Causes and Prevention of Prostate Cancer

Rev A

_Topic                                                                                                 Paragraph

Introduction and List of Causes by Category 1.0
Discussion 2.0
Age 2.14
Chemicals and Pesticides 2.1, 2.2, 2.3, 2.4
Diet and Nutrition 2.11
Ejaculation and Masturbation 2.22,2.23
Exercise and Physical Activity 2.29, 230, 2.31, 2.32, 2.33, 2.34, 2.35, 2.36
Fertility and Fatherhood 2.19, 2.20 ,2.21
Genetics 2.10
Hair 2.24, 2.25, 2.25A
Heredity 2.5, 2.6, 2.7, 2.8, 2.9
Height and Finger length 2.26, 2.27, 2.28
Obesity 2.12
Race 2.15
Smoking 2.13
Weather, Sunlight, and Night work 2.16, 2.17, 2.18
Two thousand year old man 2.37
Comments 3.0
References 4.0

1.0 Introduction and List of Causes by Category
The following are possible causes and methods to prevent and/or reduce the effects of prostate cancer.
There are no guaranteed ways to prevent Prostate Cancer, but here are a few suggestions guaranteed to work:
– Be born a female. This is guaranteed to prevent PC.
– Be born with the right genes. Another almost guarantee.
– Hope that there is no mishap when your fetus was developing so that the right inherited genes are not corrupted.

1.1 This segment is devoted to the many causes of and methods to prevent prostate cancer that the medical profession has enumerated over many years. Some factors can be observed by statistics, others by a theory, but in general the answer is elusive.
Some causes are very well established such as knowing that African American Men are more prone to having prostate cancer, and usually having a more aggressive case. Knowing why this occurs is a completely different matter. Other causes are pure conjecture, and based on epidemiological studies and observation, not scientific proof. I must assume that most were written to alert other physicians to be observant so the assumption may be verified. However, some causes I believe are pure foolishness, and not meant to be taken seriously. The portion about the number of children a man has, and how, and where he had an ejaculation, I believe is in this last category. Never the less, I am reporting on what is being written and thought by learned people. I must allow you to be the judge.  Enjoy.
Some factors for causing prostate cancer have been studied, and are documented herein. Again, it is for you to decide what to believe.

It has been repeatedly reported, that one of six men in this country will develop prostate cancer in his lifetime. This means 16 percent (16%), of the men will be afflicted. After I read this section on Causes of Prostate Cancer, I realized that the one in six men cannot be accurate. If the number of men who fit into one or more of the causes, had prostate cancer, the prostate rate would have to be about 130 percent of all men. Those of you who have avoided this illness, are very fortunate, considering one hundred and thirty percent of the men have this cancer!
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2.0 Discussion

2.1 Chemicals and Pesticides
U.S. panel’s report focuses on substance used in containers. WASHINGTON – A chemical used in all kinds of plastic, including baby bottles and food containers, could be linked to prostate and breast cancer, a preliminary government report has found. The federal National Toxicology Program said yesterday that experiments on rats found precancerous prostate tumors, urinary system problems and early puberty when the animals were fed or injected with low doses of the chemical, bisphenol-A. The latest draft significantly increased the chemical’s risk level from a bisphenol-A statement the government released last year. “It’s an important step to have a federal agency acknowledge that it has concerns about bisphenol-A and breast cancer and prostate cancer,” said Pete Myers, chief scientist for Environmental Health Sciences, a nonprofit that raises awareness of chemical risks. “It’s a scary compound.” From Staff and Wire Reports April 16, 2008 (R712).

2.2 Study Links Pesticide Exposure To Prostate Cancer.
A study finds that older men living in California’s Central Valley are more likely to develop prostate cancer if they were exposed to certain agricultural pesticides than those who were not exposed. The study examines exposure via drift rather than occupational exposure, although similar results have been noted in farm worker populations. Exposure to methyl bromide or various organochlorine pesticides increased the risk of cancer by about one and a half times.  The study, “Prostate cancer and ambient pesticide exposure in agriculturally intensive areas in California,” was published in the June 2011 issue of the American Journal of Epidemiology. (R422)

2.3 In 2008, University of California Davis Cancer Center research showed that Vietnam War veterans exposed to Agent Orange have greatly increased risks of prostate cancer and even greater risks of getting the most aggressive form of the disease as compared to those who were not exposed. Based on medical evaluations conducted between 1998 and 2006, the study identified twice as many men exposed to Agent Orange with prostate cancer. In addition, Agent Orange-exposed men were diagnosed two-and-a-half years younger and were nearly four times more likely to present with metastatic disease.

