What strategies can patients with a strong family history of prostate cancer employ to decrease risk of developing the disease?
—Everett W. Schlam, MD, Franklin Lakes, N.J.
There is much anecdotal evidence for chemoprevention of prostate cancer ranging from herbal supplements (e.g., saw palmetto) to dietary alterations (e.g., consuming more cooked tomatoes [lycopene]) to vitamin/mineral supplements (e.g., zinc, selenium, and vitamin E). None of these has any proven benefit, however. We still await the results of the National Cancer Institute’s Selenium and Vitamin E Cancer Prevention Trial (SELECT), which may shed some light on this issue. Generally, a “heart-healthy” diet is felt to be a “prostate-healthy” diet (Urol Clin North Am. 2004;31:207-212).
Family history of prostate cancer is an important risk factor for developing the disease. In fact, one first-degree relative connotes a threefold increase, while two relatives connote a sevenfold increase and three relatives connote an 11-fold increase. Your patient should be followed, after the age of 40, with yearly digital rectal examination and prostate-
specific antigen levels.
—David T. Noyes, MD (119-20)