Prostate Cancer Symptoms & Nutritional Supplements

Function of the Prostate
Symptoms of Prostate Cancer
Who is at risk?
Nutrients for Prostate Cancer
Calcium D-glucarate
Selenium
Broccoli Sprouts
Green tea
Maitake Mushroom
Lycopene

Years of research have discovered that the foods a man chooses to eat (or doesn’t eat) can have a profound impact on the health of his prostate gland.1-3 Because of this close nutritional link, prostate cancer may be the most preventable type of cancer (after smokingrelated lung cancers).4,5

In this article, we will discuss prostate cancer and how men can actually prevent it with the use of these six nutrients. Plus, if men already have prostate cancer, these nutrients can be an important part of their treatment regimen in fighting their disease.

What does the prostate gland do?

The prostate is a gland in a man's reproductive system. It makes and stores seminal fluid, the milky fluid that nourishes sperm. This fluid is released to form part of the semen. The prostate is about the size of a walnut and it is located below the bladder and in front of the rectum. The prostate actually wraps around the upper part of the urethra, the tube that empties urine from the bladder.6

What are the symptoms of prostate cancer?

Early prostate cancer often does not cause any symptoms. However, many symptoms of prostate cancer are also symptoms of other problems with the prostate, such as an infection or benign prostatic hyperplasia, a prostate enlargement associated with age related changes.7,8

A man who has any of these symptoms should see his health care practitioner for evaluation:

A need to urinate frequently, especially at night
Difficulty starting urination or holding back urine
Inability to urinate
Weak or interrupted flow of urine
Painful or burning urination
Difficulty in having an erection
Painful ejaculation
Blood in urine or semen
Frequent pain or stiffness in the lower back, hips, or upper thighs.7,8

Are certain men more prone to get prostate cancer?

Age is the biggest risk factor: most prostate cancers occur in men over 65 years of age. A man's risk for developing prostate cancer is higher if his father or brother has had the disease. African- Americans are at higher risk for the disease. Mechanics, farmers, sheet metal workers, and workers exposed to cadmium have also have high rates of prostate cancer.4,5

How is prostate cancer diagnosed?

A man who has any of these risk factors may want to ask his health care professional whether to begin screening for prostate cancer (even though he does not have any symptoms), what tests to have, and how often to have them.4,5

The usual prostate tests include: Digital rectal exam: the doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall to check for hard or lumpy areas.

Blood test for prostate-specific antigen (PSA): a lab measures the levels of PSA in a blood sample. The level of PSA may rise in men who have prostate cancer, benign prostatic hyperplasia ( a noncancerous enlargement of the prostate gland), or an infection in the prostate.

These tests will only determine if there is a problem with a man’s prostate gland. They cannot determine if the problem is cancer. Only a biopsy of a sample of prostate tissue can reveal the presence of actual prostate cancer.4,5

What nutrients help prevent or treat prostate cancer?

The prostate health nutrients, calcium D-glucarate, selenium, broccoli, green tea, maitake, and lycopene, each work in unique ways. Some help men’s bodies work more effectively, some keep cancer cells from growing, while others actually kill prostate cancer cells. Let’s discuss each nutrient and how it works.

Calcium D-Glucarate

It is a troubling fact of modern life that we are continuously exposed to cancer-causing chemicals and toxins. These toxins come in part from contaminants in the food we eat and pollutants in the air we breathe. There are also “natural” toxins that are produced in our bodies. Excess hormones, such as estrogen and testosterone, can cause cancer when they are no longer needed. Cancer causing chemicals not only initiate cancer, but exposure to them can also cause existing cancers to grow bigger, stronger, and more deadly.9

Our bodies do a fairly good job of eliminating some of these toxins before they can cause us harm. In the liver, the toxin is bound or attached to a chemical called glucuronic acid. The bound toxin is then excreted in bile and eventually eliminated as a waste product in the stool.10-13 However, yet another chemical, an enzyme called glucuronidase, can break this bond between the toxin and glucuronic acid. When this happens, the hormone or toxin is released back into our bodies, capable of causing us harm once more. The longer the toxins and excess hormones are in our bodies, the greater the chances they can make us seriously sick. Scientists have discovered that increased glucuronidase activity in the body is strongly associated with prostate cancer.14

Fortunately, scientists have also discovered that a natural substance found in foods, calcium D-glucarate, can greatly reduce the activity of glucuronidase.