For more information on the diseases linked to pesticide exposure, see Beyond Pesticides’ Pesticide-Induced Diseases Database. Source: ( R422)

2.4 New Alarm Bells About Chemicals and Cancer
The President’s Cancer Panel declared chemicals threaten our bodies, and suggests other eye-opening steps as well, such as giving preference to organic food, checking radon levels in the home and microwaving food in glass containers rather than plastic. In particular, the report warns about exposures to chemicals during pregnancy, when risk of damage seems to be greatest. Noting that 300 contaminants have been detected in umbilical cord blood of newborn babies, the study warns that: “to a disturbing extent, babies are born ‘pre-polluted.’ ” The report blames weak laws, lax enforcement and fragmented authority, as well as the existing regulatory presumption that chemicals are safe unless strong evidence emerges to the contrary. “Only a few hundred of the more than 80,000 chemicals in use in the United States have been tested for safety,” the report says. It adds: “Many known or suspected carcinogens are completely unregulated.” Published: May 5, 2010. (REF 23)
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2.5 Heredity:
First degree relatives are a father or brother. If two first degree relatives have a history of PC, the risk of PC is 4.9 times greater, and if three first degree relatives have a history of PC, the risk is 10.9 times greater (H1). If a brother has PC the risk is 4.5 times greater for having PC, but if the father has PC, the risk is 2.3 times greater Similar magnitude risks were noted for African American men, with the numbers being 5.3, and 2.5 respectively. A study done at the Fox Chase Cancer Center in Philadelphia, analyzing 23 published studies and concluded if a grandfather or uncle (second degree relatives) had PC the risk is 1.8 times greater and 2.1 times greater if the father had PC ( 2003 International Journal of Cancer) A family history of PC in first degree relatives also increases the probability of the PC starting at an earlier age (55 years or younger). A family history of maternal breast cancer increases the probability of the man having PC. (Ref 713).

2.6 Kenneth Offit, MD, Chief of Clinical Genetics Services at the Memorial Sloan-Kettering Cancer Center ,(MSK), determined that men in families with a mutation of the BRAC gene have a 3 to 5 times increased risk of PC. The risk was 4.8 times greater in carriers of a certain BRAC2 mutation. The age of the onset of the PC is no different than that of the general population. This was published in 2005 by MSK

2.7 Dr. Patrick A. Kupelian from the M.D. Anderson Cancer Cencer in Orlando , Fl., and associates studied 4112 men from 1986- 2002 and determined that prostate cancer in men with a family history may not behave more aggressively than do cancers in men with no family history. (Source: Journal of Clinical Oncology, July, 20, 2006)

2.8 Men who have a BRACA-1 or -2 gene mutation have twice the risk of PC, and seven times the risk of Breast Cancer in men. (You read it correctly) Source: Health and Age : January 2, 2008. The article also added that this appears to be independent of diet and exercise, and all other factors pertaining to the cause of PC.

2.8A    BRCA2 gene
The First genetic factor in prostate cancer prognosis identified April 9, 2013 in Cancer Patients with prostate cancer and hereditary mutations in the BRCA2 gene, have a worse prognosis and lower survival rates than do the rest of the patients with the disease. This is the main conclusion to come out of a study published this week in the Journal of Clinical Oncology, in which David Olmos, Head of the Prostate Cancer and Genitourinary Tumours Clinical Research Unit at the Spanish National Cancer Research Centre (CNIO), has taken part in, along with Elena Castro, a member of the Unit, and British researchers at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust.   -4/10/2013
Read more at:

