Prostate cancer is one of the most common cancers in men, second only to skin cancer, but it’s not the most fatal. It occurs in 1 in 8 men over the course of their lifetime but only 1 in 41 men die from it.

Know Your Screening Tools

Not every man needs to be screened for prostate cancer. Some men, particularly black men and those with a family history, may be at higher risk though. A decision to screen with a PSA test or a digital rectal exam (DRE) should be based on a discussion of the possible risks and benefits from screening.

Medical Organization	Current Recommendations/Guidelines
American Cancer Society (ACS)	PSA testing +/- DRE should be considered for men starting at: – 40 years old if they are VERY HIGH risk (e.g., more than one 1st degree relative with prostate cancer before 65) – 45 years old if they are HIGH risk (e.g., Black men, one 1st degree relative with prostate cancer before 65) – 50 years old if they are AVERAGE risk with a life expectancy > 10 years
American Urologic Society (AUS)	– PSA testing may be considered for men 55 to 69 years old. – They discourage screening for men with a life expectancy < 10-15 years. – They discourage screening for men 70+ years old unless they are in excellent health.
U.S. Preventive Services Task Force (USPSTF)	– PSA testing may be considered for men 55 to 69 years old. – Screening is not recommended for men over 70 years old.

How to Decrease Your Prostate Cancer Risk

You may not be able to control your gender, race, or family history, but you can control your lifestyle!

The Mediterranean diet may slow prostate cancer progression.

Diagnosis Life summary:
Once you have cancer, is there any way to slow it down? When it comes to the prostate, the answer could be yes. A study in Cancer (https://doi.org/10.1002/cncr.33182) looked at the diets of 410 men with early-stage prostate cancer. Specifically, they used a point scale to see how close their diets were to a Mediterranean diet. After 36 months of follow-up, 76 men had worsening of their disease. Those that had the highest Mediterranean diet scores were 32% less likely to see their disease progress than those who had the lowest scores. For every 1 point improvement on the diet point scale, risk decreased by 12% for all men but by as much as 36% for non-white men (17% of the study population). This is especially important because Black men who are at higher risk for this type of cancer in the first place.

Men who take aspirin are less likely to die from prostate cancer.

Diagnosis Life summary:
A study in the European Urology (https://doi.org/10.1016/j.eururo.2017.01.044) looked at more than 22,000 healthy men from the Physicians’ Health Study. They were treated with aspirin, beta-carotene, a combination, or placebo. By 2015, 3,277 men were diagnosed with prostate cancer and 407 of them died. Men who took aspirin at least 3 days per week had a 68% lower risk of dying. The preferred aspirin dose was not clear. Still, as long as there are not contraindications for other health reasons, aspirin a few days a week may be a simple step to take to decrease your risk.

Sugar-sweetened beverages may increase your risk for prostate cancer.

Diagnosis Life summary:
A study in the British Journal of Nutrition (https://doi.org/10.1017/S0007114518001812) looked at approximately 23,000 men from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. After 9 years of follow-up, 1,996 of those men developed prostate cancer. Men who drank the most sugar-sweetened beverages had a 21% higher risk for prostate cancer when compared to those who drank the least. Natural fruit juices did not have the same effect. You may want to temper how much sugar you drink to decrease your cancer risk.