Calcium D-glucarate helps our bodies keep the harmful toxins and chemicals bound to glucuronic acid. While CDG is found in fruits and vegetables, the amounts may not be sufficient to maintain effective levels to stop betaglucuronidase. CDG has been shown in many experimental studies to significantly stop prostate cancer growth.10-13 Studies have shown that by taking calcium D-glucarate, our bodies can get rid of the toxic chemicals and excess hormones that might stimulate cancer formation.10-14

Selenium

Selenium is an essential trace mineral found in the soil. Both plant foods like oatmeal, and meats that we eat, such as chicken and beef, contain selenium. How much selenium, however, is difficult to determine. This is because the amount of selenium in soil, which varies by region, determines the amount of selenium in the plant foods that are grown in that soil. Animals, too, will have varying levels of selenium in their muscle, depending on the amount of selenium in their feed. The actual selenium level in the grasses and grains that make up animal feed reflect the amount of the selenium in the soil where they grew.15

A major antioxidant, selenium slows down aging, keeps our skin supple, and helps prevent dandruff. Selenium also keeps our blood vessels healthy and protects us from heart disease. However, some of selenium’s most powerful effects are on the prostate gland.17,18

In a recent study, researchers recruited 974 men to take part in a large clinical trial to determine if selenium could prevent cancer. Half of the men were given selenium supplements and half were given a placebo. Researchers, who did know which group got the selenium and which group got the placebo, watched and recorded the men’s progress. The researchers were amazed to learn that selenium cut the rate of prostate cancer by 63%!18

The results of this study were so impressive that it has led to many other studies of selenium and prostate cancer. In fact, researchers at the Arizona Cancer Center and the Arizona College of Public Health in Tucson are currently studying the effect of selenium on prostate cancer in four ongoing clinical trials.19

Broccoli Sprouts

Scientists have observed over for a long period of time, that men who eat lots of broccoli have a lower risk of getting prostate cancer. It seems that sulforaphane, a compound abundant in broccoli, is the secret ingredient responsible for this connection.20,21 Sulforaphane increases certain enzymes in the body, called phase 2 enzymes, that deactivate cancercausing chemicals.22 In lab experiments, prostate cancer cells that were exposed to sulforaphane, the compound inhibited the growth of the cancer cells up to 80 percent.23

Green Tea

There is a potent plant substance in green tea that is a very effective killer of prostate cancer cells. A recent study tested four common components of green tea and determined that one of these compounds, epigallocatechin gallate or EGCG, has a special affinity for prostate cancer cells. Scientists discovered that EGCG can stop the growth of prostate cancer dead in its tracks. The chemical structure of EGCG is very similar to substances in red wine and cruciferous vegetables, known cancer killers.24-26

Maitake mushroom

For many years, maitake mushrooms have been linked to good health in those who eat them. Called “dancing mushrooms” (possibly due to their wavy, rippling appearance or possibly due to the little dance of joy mushroom hunters perform when they find them in the woods), maitakes contain an important compound called D-fraction.27,28

A recent study at New York Medical College showed that maitake D-fraction destroyed 95% of human prostate cancer cells in lab experiments.29

Lycopene

Some of the most exciting nutritional news in relation to prostate health involves lycopene. This carotenoid is found primarily in tomatoes, and men who eat lots of cooked tomatoes have very low rates of prostate cancer.30,31 Because promising preliminary reports demonstrate that lycopene can actually kill prostate cancer cells, there has been an explosion of lycopene and prostate cancer studies.32-34

In one of these studies, 32 prostate cancer patients ate a pasta meal covered with three-fourths cup of tomato sauce every day for three weeks. Results showed their PSA levels dropped two points. Even signs of DNA damage dropped sharply. The ability of lycopene to drop these levels in just three weeks has impressed researchers and scientists worldwide.34

Do I have to take each nutrient separately?