2.9 A study done at the FoxChaseCancerCenter in Philadelphia, analyzing 23 published studies and concluded if a grandfather or uncle (second degree relatives) had PC the risk is 1.8 times greater and 2.1 times greater if the father had PC. (R713 International Journal of Cancer 2003).
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2.10 –Genetics.   Should something go wrong during a pregnancy when a fetus was developing, it is possible that the good and normal  inherited genes become corrupted. This male child may very well develop prostate cancer many years later. This is not an inherited genetic factor
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2.11 Diet and Nutrition.
Please see segment called Diet and Nutrition.
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2.12 Obesity.
In the 8 or 9 articles I reviewed, obesity was shown to increase the risk of a more aggressive PC and a higher probability of metastatic PC developing, but not cause PC.
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2.13 Smoking.
None of the articles I found mentioned that smoking was a factor in developing PC. It was associated with a higher risk of aggressive PC, and death, but not causing PC
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2.14 Age.
Young men never develop prostate cancer, but about in their mid forties and usually mid fifties and older, PC starts developing. After a few years of being nurtured by the body, (gestation), the cancer grows to a point where it can be detected. It is during the first 40 or 50 years of life that whatever is causing the cancer to start, is doing its dirty work.
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2.15 Race.
For reason not known African American men have a higher incidence of prostate cancer, and usually have a more aggressive case. It is believed that the darker skin color pigmentation prevents the suns vitamin D from protecting them. However, because black men in Africa have a much lower incidence of prostate cancer, this theory is questioned. Some people conjecture that because the men in Africa die at a younger age of other causes, they do not live long enough to develop prostate cancer. Consequently, some theories believe the difference is diet associated, but this has never been proven. (Everyday Health Jan. 31, 2012 — R529)
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Weather, Sunlight, and Night work
2.16 Cold Weather
Cold Weather in Northern Climates Linked to Prostate Cancer.
Colder, cloudy climate could increase the risk of prostate cancer for men in northern regions of the globe, according to a study from Idaho State University. Dr. Sophie St-Hilaire and her colleges found that the combination of the lack of sun and cold temperatures are what explain the higher rates of prostate cancer in the northern part of the world. Low exposure to the sun can lead to vitamin D deficiency in men, which contributes to their prostate cancer risk. The study, published in the International Journal of Health Geographics, showed that cold temperatures play a role by slowing the breakdown of industrial pollutants in the in environment that could trigger cancer. In addition, the frigid air is believed to pull chemicals from the atmosphere to the earth. “We found that colder weather, and low rainfall, were strongly correlated with prostate cancer,” the Daily Express quoted St-Hilaire as saying. Fox news, April 22, 2010 (REF 29)

2.17 Exposure To Sunlight May Decrease Risk Of Prostate Cancer
In the largest such study to date, a research team from three cancer centers measured sunlight exposure in men and found that increased exposure to sunlight may decrease the risk of prostate cancer. Reporting in the June 15, 2005 issue of Cancer Research, the researchers, led by Esther John, Ph.D., of the NorthernCaliforniaCancerCenter, and including others, found that men with high sun exposure had half the risk of prostate cancer than did men with low sun exposure. They said in men with certain gene variants, risk was reduced even further, to as much as 65 percent. “We believe that sunlight helps to reduce the risk of prostate cancer because the body manufactures the active form of vitamin D from exposure to sunlight,” John said. (R52)

2.18 Graveyard Shift Work Linked to Cancer.
LONDON (AP) —Working the graveyard shift will soon be listed as a “probable” cause of cancer. Next month, the International Agency for Research on Cancer, the cancer arm of the World Health Organization, will add overnight shift work as a probable carcinogen. The higher cancer rates don’t prove working overnight can cause cancer. There may be other factors common among graveyard shift workers that raise their risk for cancer. However, scientists suspect that overnight work is dangerous because it disrupts the circadian rhythm, the body’s biological clock. The hormone melatonin, which can suppress tumor development, is normally produced at night. (R72)
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2.19 Fertility and Fatherhood
Infertile men 2.6 times as likely to have aggressive prostate cancer.
Men who have difficulty conceiving children are 2.6 times as likely to have highly aggressive prostate cancer and 60% more likely to have slow-growing tumors, researchers reported Monday. Although the absolute risk of developing prostate cancer was still low in these men, the findings suggest that such men should be screened for prostate cancer at an earlier age, said Dr. Otis Brawley, chief medical officer of the American Cancer Society. (R24 March 22, 2010)

2.20 Dads at Risk for Prostate Cancer.
Childless men may be at a lower risk of developing prostate cancer than men who have children. According to a study done be a team of Danish researchers, men without children are 16 percent less likely to be diagnosed with prostate cancer than men who have children. Oddly enough, a fathers risk decreases when the number of children he has increases. Authors suggest this may be caused by what they call a “healthy father” phenomenon, which says men who retain fertility are less likely to develop cancer. Researchers collected data for the study by looking at record for all men born in Denmark between 1935 and 1988, among which they noted 3,400 cases of prostate cancer. The analysis did not reveal what kind of factors associated with childlessness accounted for the decreased risk for prostate cancer. Study authors note that additional studies are needed to further investigate underlying factors that contribute to their findings. SOURCE: CANCER, Published online Jan. 7, 2008 (R54)

