Like breast and bowel cancer (the most famous forms as well as many other cancers), it is now well understood that there is a strong genetic element to a man’s risk of developing prostate cancer. For example, if your father had prostate cancer, then you are more likely to develop it too. It’s important to clarify that I say more likely, not likely. Interestingly, twin and migration studies (used to control for environmental factors) have shown that prostate cancer may develop when two conditions meet: a genetic predisposition to it and an environmental trigger.
Men with an increased genetic risk of getting prostate cancer
- Black men (multiple studies are ongoing internationally as to why they have a higher risk)
- Men with a family history of prostate cancer – the more family members affected and the closer their relationship to you, the higher the risk
- Specific gene defects – such as the BRCA1 and 2 gene mutations and Lynch syndrome https://www.cancer.net/cancer-types/lynch-syndrome.
Environmental triggers for prostate cancer
- Excess saturated fat – found in red meat and dairy products
- Insufficient fruit and vegetables – these are rich in antioxidants
- Lack of exercise
- Obesity
- Smoking
How can you reduce your risk of dying of prostate cancer?
- Early detection – screening with regular PSA blood tests from the age of 40 years remains controversial, but if there is one group of men in whom there is general agreement about screening, it is those with a genetic predisposition.
- Early treatment – men with an increased genetic risk of getting prostate cancer appear to fail active surveillance more frequently (i.e. they go on to develop prostate cancer anyway), making active treatment a more attractive option.
- Living a healthy lifestyle – this has been borne out by a recent US study published in European Urology of more than 73,000 men who were at increased risk of developing prostate cancer https://www.europeanurology.com/article/S0302-2838(22)02342-9/fulltext.
The above study found that if men had a genetic predisposition for prostate cancer, the lifestyle changes listed below reduced their probability of it spreading following diagnosis (metastasis) and resulting in death.
- BM (body mass index – weight divided by height squared) of less than 30 kg/m2 (https://www.nhs.uk/live-well/healthy-weight/bmi-calculator/)
- high vigorous physical activity
- never smoked or having quit more than 10 years ago
- high intake of tomato-based products
- high intake of fatty fish
- low intake of processed meat
The strong take-home message from this study is that if you are at increased risk of getting prostate cancer, early detection and treatment are important but also modifying your lifestyle might be lifesaving.
However, as the authors of the study also state that these ‘benefits may extend to men at a lower genetic risk, but such differences could be more difficult to detect’, this study should serve as a call to action for all men to adopt a healthy lifestyle, not only to reduced their risk of prostate and other obesity related cancers (notably kidney, liver and bowel) but also their risk of heart disease and wearing out their joints prematurely.
