Does diet affect prostate cancer and when should men get tested? Some myths about the disease busted
Prostate cancer has become Hong Kong’s third most common cancer in men. Here are some facts and misconceptions about a condition many sufferers don’t bring up with their doctors soon enough
In 2014, some 1,709 Hong Kong men were diagnosed with prostate cancer, “the largest increase in incidence rate among the common male cancers in Hong Kong over the past two decades” according to the city government’s Centre for Health Protection. It is the third most common cancer in the city’s men.
Hospital Authority data shows that the average age of men afflicted is above 70 but that men as young as 47 have been hit with this condition.
Many don’t know the facts about prostate cancer, or visit the doctors when symptoms arise, according to research released last year by the Hong Kong Prostate Cancer Alliance. The survey found 60 per cent of the 500 men it surveyed (all 50 or older) had shown prostate cancer symptoms but did not seek professional help.
Dr Andrew Wai-chun Yip, a urologist and co-convenor of the alliance, says men’s reluctance to discuss urine-related issues with their doctor, and their tendency to tolerate symptoms until they become unbearable, are not the best strategies to stave off this condition. Men shouldn’t ignore the symptoms. In Hong Kong, the disease is the fifth leading cancer killer in men.
Men aged 50 or older (even those 40 or older) should get yearly health checks that include the PSA (prostate specific antigen) test to detect this condition early, says Yip.
A prostate tumour means an obstruction to the urethra which interferes with urine flow. Get your prostate checked out if your visits to the toilet have become more frequent or you have difficulty passing urine.
Contact the doctor immediately if experiencing backache, says Yip, as this could indicate advanced prostate cancer that has spread to the bones, including the spine.
Myth No 1: diet does not affect men’s risk of prostate cancer
The facts: your steak-chomping, greasy Western food munching ways may be hazardous to your prostate health.
“When I started out as a urologist almost 30 years ago, we didn’t see that many prostate cancer patients – at most, two or three cases a year,” recalls Yip. “Now, we see something like one case every other week.”
The urologist blames the popular, meat-heavy, high-fat Western diet for the rapid rise of prostate cancer in Hong Kong.
Extensive research literature shows a link between intake of fatty foods and red meat and prostate cancer risk, including a study in 2015 by Meng Yang et al in Cancer Prevention Research which tracked 926 men diagnosed with prostate cancer over an average of 14 years.
The study found those that consumed a meat- and dairy-rich Western diet showed a two-and-a-half times the risk of death from prostate cancer compared with those who switched to a more plant- and fish-based diet.
Yip advises men to consume less red meat and eat more vegetables and fish.
Myth No 2: a high prostate specific antigen (PSA) score definitively means you have prostate cancer
The facts: don’t be rattled by the result just yet.
Controversy continues to plague this test, which emerged decades ago to assess levels of PSA in your blood. PSA is a protein generated by the prostate gland. The screening is not perfect, as it can’t distinguish between the PSA generated from normal and cancerous cells. Other conditions could be behind the rise of this tumour marker in your blood.
PSA scores of 4.0 nanograms per millilitre (ng/mL) or above may indicate prostate cancer or other abnormalities, so further investigation is warranted, normally by biopsy.
“If a patient’s score is four to 10ng/mL, his chance of having prostate cancer is only 25 per cent, so this test is not a great marker, but it can still mean something,” says Yip.
The best method is to get yearly screenings to monitor one’s PSA levels over time. For example, if you have a low PSA score at 52 years old, then two years later the PSA score rises to 5ng/mL, this would warrant further investigation.