2.21 Fatherhood and incident prostate cancer in a prospective US Cohort Abstract. Fatherhood status has been hypothesized to affect prostate cancer risk but the current evidence is limited and contradictory. We prospectively evaluated the relationship between offspring number and the risk of prostate cancer in 161,823 men enrolled in the National Institues of Health – American Association of Retired Persons Diet and Health Study. When examining the entire cohort, there was no relationship between fatherhood and incident prostate cancer. The number of children fathered was not related to prostate cancer. University of California and National Cancer Institute personnel were involved. Reference: Int J Epidemiol. 2010 Oct 19. PubMed Abstract PMID: 20959354 (R295)
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2.22 Ejaculation and Masturbation
Masturbation May Prevent Prostate Cancer.
Frequent masturbation may help men cut their risk of contracting prostate cancer, Australian researchers have found. It is believed that carcinogens may build up in the prostate if men do not ejaculate regularly, the BBC News reported. The researchers surveyed more than 1,000 men who had developed prostate cancer, and 1,250 men who had not. They found that men who had ejaculated the most between the ages of 20 and 50 were the least likely to get cancer. Men who ejaculated more than five times each week were a third less likely to develop prostate cancer. Sexual intercourse may not have the same effect because of the higher risk of contracting a sexually transmitted disease, which could in turn raise the risk of cancer. (Stan’s Comment: I don’t make this up, I’m just reporting it). Health News April 18, 2008 (R118)

2.23 Frequent ejaculation may protect against cancer. (R65)
Frequent sexual intercourse and masturbation protects men against a common form of cancer, suggests the largest study of the issue to date yet.The US study, which followed nearly 30,000 men over eight years, showed that those that ejaculated most frequently
were significantly less likely to get prostate cancer. The results back the findings of a smaller Australian study revealed by New Scientist in July 2003 that asserted that masturbation was good for men. Washington D.C – États-Unis] – 04-05-2008 Journal of the American Medical. In the US study, the group with the highest lifetime average of ejaculation – 21 times per month – were a third less likely to develop the cancer than the reference group, who ejaculated four to seven times a month. Michael Leitzmann, at the National Cancer Institute in Bethesda, Maryland, and colleagues set out to test a long-held theory that suggested the opposite – that a higher ejaculation rate raises the risk of prostate cancer. “The good news is it is not related to an increased risk,” he told New Scientist. In fact, it “may be associated with a lower risk.””It goes a long way to confirm the findings from our recent case-control study,” says Graham Giles, who led the Australian study. He praises the study’s large size – including about 1500 cases of prostate cancer. Furthermore, it was the first to begin by following thousands of healthy men. This rules out some of the biases which might be introduced by asking men diagnosed with prostate cancer to recall their sexual behaviour retrospectively.

Every Second Day.
At the start of the study, the men filled in a history of their ejaculation frequency and then filled in further questionnaires every two years. Men of different ages varied in how often they ejaculated, so the team used a lifetime average for comparisons. Compared to the reference group who ejaculated four to seven times a month, “each increase of three ejaculations per week was associated with a 15 per cent decrease in the risk of prostate cancer”, says Leitzmann.”More than 12 ejaculations per month would start conferring the benefit – on average every second day or so,” he says.However, whilst the findings are statistically significant, Leitzmann remains cautious. “I don’t believe at this point our research would warrant suggesting men should alter their sexual behaviour in order to modify their risk.”A further caveat is that the benefit of ejaculation was less clear in relation to the most dangerous, metastasising form of prostate cancer, compared to the organ-confined or slow-growing types. 

Clear Out.
Leitzmann and Giles both agree that there are biologically plausible ways that ejaculating frequently might prevent prostate cancer.”Increased ejaculation may allow the prostate gland to clear itself of carcinogens or of materials that form a substrate for the development of carcinogens,” Giles told New Scientist. Another theory is that frequent drainage of prostate fluid stops tiny crystalloid microcalcifications – which have been associated with prostate cancer – from forming in the prostate duct, says Leitzmann.Giles notes that neither study examines ejaculation during the teenage years – which may be a crucial factor. But he says: “Although much more research remains to be done, the take home message is that ejaculation is not harmful, and very probably protective of prostatic health – and it feels good!” Journal reference: Journal of the American Medical Association (vol 291, p 1578) R65
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2.24- Hair Loss Reduces Prostate Cancer Risk.
A recent study suggests hair loss almost halves the risk of prostate cancer. Men who start going bald at a young age are up to 45 percent less likely to fall victim to prostate cancer later in life, scientists have found, reports Although half of all men suffer significant hair loss by the age of 50, an American team has linked the high levels of testosterone in those who go bald earlier to a lower risk of tumours. Men who had started to develop bald spots on the top of their heads as well as receding hairlines had the least risk of cancer. The findings published in the journal Cancer Epidemiology would be controversial as previous smaller studies have suggested hair loss increases the risk of cancer.
Most baldness is caused when hair follicles, become exposed to too much dihydrotestosterone, or DHT. This is a chemical produced by the male hormone testosterone. If there is too much DHT circulating in the blood, the follicles shrink, so the hair becomes thinner and grows for less time than normal.  
Experts believe men with high levels of testosterone are more likely to lose their hair, especially if baldness already runs in the family. The findings were surprising, said professor Jonathan Wright, an expert in prostate cancer at the University of Washington School of Medicine in Seattle.(R75)