While you can purchase each one of these nutrients and take them separately, all of these nutrients are available in prostate health formulas. Make sure the formula you buy contains calcium d-glucarate, lycopene, selenium, broccoli standardized to contain a minimum of 125 mcg sulforaphane, green tea, and maitake mushroom extract. Standardized ingredients provide consistently effective nutrients.

What else can men do to prevent prostate cancer?

Adopting a healthy diet, including eating 5 to 9 servings of fruits and vegetables every day, eating several servings of whole grain cereals and bread, and reducing red meat consumption to 2 or 3 servings per week has been shown to reduce the risk of all kinds of cancer. In addition, the recent lycopene studies suggest that a diet that regularly includes tomato-based foods may help protect men from prostate cancer.34

Men 50 years and older should have a digital rectal exam (DRE) and PSA test each year. African- Americans and those at higher risk should begin at age 40.4,5 Talk with your health care professional to determine how frequently the test should be done.

Conclusion

This year doctors expect to find 180,000 new cases of prostate cancer is the United States and 37,000 men will die of it. Prostate cancer is the second leading cause of cancer death in men.5 But there is hope.

More cancers are caught early and new treatments might help make it possible for men to live long and healthy lives following their diagnosis. By taking a few simple steps, men diagnosed with prostate cancer can take charge of their lives and overcome much of the fear and anxiety that accompany a cancer diagnosis.

References

1. Jankevicius F, Miller SM, Ackermann R. Nutrition and risk of prostate cancer. Urol Int. 2002;68:69-80.

2. Fleshner NE, Kucek O. Antioxidant dietary supplements: Rationale and current status as chemopreventive agents for prostate cancer. Urology. 2001;57:90-94.

3. Fair WR, Fleshner NE, Heston W. Cancer of the prostate: a nutritional disease? Urology. 1997;50:840-848.

4. National Institutes of Health Cancer Institute. Accessed on April 9, 2002. Available at: http://www.cancer.gov /cancer_information/.

5. American Cancer Society. Prostate cancer information. Available at: http://www3.cancer.org/ cancerinfo/load_cont.asp?ct=36&language=English Accessed: July 17, 2000.

6. Guyton AC, Hall JE. Reproductive and hormonal functions of the male (and the pineal gland). In: Textbook of Medical Physiology. 9th ed. Philadelphia, Pa: WB Saunders Company; 1996: 1003-1016.

7. Stewart SM. Alterations in structure and functions of the male genitourinary system. In: Porth CM. Ed. Pathophysiology: Concepts of Altered Health States. 5th ed. Philadelphia, Pa: Lippencott-Raven Publishers; 1998: 1175-1215.

8. Held-Warmkessel J. Prostate cancer. In: Groenwald SL, Hansen FM, Goodman M, Yarbo CH, eds. Cancer Nursing: Principles and Practice. 4th ed. Sudbury, Mass: Jones and Bartlett Publishers; 1997: 1334-1354.

9. Groenwald SL, Hansen Frogge M, Goodman M, Henke Yarbo C. Controversies in carcinogenesis. In: Cancer Nursing: Principles and Practice. 4th ed. Sudbury, Ma: Jones and Bartlett; 1997: 46-47.

10. Walaszek Z, Szemraj J, Narog M, et al. Metabolism, uptake, and excretion of a Dglucaric acid salt and its potential use in cancer prevention. Cancer Detect Prev.1997;21:178-190.

