Prostate cancer is the most common cancer in men and the second leading cause of death caused by cancer in the United States. In 2014, there were an estimated 3 million men living with prostate cancer. The National Cancer Institute’s Surveillance, Epidemiology, and End Results Program estimates that in 2017 there are already over 161,000 new cases of prostate cancer. Although survival rates remain high, thousands of men still die every year and the cost of therapy can extremely burdensome. Men usually begin checking their prostate health between 40 and 50 years of age. Most cases of prostate cancer are detected in men 65 or older.

 

The prostate is a gland which sits between the anus and the scrotum. It is responsible for producing fluid used in semen. Normally this gland is about the size of a walnut. When a tumor forms, this can cause the size to dramatically increase, in some cases even to the size of a grapefruit. A physical exam by a physician is necessary in order to palpate and properly record physical characteristics. Digital rectal examination is commonly done. Imaging such as an IVP, MRI, or CT scan is used to examine the urinary system. Tumor markers are also used like the ALP, or alkaline phosphatase, and the PSA, or prostate specific antigen. Finally, a biopsy can be used to examine the cells growing in the prostate and classify the degree of differentiation, also known as the Gleason’s score. Well-differentiated cells usually progress slower than poorly differentiated cells. The stage of prostate cancer is dependent on the spreading of the tumor.

 

Prostate health and the correlation with dietary supplements has been studied throughout the 90’s and 2000’s. Since prostate cancer is so common in men, it is only right to find out the most we can about it. Today, scientists have found a correlation between DHT and increase in prostate size. DHT, also known as dihydrotestosterone, is responsible for giving men their male characteristics as well as other less desirable ones such as balding and acne. Recent studies have also shown an association between male pattern baldness and prostate cancer. The Canadian Urological Association journal and American Journal of Epidemiology have both published studies showing the significant increase in fatal prostate cancer and men with patterned hair loss. African-American men have the highest risk of developing prostate cancer. Many factors contributing to prostate tumors are non-modifiable and far from our control. Other factors, however, like the foods we eat or supplements we consume can affect our risk of malignancy.

 

In a study published in 2014 by The World Journal of Men’s Health, milk protein was shown to significantly increase prostate cancer cell proliferation (rapid growth). This study was performed in-vitro, meaning it was done in a culture dish or test tube and not in a living organism. Other cancer cell lines like A459 (lung-cancer cells), SNU484 (stomach cancer cells), MCF7 (breast cancer cells), embryonic kidney cells (HEK293), and normal prostate cells (RWPE1) were also tested and showed no significant proliferation. Although these results are alarming, additional research is necessary, specifically for in-vivo design, meaning in a live organism, to better understand how milk proteins influence cancer proliferation.

 

Oxidative stress reduction has been a studied topic in the prevention of cancer cell proliferation. In a study published by Clinical Cancer Research, the effects of pomegranate juice consumption on PSA progression was investigated. The study concluded that 83% of subjects achieved improvement in PSA doubling time. When PSA doubling time is greater, PSA will rise slower, which mean prostate cancer may develop slower too. In-vitro studies showed LNCaP cells were reduced by 12% in growth and apoptosis was increased by 17.5%. PC-3 prostate cancer cell invasion inhibition was seen in-vitro when pomegranate, Punica granatum, was added.

 

Lycopene is a phytochemical found in some red produce like tomatoes, watermelon, pink grapefruit, carrots, and Gac, a fruit found in Asia. Lycopene has been studied throughout the world for its prevention of prostate cancer. In studies published by the International Journal of Cancer, increased dietary lycopene from 1608.6 mcg/day to 4,916.7 mcg/day decreased the number of prostate cancer cases by over 40%. Dietary lycopene in these studies was obtained from tomato-based foods and showed cooked tomatoes to be higher in lycopene than raw tomatoes. Gac, Momordica cochinchinensis, is sometimes sold in capsule and concentrated juice blends. Other food like pumpkin spinach, and citrus do not contain lycopene, but they do have carotenoids like α-carotene, β-cryptoxanthin, and lutein/zeaxanthin which were also found to prevent prostate cancer. So maybe having that slice of pizza or spaghetti with tomato sauce every now and then is good for you.