2.25-Prostate Cancer Risk Linked To Early-Onset Baldness
French researchers said it, and now a team from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania in Philadelphia have released new evidence to support their claim: Men who lose their hair early in life have a greater risk of developing prostate cancer.
In a study of 537 African-American men — 318 with prostate cancer and 219 controls — investigators discovered that baldness of any kind was associated with a 69 percent increased risk of prostate cancer, particularly among African-American men. According to the study, which was published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, black men with frontal baldness, and not vertex baldness, were more than twice as likely to have been diagnosed with advanced prostate cancer. The association was even stronger among those who were diagnosed when younger than 60, with a sixfold increase in high-stage prostate cancer and a fourfold increase in high-grade prostate cancer. R740.

2.25A  Hair Baldness Pattern and Prostate Cancer
The Prostate, Lung, Colorectal, and Ovarian Study (PLCO) reported in the September 15, 2014 Journal of Clinical Oncology that men with a specific pattern of baldness at age 45 have a 40% increased risk of developing aggressive prostate cancer later in life, compared to men with no baldness at 45.  The study interviewed 39,000 men. 

Both baldness and prostate cancer have a strong male inheritance factor, so to determine if baldness is really a cause or just a coincidental indicator, another factor is required. If the data was separated into two groups as follows:
A-Have a family history of prostate cancer and
B-Do not have a family history of prostate cancer.
Also were the men asked if their mother had the BRAC 1 or 2 Gene, as this is also a prostate cancer inheritance factor.
If a larger percentage of men in group B develop prostate, then it would be more likely that the baldness is a factor and / or a predictor of developing prostate cancer.
The replies were that the study did not ask about the mothers BRAC Gene, and they did NOT separate the men into group A or B.
The Study director, Michael Cook, MD said , “——-Therefore, men with any degree of baldness at any age should not in any way be additionally concerned about their individual risk of prostate cancer when reading the results of our study”.

Stan’s Comment: It appears that a high Testosterone level is a factor in men losing their hair, and also developing prostate cancer, so the hair loss is not a factor in men developing prostate cancer, but rather may explain why men lose their hair. It is possible that the hair loss pattern does not matter.  Dr Cook said they are still analyzing the PLCO Data.       
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Height and Finger length
2.26- Taller Men Are At Higher Risk for Aggressive Prostate Cancer.
Tall men are at significantly increased risk of developing aggressive prostate cancer (PCa), especially if they are younger than 65 years, according to a study published in the British Journal of Cancer (2009;101:522-525).
The prospective study, led by Jiyoung Ahn, PhD, Assistant Professor of Epidemiology at the New York University School of Medicine, analyzed data from 34,268 men. Greater height was not associated with an increased risk of PCa overall, but men who were at least six feet, three inches tall had a 39% increased risk for aggressive PCa compared with men who were no taller than five feet, seven inches.
This association held true for both high-grade and high-stage disease. Each 5-cm increment in height was associated with a 5% increased risk of aggressive PCa. Furthermore, among men younger than age 65, those who were at least six feet, three inches tall had a 76% increased risk of aggressive PCa compared with those no taller than five feet, seven inches.
Luisa Zuccolo, MSc, of the University of Bristol in the U.K., who led a previous study that found an association between increased height and high-grade prostate cancer (Cancer Epidemiol Biomarkers Prev. 2008;17:2325-2336), said the new study provides independent replication of her team’s results, but it does not shed light on the reasons for the association.“We need more studies to explore the underlying mechanisms that could explain this link,” Zuccolo commented. “We do not believe that height itself matters in determining the risk of prostate cancer, or aggressive prostate cancer in particular, but we speculate that factors that influence height may also influence cancer, and height is therefore acting as a marker for these underlying causal factors.” ( See Paragraph 2.25B below for a rationale)
Dr. Ahn’s team plans to evaluate whether gene variants associated with height are also linked to the development of aggressive PCa. (October 2009 Issue of Renal And Urology News). Also: British Journal of Cancer, August 2009) (R202A)