11. Walaszek Z. Potential use of D-glucaric acid derivatives in cancer prevention. Cancer Lett 1990;54:1–8.

12. Walaszek Z, Hanausek-Walaszek M, Webb TE. Dietary glucarate-mediated reduction of sensitivity of murine strains to chemical carcinogenesis. Cancer Lett 1986;33(1):25–32.

13. Walaszek Z, Hanausek-Walaszek M, Webb TE. Repression by sustained-release beta-glucuronidase inhibitors of chemical carcinogen-mediated induction of a marker oncofetal protein in rodents. Journal of Toxicol Environmental Health 1988;23:15–27.

14. Dwivedi C, Heck WJ, Downie AA, et al. Effect of calcium glucarate on beta-glucuronidase activity and glucarate content of certain vegetables and fruits. Biochemistry Medicine Metabolism Biology 1990;43:83–92.

15. Fleming T. ed. Selenium. In: PDR® for Nutritional Supplements. Montvale, NJ: Medical Economics Company; 2001: 416-422.

16. Brooks JD, Metter EJ, Chan DW, et al. Plasma selenium level before diagnosis and the risk of prostate cancer development. Journal of Urol. 2001;166:2034-20348.

17. Brawley OW, Barnes S, Parnes H. The future of prostate cancer prevention. Ann N Y Acad Sci. 2001;952:145-152.

18. Clark LC, Dalkin B, Krongrad A, et al. Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trial. British Journal of Urol.1998;81:730-734.

19. Clark LC, Marshall JR. Randomized, controlled chemoprevention trials in populations at very high risk for prostate cancer: Elevated prostate-specific antigen and high-grade prostatic intraepithelial neoplasia. Urology. 2001;57:185-187.

20. Verhoeven DT, Goldbohm RA, van Poppel G, Verhagen H, van den Brandt PA. Epidemiological studies on brassica vegetables and cancer risk. Cancer Epidemiol Biomarkers Prevention. 1996;5:733-748.

21. Kolonel LN, Hankin JH, Whittemore AS, et al. Vegetables, fruits, legumes and prostate cancer: a multiethnic case-control study. Cancer Epidemiol Biomarkers Prevention. 2000;9:795-804.

22. Fahey JW, Zhang Y, Talalay P. Broccoli sprouts: an exceptionally rich source of inducers of enzymes that protect against chemical carcinogens. Proc Natl Acad Science U S A. 1997;94:10367-72.

23. Brooks JD, Paton VG, Vidanes G. Potent induction of phase 2 enzymes in human prostate cells by sulforaphane. Cancer Epidemiol Biomarkers Prevention. 2001;10:949- 954.

24. Hiipakka RA, Zhang HZ, Dai W, Dai Q, Liao S. Structure-activity relationships for inhibition of human 5alpha-reductases by polyphenols. Biochemistry Pharmacology. 2002;63:1165-1176.

25. Gupta S, Hastak K, Ahmad N, Lewin JS, Mukhtar H. Inhibition of prostate carcinogenesis in TRAMP mice by oral infusion of green tea polyphenols. Proc Natl Acad Science U S A. 2001;98:10350-10355.

26. Chung LY, Cheung TC, Kong SK, et al. Induction of apoptosis by green tea catechins in human prostate cancer DU145 cells. Life Sci. 2001;68:1207-1214.

27. Matsui K, Kodama N, Nanba H. Effects of maitake (Grifola frondosa) D-Fraction on the carcinoma angiogenesis. Cancer Lett. 2001;172:193-198.

28. Kodama N, Yamada M, Nanba H. Addition of Maitake D-fraction reduces the effective dosage of vancomycin for the treatment of Listeria-infected mice. Japan Journal of Pharmacology. 2001;87:327-332.

29. Fullerton SA, Samadi AA, Tortorelis DG, et al. Induction of apoptosis in human prostatic cancer cells with beta-glucan (Maitake mushroom polysaccharide). Molecular Urol. 2000;4:7-13.

