Does Prostate Cancer Screening Work?

 

As men age, they are likely to hear horror stories about someone that someone knows who died of prostate cancer. This often causes a fear-response that directs the person to ask their doctor for a PSA test. But do they cause more harm than good?

Intuition

It seems intuitively sensible to have a test to make sure that you don’t have this cancer. But intuition would be misplaced in this instance.

The PSA test

The test that’s used in prostate cancer (PC) screening is called the PSA (prostate-specific antigen) test. PSA is a protein produced by cells (both normal and malignant) in the prostate gland. It is usually measured and reported in nanograms of PSA per millilitre of blood (ng/mL). If there is a high number as a result of the test, it could suggest a problem with your prostate – although not necessarily cancer.

Review of recent research

(My bold highlights)

A 2011 review of 5 RCT’s (randomised controlled trials) found the following:

“Prostate cancer screening did not significantly decrease all-cause or prostate cancer-specific mortality in a combined meta-analysis of five RCTs. Any benefits from prostate cancer screening may take > 10 years to accrue; therefore, men who have a life expectancy of < 10-15 years should be informed that screening for prostate cancer is not beneficial and has harms.”

A 2013 follow-up to the 2011 review confirmed the above findings:

“Pooled data currently demonstrates no significant reduction in prostate cancer-specific and overall mortality. Harms associated with PSA-based screening and subsequent diagnostic evaluations are frequent, and moderate in severity. Overdiagnosis and overtreatment are common and are associated with treatment-related harms. Men should be informed of this and the demonstrated adverse effects when they are deciding whether or not to undertake screening for prostate cancer. “

A 2018 study drew the same conclusions:

The Cancer Research UK CAP trial looked at whether a single PSA blood test would reduce the number of men dying of prostate cancer. This was a large UK study with over 400,000 men between the ages of 50 and 69 taking part. Around half the men had a PSA blood test the other half didn’t.

The results in early 2018 showed that the number of men dying from prostate cancer was the same in both groups. This was after 10 years of follow up. The researchers say that this trial doesn’t support PSA testing as a screening test for prostate cancer.”

Two anecdotal tales

  1. My father was diagnosed with PC several years before he died. However, he didn’t die of it – he died with it. His cause of death was pneumonia and COPD.
  2. Frank Zappa, the genius musician and one of my personal heroes, died of PC. He used to have regular PSA screening. His PC was not picked up!

So what’s to do?

As with all things, prevention is better than cure – and the WFPB diet combined with regular daily exercise have been shown to significantly reduce the risk of PC and of treating/reversing it once it has developed. Dr Greger presents plenty of convincing evidence that the fate of a man’s prostate is in his own hands – so to speak…

Mainstream media is catching up, too

It was refreshing to read a recent Times article that said pretty much everything outline above. And it was nice to see a range of plant food suggestions to fight PC. I mention them below, not so that people will concentrate on eating only these plant foods, but so that it might illustrate the variety of plant foods involved. I advocate the wholistic approach to nutrition – forget worrying getting specific micronutrients from a specific plant; rather, concentrate on eating as wide a range as possible of every whole plants as you can lay your hands on – I mention, in particular, Dr Joel Fuhrman’s G-BOMBS (greens, beans, onions, mushrooms, berries and seeds).

The Times they are a-changing

What to eat to beat prostate cancer (based on linked research):

There are literally thousands of research papers showing that plant foods can prevent, treat and reverse a vast array of chronic diseases.

But how often has your doctor written out a prescription for these humble life-savers?


References

BJU Int. 2011 Mar;107(6):882-91. doi: 10.1111/j.1464-410X.2010.10032.x. Screening for prostate cancer: an updated Cochrane systematic review. Ilic D, O’Connor D, Green S, Wilt TJ.

BMJ Open. 2013; 3(3): e002452. Published online 2013 Mar 1. doi: 10.1136/bmjopen-2012-002452
PMCID: PMC3612777. A cluster-randomised, parallel group, controlled intervention study of genetic prostate cancer risk assessment and use of PSA tests in general practice—the ProCaRis study: study protocol. Pia Kirkegaard, Peter Vedsted, Adrian Edwards, Morten Fenger-Grøn, and Flemming Bro.

The Cancer Research UK CAP trial. 2018. (http://www.cancerresearchuk.org/about-cancer/prostate-cancer/getting-diagnosed/screening).

Prostate Cancer blog on WFPBD.com. 2018. (https://www.wholefoodplantbaseddiet.com/health-conditions/prostate-cancer/)

Prostate Cancer blog on nutritionfacts.org. (https://nutritionfacts.org/topics/prostate-cancer/)

The Sunday Times March 10th 2018. What to eat to beat prostate cancer. (https://www.thetimes.co.uk/article/what-to-eat-to-beat-prostate-cancer-zd79jz78p).

Fighting prostate cancer with a tomato-rich diet. University of Bristol press release issued: 27 August 2014. (http://www.bristol.ac.uk/news/2014/august/tomatoes-prostate-cancer.html)

Study: green tea prevents prostate cancer. UPI April 20, 2005. (https://www.upi.com/Study-green-tea-prevents-prostate-cancer/29111114038937/)

The Secret Power of Broccoli. Oregon State University. Summer 2016. (http://oregonprogress.oregonstate.edu/summer-2016/secret-power-broccoli)

A Meta-Analysis of Dietary Carotenoids and Prostate Cancer Incidence. Thesis. April 2014. DOI: 10.13140/RG.2.1.5074.7761. Thesis for: B.Sc. Human Health & Disease, Advisor: Dr. Katarina Bälter, Dr. Jennifer Protudjer, Dr. Arvid Sjölander (https://www.researchgate.net/publication/303347107_A_Meta-Analysis_of_Dietary_Carotenoids_and_Prostate_Cancer_Incidence)

Starving Prostate Cancer With What You Eat for Dinner. University of Texas at Austin News. June 6, 2017. (https://news.utexas.edu/2017/06/06/starving-prostate-cancer-with-what-you-eat-for-dinner).

Prostate Cancer Prostatic Dis. 2017 Sep; 20(3): 265–270. A Review of Pomegranate in Prostate Cancer. Channing J. Paller, MD, Allan Pantuck, MD, MS, FACS, and Michael A. Carducci, MD, FACP.

Reduction by Coffee Consumption of Prostate Cancer Risk: Evidence From the Moli-Sani Cohort and Cellular Models. G Pounis et al. Int J Cancer 141 (1), 72-82. 2017 Apr 24. (https://www.ncbi.nlm.nih.gov/labs/articles/28436066/)

J Med Food. 2014 Dec 1; 17(12): 1281–1286. PMCID: PMC4259176. TRAMP Prostate Tumor Growth Is Slowed by Walnut Diets Through Altered IGF-1 Levels, Energy Pathways, and Cholesterol Metabolism. Hyunsook Kim, Wallace Yokoyama, and Paul Andrew Davis.

 

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