2.27-In a discussion about Prostate Cancer in Japanese men, a rationale why height may effect prostate cancer was given to me by Edward Giovannucci,MD, on March 24, 2013:
“In my opinion, what is clearly the most important nutrition related factor for cancer in general, including prostate cancer, is overall nutritional status or energy balance. In simple terms, energy balance is the balance of calorie intake vs expenditure. We can think of 2 main periods in life, the growth phase and adulthood. A lot of evidence (e.g. animal) suggests that restriction of calories and probably protein restricts growth, as evidenced by shorter height and delayed onset of puberty. Some degree of caloric restriction consistently lowers cancer risk, particularly of western cancers. Height is a surrogate – taller people have in general a tendency for higher cancer risk – of course, this is just a tendency not an absolute. There is not a clear public health message here as parents are unlikely to restrict calories and nutrients to their children to lower cancer risk in adulthood, but this relationship is critical in understanding the role of nutrition on cancer. If you look at populations that have had lower risk of western cancers such as prostate, breast, colorectal, these population were shorter on average than those with higher risk. Likely, during the growth period (puberty, adolescence), the taller people likely had a richer diet and more exposure to growth hormones which may have increased their cancer risk.”

2.28 Finger Length Linked to Prostate Cancer Risk.
The key to predicting a man’s risk of prostate cancer could lie in—his pointer finger? That’s what a new study published today in the British Journal of Cancer suggests. Researchers compared the hands of 1,500 prostate cancer patients and 3,000 healthy men, and found that those whose index fingers were longer than their ring fingers were 33 percent less likely to develop the disease.
The study authors said that’s probably because longer index fingers indicate less testosterone, a hormone that’s associated with the cancer. Previous studies have found that men with naturally high testosterone levels have a heightened risk of prostate cancer. The study’s lead author Professor Ros Eeles, of the Royal Marsden NHS Foundation Trust told BBC News.
The study was published in the British Journal of Cancer (2010) (R342 and R342A). 
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2.29-Exercise and Physical Activity
Prostate Cancer Risk may be lowered with Moderate
Exercise.    October 5, 2009
Dr. Jodi A. Antonelli and colleagues conducted a study at DukeUniversityMedicalCenter which suggests that men who exercise at a moderate rate may have a lower risk of prostate cancer than sedentary men. Researchers found in a group of 190 men who underwent biopsies to detect possible prostate cancer that those who had been exercising regularly had a lower chance of being diagnosed with the disease. Men who exercised moderately which would be equal to three or more hours of brisk walking every week were two-thirds less likely than their sedentary counterparts to have prostate cancer. On the other hand, those who did have the disease and included only one hour of walking per week were less likely to have an aggressive or fast-growing cancer.
Dr. Jodi A. Antonelli and colleagues said, “It is impossible to state that exercise alone was responsible for the benefits we observed because participants who exercised might also have engaged in other behaviors linked to better health, like adhering to good diet”.
Exercise tends to lower testosterone and other hormones that help feed prostate tumor growth, which may lower the risk of prostate cancer. The researchers conclude that the findings definitely suggest that exercise protects against prostate cancer but they could not prove it beyond all doubt.  (Ref R 51B)

2.30-Exercise may extend life after prostate cancer diagnosis.
A study published in the 2010 Journal of Clinical Oncology found that men who engaged in various levels of physical activity during the years after their diagnosis with prostate cancer enjoyed substantial reductions in overall mortality (that is, death from any cause). And those who engaged in modest amounts of vigorous activities such as biking, tennis, jogging or swimming for three or more hours a week substantially reduced their risk of dying specifically from prostate cancer.
In short, the study found that those who walked 90 minutes per week at a normal to very brisk pace had a 46-percent lower risk of dying of any cause compared with those who walked for shorter durations at an easy walking pace. Men who got three hours per week of vigorous activity had a 49-percent lower risk of all-cause mortality and a 61-percent lower risk of dying from prostate cancer compared with men who got less than 1 hour per week of vigorous activity. Men exercising vigorously before and after diagnosis had the lowest risk. (Ref R349)

 2.31-Brisk walking may help men with prostate cancer avoid a Recurrence 
Earlier reviews yielded contradictory results for reducing the risk of prostate cancer by physical activity.  Thirty two (32) Cohort studies and 17 case control studies between 2001 and 2010 were reviewed, and in the mean, no risk reduction was found in earlier and in studies from the last 8 years with mostly imprecisely measured activity. In seven studies with subgroups on aggressive forms, a positive dose response relationship was documented, being significant in 3 studies. The subgroup over 65 years with high amount of physical activity yielded a significant effect in 3 studies.
In conclusion, physical activity in leisure and in work fails to be protective but Substantial evidence exists for an effective prevention by intensive physical activity. Published on November 8, 2012. (Ref 659)