30. Giovannucci E, Rimm EB, Liu Y, Stampfer MJ, Willett WC. A prospective study of tomato products, lycopene, and prostate cancer risk. Journal of Natl Cancer Inst. 2002;94:391-398.

31. Lu QY, Hung JC, Heber D, et al. Inverse associations between plasma lycopene and other carotenoids and prostate cancer. Cancer Epidemiol Biomarkers Prevention. 2001;10:749-756.

32. Chen L, Stacewicz-Sapuntzakis M, Duncan C, Sharifi R, Ghosh L, van Breemen R, Ashton D, Bowen PE. Oxidative DNA damage in prostate cancer patients consuming tomato sauce-based entrees as a whole-food intervention. Journal of Natl Cancer Inst. 2001;93:1872-1879.

33. Kucuk O, Sarkar FH, Sakr W, et al. Phase II randomized clinical trial of lycopene supplementation before radical prostatectomy. Cancer Epidemiol Biomarkers Prevention. 2001;10:861-868.

34. van Breemen RB, Xu X, Viana MA, et al. Liquid Chromatography-Mass Spectrometry of cis- and all-trans-Lycopene in Human Serum and Prostate Tissue after Dietary Supplementation with Tomato Sauce. Journal of Agricultural Food Chemistry. 2002;50:2214-2219.

Flaxseed & Prostate Cancer

By Dr. Robert Rowen, MD

I have long promoted the concept that the whole is better than the sum of its parts, especially where nutrition is concerned. In the July 2001 issue of Urology, a Duke University team reports that men who were on a low-fat, flaxseed-supplemented diet for an average of 34 days experienced decreased levels of testosterone, lower tumor-cell proliferation rates, and higher levels of cancer-cell death. The researchers attributed this to the presence of a fiber called lignan in the flaxseed. They concluded that lignan’s binding effect on the hormone testosterone contributes to this effect.

Earlier studies have suggested lower levels of testosterone to be helpful in preventing cancer, and this may support that hypothesis. Men in the study group had lower levels of cancer proliferation and higher numbers of cancer-cell death than those not on the low-fat, flaxseed-supplemented diet.

There may be another angle to this story, however. Flaxseed is a rich source of omega-3 fatty acids, which has wonderful effects on prostate and breast cancers. have seen tissue sample reports from patients with such cancers and they have much less omega-3 fatty acids than normal tissue. Flaxseed is a whole food and its benefits may come from both the fiber and the omega-3 fatty acids (and perhaps other factors).

This story also reconfirms the earlier work of a medical pioneer, Joanna Budwig, who used cold processed flax oil in yogurt with her cancer regimens, reporting wonderful results from the omega-3 fatty aspects of flax.

Action to take: I encourage flaxseed and omega-3 oils as part of a daily routine, considering them to be more of a necessary food" for health than a "supplement." The best way to get essential fatty acids is intact in your food where it’s in its natural state. I’ll have more on EFAs in a future issue, but for now, eat plenty of raw nuts and seeds, as well as cold-water fish cooked). If you take the oil as a supplement, buy it in glass or metal containers only and take one to two tablespoons per day and keep it refrigerated. Never eat hydrogenated oil or products containing them.

Ref: Urology, July 2001.

Page Updated: January 2013

Introduction to the Prostate Gland

Enlarged Prostate Symptoms

Prostate Cancer Symptoms Exam

Prostate Cancer Testing - PSA testing

Green Tea Polyphenols Thwart Prostate Cancer Development at Multiple Levels

By the American Association for Cancer Research

The polyphenols present in green tea help prevent the spread of prostate cancer by targeting molecular pathways that shut down the proliferation and spread of tumor cells, as well as inhibiting the growth of tumor nurturing blood vessels, according to research published in the December 1 issue of Cancer Research. More about polyphenols

Grape seed extract inhibits advanced human prostate tumor growth.

