are older with low-grade, low-volume cancer and other medical problems, they may not need any treatment for their cancer in their lifetime.”
Know when to get tested, and how to cut your risk of prostate cancer in the first place:
• Get tested on schedule. It’s recommended that men over 50 have their PSA tested, sooner for men at higher risk (risk factors include obesity, a family history of the disease, and being in certain racial or ethnic groups). A high PSA test could signal a problem, but not always: It could also point to a benign enlarged prostate, or prostatitis, a bacterial infection. At any rate, getting tested regularly gives you and your doctor a baseline to spot changes that occur later in life. Even if you’re 30 and want the test, don’t hesitate to ask your doctor. For men over 75, a conversation with their physician about the need to keep testing is in order.
• Don’t overdo it on calcium. Taking megadose supplements of calcium (1,200 milligrams or more) can lower your PSA, masking an early warning sign of prostate cancer, according a 2007 study. Going into calcium overdrive pushes down your levels of vitamin D, which is tied to prostate health. Get most of your calcium from food and drink, such as low-fat milk, yogurt, and dairy products, and from and green vegetables like kale or bok choy. Take smaller doses in supplement form to add to what your diet gives you (guys over age 18 should get 1,000 mg/day from food and supplements; guys over age 50 should get 1200 mg/day).
• Catch a few rays. There’s also some evidence that increased sunlight exposure is associated with a lower risk of prostate cancer, and this could tie in with vitamin D, which your body creates when sunlight hits your skin. (In places north of Atlanta, that only happens during warmer months.) Sun exposure can raise your risk of skin cancer, though, so spend time in the sun wisely. If your arms are exposed to the sun for just 5 or 10 minutes, your body will make more than enough D. However, some doctors recommend taking a 1,000-mg vitamin D supplement year round to make sure.
• Cut out the red meat. Cutting back or cutting out red meat, especially charred red meat, could lower your risk of getting prostate cancer, Schaeffer says. The lowest number of cases occurs in Japanese men and vegetarians.
• Load up on veggies. Eating more vegetables, and particularly tomatoes, could make a man’s chance of getting prostate cancer lower. Fish could also potentially lower the risk, but make sure you’re picking species that are low in contaminants.
• Eat a pair of nuts. Eating just two Brazil nuts a day can pack a powerful punch of selenium. Researchers from the National Cancer Institute found that men with the highest selenium levels who also popped a multivitamin were nearly 40 percent less likely to develop prostate cancer than those with the lowest levels.
If you’re diagnosed with prostate cancer…
• Find the right doctor. Schaeffer strongly suggests finding a doctor who specializes in prostate cancer treatment, which is usually a urologist. “With the advent of prostate cancer screening and advances in surgical removal, prostate cancer deaths have begun to decline,” he says. “We are making an impact on this terrible disease.”
• Know you’re not alone. More than 180,000 American men were diagnosed with prostate cancer last year—and many are beating it. Join a support group to share your story and listen to others’. Visit Johns Hopkins James Buchanan Brady Urological Institute to learn more about the disease and treatment options.