2.32-Brisk walking may help men with prostate cancer avoid a Recurrence
A STUDY of 1,455 U.S. men diagnosed with early-stage prostate cancer has found a link between brisk walking and lowered risk of prostate cancer progression, according to scientists at the University of California, San Francisco and the Harvard School of Public Health.
The scientists found that men who walked briskly at least three miles per hour for at least three hours per week after diagnosis were nearly 60 percent less likely to develop biochemical markers of cancer recurrence or need a second round of treatment for prostate cancer.
“The important point was the intensity of the walking activity had to be brisk for men to experience a benefit,” said Erin Richman, ScD, a postdoctoral fellow at UCSF who is the first author on the study, published in the Journal Cancer Research. “Our results provide men with prostate cancer something they can do to improve their prognosis.”
An earlier study, published by UCSF’s June Chan, ScD, and collaborators at the Harvard School of Public Health, showed that physical activity after diagnosis could reduce disease-related mortality in a distinct population of men with prostate cancer.
“Our work suggests that vigorous physical activity or brisk walking can have a benefit at the earlier stages of the disease,” said Chan, the Steven and Christine Burd-Safeway Distinguished Professor at UCSF and senior author of both studies.
A particular strength of this study is the focus on early recurrence of prostate cancer, which occurs before men may experience painful symptoms of prostate cancer metastases, a frequent cause for men to decrease their usual physical activity. Additionally, the researchers reported that the benefit of physical activity was independent of the participants’ age at diagnosis, type of treatment and clinical features of their disease at diagnosis. (R376)

2.33-Exercise Can Benefit Men With Prostate Cancer
Patients Who Exercise Even 15 Minutes a Day May Up Their Chances of Survival.
As little as 15 minutes of physical activity a day can substantially cut death rates in men with prostate cancer, new research hints stated lead investigator Dr. Stacey A. Kenfield of Harvard School of Public Health, Boston, in a statement from the American Association for Cancer Research Frontiers in Cancer Prevention Research Conference.
Regular physical activity — both vigorous and non-vigorous — was associated with a lower risk of death from any cause, the researchers found, whereas regular vigorous activity was associated with a lower, but non significant, risk of death due to prostate cancer. (R50)

2.34  The Department of Population Health Research, Alberta Health Services, Canada, found there is a weak association for a beneficial effect of physical activity on the risk of prostate cancer. (R277)

2.35 Exercise Reverses Bone Loss Caused by Androgen Deprivation for Prostate Cancer  Patients. 
Researchers from JohnsHopkinsUniversity have reported that walking can reverse the effects of androgen deprivation therapy (ADT) on bone loss among men with prostate cancer. The details of this study were reported at the 2007 annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO).  (R51)

