March 12, 2010
Dear Mayo Clinic:
Does Mayo have advice for preventive measures men can take for prostate health?
There are no formal guidelines, but the advice I give my patients focuses on living a heart-healthy lifestyle. I encourage them to take care of their hearts because recent research has shown that what's good for your heart is also good for your prostate, particularly when it comes to lowering your risk of prostate cancer.
For example, some recent research indicates that cholesterol levels can correlate with a man's prostate cancer risk. The higher your LDL ("bad") cholesterol and the lower your HDL ("good") cholesterol, the higher your risk of prostate cancer.
Also, later this year, Mayo Clinic will publish the results of a research study that found men who took statins — drugs used to lower cholesterol — were less likely to develop prostate cancer, compared to men who did not take statins.
In this study, researchers followed 2,447 men for more than 15 years. Of the statin users, six percent were diagnosed with prostate cancer. Comparatively, non-statin users were three times more likely to develop prostate cancer, suggesting statin use may prevent development of prostate cancer.
Statin medications are currently used to lower cholesterol or to help prevent heart attack and stroke in high-risk patients. In the laboratory setting, researchers have observed that statin medications can prevent cancer cells from dividing and, in fact, may cause some cancer cells to die. The results of this study are preliminary, and more research is needed to determine if statins can protect against prostate cancer. It is not known whether this is a direct result of the drug or the results of the drug's lowering of the cholesterol, or a combination that might include adaptation to a "heart-healthy" lifestyle. But the current research appears to indicate there is some correlation between heart health and a lower risk of prostate cancer.
With these findings in mind, I recommend that my patients engage in a heart-healthy lifestyle. That lifestyle consists of exercising for at least 150 minutes each week, quitting smoking, managing stress and eating a healthy diet. A diet that's good for your heart typically includes whole grains; lean meat, poultry and fish; and at least five servings of fruits and vegetables a day. Following these guidelines is not only important for prostate health, but for a person's health overall. The leading cause of illness and death in U.S. men with prostate cancer is actually cardiovascular disease.
Although researchers have not established a direct link between obesity and the incidence of prostate cancer, obesity might affect levels of hormones related to prostate cancer risk. Obesity may also increase the risk of dying of prostate cancer. So, following strategies for preventing obesity — such as eating a healthy diet and doing some form of aerobic exercise for 30 minutes or more on most days — may have a positive effect on prostate health, as well.
An annual prostate checkup can't reduce your risk of cancer or other prostate disorders, as perhaps a healthy diet and exercise can. But if a prostate problem develops, a digital rectal exam and a prostate-specific antigen (PSA) test may discover the problem in its earliest stage, when treatment can be most effective.
If an exam reveals an enlarged prostate, two drugs — finasteride and dutasteride — both have been shown to prevent the progression of benign (noncancerous) enlargement of the prostate and its associated symptoms and, potentially, can also lower a man's risk of developing prostate cancer.
To monitor your risk of prostate cancer and other potential prostate disorders, stay in regular contact with your doctor about your prostate health. Ask about prevention strategies that make the most sense for you, given your current health and medical history.
— R. Jeffrey Karnes, M.D., Urology, Mayo Clinic, Rochester, Minn.