4th February 2020
Today is World Cancer Day 2020 and it is, therefore, an opportune time to focus on men’s health and prostate cancer.
Each year in the UK there are just under 12,000 thousand deaths from prostate cancer (Cancer Research UK figures 2015-2017) and nearly 50,000 diagnoses. Given this astonishing figure, many of us will know a friend or family member who has suffered with this disease. There is much debate on the role of screening, with much citing of literature to support or refute the extolled benefits. It is not widely known though that relatives of patients with prostate cancer are themselves at a higher risk and need special advice, guidance and surveillance. We expect that in some form in the next five years there will a prostate cancer screening programme in the UK, but until then prostate cancer detection depends on ‘case finding’ in men who happen to have lower urinary tract symptoms. This means that comprehensive men’s health services will continue to perform an important role in providing a personalised screening service for patients concerned about prostate cancer.
Spotting the symptoms
Lower urinary tract symptoms (or LUTS for short) are usually symptoms caused by having a benign enlarged prostate. Such symptoms might include worsening urinary flow, urinary frequency or waking at night to pass urine. The enlargement is usually caused by benign prostate disease (otherwise known as BPH). Because these symptoms can also occur in the presence of prostate cancer, we would advise all men over the age of 40 years with such symptoms to seek medical advice, so that the symptoms can be addressed and so that prostate cancer can be ruled out.
Who is at risk?
Men at particular risk of prostate cancer include those with Afro Caribbean ancestry, men with a first-degree relative who has been diagnosed with prostate cancer, and those men over the age of 45 with a family history of breast cancer on the maternal side (Page EC et al. Eur Urol 2019; 76(6): 831-42).
Improving early detection
Many organisations including Anglian Urology Associates now offer comprehensive Men’s Health packages that not only screen for prostate cancer and LUTS, but also other cancers such as testicular cancer. Whilst testicular cancer is a relatively uncommon cancer, it can be devastating if left untreated. With the advent of chemotherapy though, these cancers can be curable even if detected at an advanced stage, though as with any cancer, early detection is preferable and associated with more favourable outcomes.
Whilst on the subject of early detection of cancers, it is also worth pointing out that there is increasing evidence that poor lifestyle habits, high cholesterol, obesity, smoking and diabetes may be responsible for increased risk of male cancers. It follows then that early detection / consideration of those other conditions are vital too in improving the health of the ageing male.
“Prevention is better than cure”
So what should we looking out for in ourselves or loved ones as we get older? What should we be seeking to improve? A comprehensive men’s health check will pick up diabetes or pre-diabetes, high blood pressure and high cholesterol, which are all modifiable factors in the prevention of heart attack or stroke. Furthermore based on current lifestyle habits and family history we can calculate the chances of having a heart attack or stroke in the next ten years. Obesity and smoking are two areas that can be tackled to reduce the risk of these serious adverse events in later life.
The role of diet in the prevention of cancer and cardiovascular disease is now a popular subject. Rarely a week goes by without an article in the popular press and media extolling the virtues of a healthy diet, the importance of the gut microbiome (bacteria in the gut), and epigenetic considerations (epigenetics describes how we can modify the risk of cancer by tinkering with environmental risks). There is emerging evidence from the literature (though by no means conclusive as yet) that a diet low in certain fats, a diet with a high intake of vegetables, and a diet that avoids excessive meat or dairy products can protect against the risk of prostate cancer. In vitro studies have shown that lycopene (found in cooked or processed tomatoes) has a chemopreventative effect on prostate cancer cells, though there are no in vivo studies to support this as yet.
So in summary, a men’s health check is to be recommended in men over the age of 40. Managing your modifiable risk factors in relation to diet and lifestyle, may reduce your risk of developing cancer.
To book your health check contact Anglian Urology Associates on 07580 307020. One of our consultants will provide you with all the information to understand what you can do to stay as healthy as possible and to try and avoid a cancer diagnosis.