Findings suggest that Grape seed extract possesses in vivo anticancer efficacy against hormone-refractory human PCA, which is associated with its antiproliferative, proapoptotic and antiangiogenic activities. More about polyphenols

Beneficial Herbs for Prostate Cancer

Damina - Balances hormone and glandular function

Milk thistle - May slow growth of cancers that do not respond to hormone treatment

Polysaccharide kureha (PSK) - Reduces rate at which prostate cancers spreads to lungs

Red wine catechins - stops cellular processes causing tumor development

Saw palmetto, pygeum, zinc picolinate - controls inflammation caused by prostate cancer but does not affect the cancer

Soy isoflavone - Slows tumor growth, reduces risk of spreading to lungs

Turmeric - Activates p53, a cancer control gene important in 50% of cases, slows spread of prostate cancer to bone.

Source - Phyllis Balch, CNC

Prostate Cancer Symptoms Symptom Resources

MedLine
Prostate cancer symptoms

University of Maryland
Signs and symptoms of prostate cancer

NOAH
Symptoms / Diagnosis Directory

Bupa Health Information Prostate cancer treatment, symptoms and causes

MEDLINEplus : Prostate cancer Symptoms / Diagnosis Directory

National Library of Medicine MEDLINE General prostate cancer information

NOAH: Prostate cancer
NY Online Access to Health

Open Directory Project Prostate Cancer Genitourinary (Other versions: Google AOL)

Health on the Net Foundation, Geneva, Switzerland Prostatic neoplasms

ClinicalTrials.gov : Prostatic neoplasms

Univ Nottingham, United Kingdom, OMNI Prostatic neoplasms

Yahoo Prostate cancer

US Government Healthfinder Prostate cancer

Prostate Cancer Institute Self evaluation

Northwesten Memorial Hospital Prostate cancer symptoms diagnosis, staging

Association For International cancer Research Prostate FAQ's

UAB Health System Prostate Signs and symptoms

Pictures of Prostate Cancer

MEDLINEplus Health Encyclopedia : Prostate cancer
A.D.A.M. / National Library of Medicine

Male genital pathology index
Edward C. Klatt, WebPath, Univ Utah

Understanding treatment choices for prostate cancer
Federal citizen information center

Prostate cancer is much more fatal if a man's PSA level rises rapidly before the cancer is even diagnosed

"The study is pretty definitive," says researcher Dr. Anthony D'Amico, a radiation oncologist at Brigham and professor of radiation oncology at Harvard Medical School. "It's not the level of PSA that matters, it's the change from year to year."

Some Men with Low PSAs Have Prostate Cancer

Most Cancers Found Are Not Likely to Be Clinically Significant

Men with low PSA (prostate specific antigen) levels on screening tests can still have prostate cancer, according to a study* released today by scientists from the National Cancer Institute (NCI), part of the National Institutes of Health, and the Southwest Oncology Group, an NCI-funded network of researchers. In this study, prostate cancers were detected by biopsy in men with normal PSA levels.

"The good news is that the vast majority of these cancers were low and intermediate grade, which often are not clinically significant," said Leslie Ford, M.D., associate director for clinical research in NCI's Division of Cancer Prevention, who participated in the research.

"This was the first systematic study of men with PSA levels from 0 to 4 nanograms per milliliter (ng/ml). It shows that cancer of the prostate can be present in men with 'normal' PSAs," said Ian Thompson, M.D., University of Texas Health Science Center at San Antonio, who led the study. Doctors often use the value of 4.0 ng/ml or greater as the trigger for further investigation, such as a prostate biopsy. A PSA level below 4.0 is generally considered normal.

Prostate Cancer Symptoms clinicians often say that men are much more likely to die with prostate cancer than from it. According to recent autopsy studies, many men over age 50 have early, undiagnosed prostate cancer. Clinicians concur that most early cancers remain harmless, though some may progress to clinically significant disease.