 

There is still ongoing debate as to whether dietary consumption of fruits and vegetables directly reduces the risk of cancer. EPIC, the European Prospective Investigation Into Cancer and Nutrition, was conducted between 1992 and 2000. This was a self-reported study of 142,605 men and 335,873 aimed at the association between overall cancer risk and total intake of fruits and vegetables. A statistically significant reduction in overall cancer risk was observed, with stronger inverse association with vegetables than with fruits. The observed inverse association between overall fruit and vegetable consumption and cancer risk was, however, weak. This leads some scientists to research dietary supplements, which concentrate the antioxidant effect found in these foods.

References:

 

SEER Training Modules, Module Name. U. S. National Institutes of Health, National Cancer Institute. Day Month Year (of access) <https://training.seer.cancer.gov/>.

 

Park S-W, et al. A Milk Protein, Casein, as a Proliferation Promoting Factor in Prostate Cancer Cells. The World Journal of Men’s Health. 2014;32(2):76-82. doi:10.5534/wjmh.2014.32.2.76.

 

Fulgham PF, Bishoff JT. Urinary tract imaging: Basic principles. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 4.

 

Al Edwan G, et al. The association of male pattern baldness and risk of cancer and high-grade disease among men presenting for prostate biopsy. Can Urol Assoc J. 2016 Nov-Dec;10(11-12):E424-E427. doi: 10.5489/cuaj.3813. Epub 2016 Dec 12. PubMed PMID: 28096933; PubMed Central PMCID: PMC5167604.

 

Zhou CK, et al. Male Pattern Baldness in Relation to Prostate Cancer-Specific Mortality: A Prospective Analysis in the NHANES I Epidemiologic Follow-up Study. Am J Epidemiol. 2016 Feb 1;183(3):210-7. doi: 10.1093/aje/kwv190. Epub 2016 Jan 12. PubMed PMID: 26764224; PubMed Central PMCID: PMC4724092.

 

Jian L, Du CJ, Lee AH, Binns CW. Do dietary lycopene and other carotenoids protect against prostate cancer? Int J Cancer. 2005 Mar 1;113(6):1010-4. PubMed PMID: 15514967.

 

Giovannucci E, et al. Intake of carotenoids and retinol in relation to risk of prostate cancer. J Natl Cancer Inst. 1995 Dec 6;87(23):1767-76. PubMed PMID: 7473833.

 

Cancer Stat Facts: Prostate Cancer. National Cancer Institute Surveillance, Epidemiology, and End Results Program. Available online at: https://seer.cancer.gov/statfacts/html/prost.html. Accessed on July 13, 2017.

 

PDQ Integrative, Alternative, and Complementary Therapies Editorial Board. Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®): Health Professional Version. 2017 Jun 6. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. Available from http://www-ncbi-nlm-nih-gov.ezproxy.hsc.usf.edu/books/NBK83261/ PubMed PMID: 26389500.

 

Pantuck AJ, et al. Phase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancer. Clin Cancer Res. 2006 Jul 1;12(13):4018-26. PubMed PMID: 16818701.

 

Lansky EP, Harrison G, Froom P, Jiang WG. Pomegranate (Punica granatum) pure chemicals show possible synergistic inhibition of human PC-3 prostate cancer cell invasion across Matrigel. Invest New Drugs. 2005 Mar;23(2):121-2. Erratum in: Invest New Drugs. 2005 Aug;23(4):379. PubMed PMID: 15744587.

 

Key TJ, et al; European Prospective Investigation into Cancer and Nutrition (EPIC). Fruits and vegetables and prostate cancer: no association among 1104 cases in a prospective study of 130544 men in the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer. 2004 Mar;109(1):119-24. PubMed PMID: 14735477.

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