2.36-Physical Job Activity May Cut Prostate Cancer Risk.
Working in a job that requires a continuous level of high physical effort may decrease the likelihood of a man developing prostate cancer, researchers report. “This study indicates that physical activity decreases the risk for prostate cancer,” said Dr. Anusha Krishnadasan, at the University of California, Los Angeles.
Krishnadasan and colleagues looked at the link between prostate cancer and physical activity among men working at a southern California facility that tested aerospace engines and nuclear power systems. The investigators compared the physical activity requirements of 392 workers who developed prostate cancer with 1,805 men similarly employed and of similar age.
The odds for prostate cancer among aerospace workers involved in highly physically active jobs were 45 percent lower than among less active co-workers, after adjusting for many variables the researchers report in the Journal Cancer Causes Control.
By contrast, the odds for prostate cancer did not differ significantly among nuclear power workers involved in high versus low levels of physical activity at work. The team suggests that differences in the level of continuous, as opposed to intermittent, physical activity required by aerospace and nuclear power workers may explain these findings.
Aerospace workers were primarily (64 percent) mechanics and technicians, or welders, assemblers, and machinists involved in work that required sustained and high levels of physical activity. Just 34 percent of the nuclear power workers held similar job titles, while another 31 percent performed jobs such as patrolmen, firemen, and electricians that only involved intermittently high levels of physical activity.
However, these findings should be confirmed in follow-up studies that take a more in-depth look at other factors that might influence the association, Krishnadasan and colleagues note.  2/19/2008   (R149) (NEW YORK FEB 19, 2008) (Reuters Health)
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Two thousand year old man
2.37-A Twenty Two Hundred Year Old Mummy Diagnosed With Prostate Cancer. (R529)
Researchers say an ancient Egyptian corpse could hold the answer to an age-old question — what causes prostate cancer? Scientists say they may have found a key piece of the prostate cancer puzzle — in an ancient Egyptian mummy. The mummy, an unnamed Ptolemaic man who died in his fifties circa 285-30 BC, was “diagnosed” after digital imaging scans detected dense bone lesions on his pelvis and spine, which researchers claim are indicative of metastatic prostate cancer. Besides being the second-oldest recorded case of the disease — the oldest is a 2,700-year-old skeleton of a Scythian king in Russia — this discovery is significant because it suggests that the cancer is a result of genetics, not the environment.
“Cancer is such a hot topic these days; experts are constantly trying to probe in hopes of answering the one question — when and how did the ailment really evolve?” said Salima Ikram, PhD, a professor of Egyptology at the American University of Cairo and a member of the team that spent two years studying the mummy at Portugal’s National Archaeological Museum of Lisbon. “Living conditions in ancient times were very different; there were no pollutants or modified foods, which leads us to believe that the disease is not necessarily only linked to industrial factors.” Scientists have been debating the genetics-environment question for years. They previously identified several inherited genes that seem to raise a man’s risk for prostate cancer, but it was believed that those genes were responsible for only a small percentage of cases. Other research has linked the disease to diet (specifically, red meat and dairy), exposure to pesticides and other toxins, and even what kind of birth control couples use. But this new data from ancient Egypt indicates that there may be more to our DNA than previously thought. “Findings such as these bring us one step closer to finding the cause of cancer,” Ikram said, “and, ultimately, [to] the cure to a disease that has besieged mankind for so long.” (Everyday Health Jan. 31, 2012 — R529)
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A review of some of the above articles strongly indicates that exercise is beneficial for everyone who is capable to exercise. It appears that vigorous is best, but any exercise is beneficial. Some of he above articles say it will decrease the probability of developing prostate cancer, other articles indicate that if a man already has prostate cancer, exercise will decrease the probability of having a recurrence  or dying from the cancer. Section 2.35 illustrates a different benefit from exercising, namely, reversing bone loss as a result of receiving Anti Deprivation Therapy.
Most of the articles use the word, “MAY” thereby indicating uncertainty about the conclusion of the study, and indeed, the articles state, “More study needs to be done”
Exercise is very beneficial for the heart and for people with diabetes, so by adding prostate cancer, it appears an excellent idea to exercise. The type of exercise is not important, but the intensity and moderation is a consideration.
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4.0 References

R24 March 22, 2010 R29 Fox news, April22, 2010 study, published in the International Journal of Health Geographics.
(R50)- Exercise can benefit men with Prostate Cancer By Megan Brooks from Reuters Health. 12/8/2009.
R51A- Exercise Prevents Bone Loss The details of this study were reported at the 2007 annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO).
R51B-Prostate Cancer Risk may be lowered with Moderate Exercise. Reported 10/ 5 / 2009.
R52 June 15, 2005 issue of Cancer Research.
R54 SOURCE: CANCER, Published online Jan. 7, 2008.
R65 Journal of the American Medical Association (vol 291, p 1578)
R72 International Agency for Research on Cancer, the cancer arm of the World Health Organization, London (AP).
R75-Professor Jonathan Wright, a prostate cancer specialist at the University of Washington School of Medicine in Seattle.
R118 Health News April 18, 2008.
R149 Physical Job Activity May Cut Prostate Cancer Risk. Reuters Health, Reported 2/19/2008.
R202 British Journal of Cancer, August 2009.
R202A October 2009 Issue of Renal And Urology News. & British Journal of Cancer, August 2009.
R277-Exercise and Prostate Cancer. Reference: Eur J Cancer. 2010 Sep;46(14):2593-604.
doi: 10.1016/j.ejca.2010.07.028 PubMed Abstract PMID: 20843488R295 Reference: Int J Epidemiol. 2010 Oct 19. PubMed Abstract PMID: 20959354 R342 British Journal of Cancer 2010.
R342A British Journal of Cancer 2010 R713 Includes the following references: – Family History & the risk of prostate cancer. Prostate 17:337-47,1990 – Cancer Epidemiol Biomarkers prev 8:53-60,1999 – British Journal Cancer86:718-22,2002 – British Medical Journal 305:855-7,1993 – J med Genet31:618-21,1994 – Epidemiology 9:925-9,1998.
R349-Exercise may extend life after prostate cancer diagnosis, Reported by Jennifer LaRue Huget, 01/ 6/2011.
R376- Brisk walking may help men with prostate cancer, Reported in the Pakistan Observer, May, 28, 2011.
R659 – Epidemiological evidence for preventing prostate cancer by Physical ActivityReference: Wien Med Wochenschr. 2012 Oct 12. Epub ahead of print, doi: 10.1007/s10354-012-0121-0
R740  Huff Post Blackvoices 3/27/2013
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