The 2,950 men in this study were from the "control arm" of the Prostate Cancer Prevention Trial (PCPT), an NCI-funded study that found in 2003 that the drug finasteride reduced by 25 percent a man's chances of getting prostate cancer.

Men in the control arm were given a placebo, or sugar pill, instead of finasteride and, like the men on the finasteride arm, received annual prostate screening for seven years with a PSA test and a digital rectal exam (DRE). All men in PCPT entered the trial at age 55 or above, had an initial PSA level of 3 ng/ml or less, and a normal DRE. All were asked to undergo an end-of-study prostate biopsy. The report released today focused on men at low risk of having prostate cancer––the 2,950 men on the placebo arm who had normal DREs and PSAs less than or equal to 4 ng/ml for the seven-year study duration.

Since the late 1980s, PSA tests have been widely used in the United States in an attempt to detect prostate cancer at an early stage. However, PSA testing has never been proven to reduce the risk of dying from prostate cancer. Not all prostate cancer detected by PSA screening is clinically relevant and, therefore, screening carries a risk of "over-diagnosing" the disease, which could lead to unnecessary surgery or radiation therapy. Thus, PSA testing is not a universally recommended screening procedure. An ongoing NCI study is addressing the issue of whether PSA screening reduces the risk of death from prostate cancer.

"The main study finding was that 15 percent of the men in the PCPT control arm had a positive end-of study biopsy despite having PSA levels below 4 ng/ml and normal DREs throughout the study," said Thompson.

Importantly, the study also found that only 2.3 percent of men in the PCPT control arm with PSA levels of 4 ng/ml or less had high-grade cancers. For men with a PSA of 2 or lower, the chance of having a high-grade cancer was even lower––1.4 percent. Grade was measured by Gleason score, a system that ranks tumors from 2 to 10 based on their appearance under the microscope. High-grade tumors––Gleason scores of 7 to 10––often grow more quickly and may be more likely to spread than lower-grade tumors.

Gleason scores of the highest grades––8 or 9––were found in only seven participants, or 0.2 percent of men in the PCPT control arm. Most of the men with prostate cancer, 349 of them (78 percent), had Gleason scores of 5 or 6.

"Most of these men would not have been diagnosed if they had not taken part in this study, since biopsies are not routinely performed in men with such low PSA levels," said Ford.

"We need better methods to distinguish the harmless, slow-growing cancers from the more aggressive ones," continued Ford. "If more biopsies are performed at lower PSA levels, more cancers will be found and treated. But some men would undergo treatment, and the risks associated with it, for tumors that would never have been clinically significant."

Treatment for prostate cancer can sometimes lead to impotence, urinary incontinence, and other problems, causing a substantial health burden for men.

"Lowering the PSA threshold for proceeding to prostate biopsy would increase the risks of overdiagnosing and overtreating clinically unimportant disease," said Thompson.

NCI-funded researchers are looking for ways to determine which men harbor aggressive tumors. The NCI Early Detection Research Network (EDRN) has a Prostate Collaborative Group, which is applying a variety of strategies to find ways to detect prostate cancer early. Some scientists are using the new tools of genomics and proteomics to look at how gene expression patterns and proteins in the blood may differ in men with aggressive tumors vs. those with slow-growing ones.

"There is a great need for methods, beyond tumor grade, to better predict which men have prostate cancers requiring treatment," said Thompson.

Prostate Cancer Symptoms is the most common cancer in men, after skin cancer. It estimated that approximately 230,110 men in the United States will be diagnosed with the disease this year, and about 30,000 men will die from it.

* Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA. Prevalence of Prostate Cancer among Men with a Prostate-Specific Antigen Level less than or equal to 4.0 ng per Milliliter. New England Journal of Medicine, May 27, 2004; 350(22):2239-2246

More Prostate Cancer Screening Information

No One Answer for Testing or Treatment http://www.fda.gov

Prostate Cancer Symptoms PSA Testing Faster, More Specific www.healthlink.mcw.edu/