Prostate cancer primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]

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Overview

Effective measures for the primary prevention of prostate cancer include healthy diet and maintaining healthy weight.

Primary Prevention

• The 5-alpha reductase inhibitors (5-ARIs) finasteride and dutasteride improve lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH), by blocking the conversion of testosterone to the more potent androgen dihydrotestosterone.
• Two randomized trials have shown a reduced risk of prostate cancer in men receiving 5-ARIs, concerns were raised about a possible increased risk of high-grade prostate cancers.
• Swedish population-based cohort study of all men over the age of 40 who had at least one prostate-specific antigen (PSA) test in Stockholm County between 2007 and 2015, men who were prescribed a 5-ARI had a decreased risk for prostate cancer, and the effect was larger with longer duration of exposure.
• The reduction was limited to patients with prostate cancers with Gleason score 6 to 7; there was no impact on the risk of higher-grade disease (Gleason score 8 to 10). These data provide some reassurance that treatment with a 5-ARI for lower urinary tract symptoms is safe with regard to prostate cancer risk, but long-term follow-up data demonstrating improved survival are needed to determine the role of 5-ARIs as chemopreventive agents.

Effective measures for the primary prevention of prostate cancer include:

• Healthy diet

• Low-fat diet
• More fruits and vegetables

• Healthy weight