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Thursday, March 28, 2024

What causes prostate cancer?

Dr. Gabe Mirkin
Dr. Gabe Mirkin

If they live long enough, all North American men will eventually develop prostate cancer, but scientists still do not know the cause or causes. They do know that rural Chinese men used to have a prostate cancer rate under two percent, but that rate is rising rapidly, particularly with migration to large cities (European Urology, June 2012;61(1):1079-1092). This leads most scientists to feel that something in the environment causes prostate cancer. Two articles and three presentations at a major medical meeting this month suggest that it may be infection or diet.

Dietary Links to Prostate Cancer
On May 21, 2014 at the 109th Annual Scientific Meeting of the American Urological Association three studies were presented:
• Men who eat lots of high complex carbohydrate foods (fiber, whole grains) are at reduced risk for prostate cancer. Other studies show that diets rich in sugar added foods and drinks are associated with increased prostate cancer risk (#PD31-11).
• High milk intake was associated with increased risk for rapidly progressive advanced prostate cancer. Yogurt, ice cream and cheese consumption were not associated with either advanced or localized cancer (#PD31-06).
• Having two or more metabolic syndrome component conditions was associated with an increased risk of high-grade prostate cancer (obesity, high blood pressure, elevated fasting blood sugar (>100), high fasting insulin (>5), low HDL (good) cholesterol (<40), high triglycerides (>150), or fatty liver — storing fat primarily in the belly (#PD31-01).

Current research links increased risk for prostate cancer with everything that raises blood sugar levels: metabolic syndrome (pre diabetes), diabetes, inflammation, obesity and weight gain (Cancer Causes and Control, 05/14/2014), lack of exercise (Cancer Epidemiology, Biomarkers & Prevention, 04/02/2014), and lack of vitamin D. Vitamin D deficiency blocks insulin receptors to raise blood sugar levels and increases risk for diabetes. Scientists have not shown that high blood sugars cause prostate cancer, but they have shown that having high blood sugar levels is associated with increased prostate cancer risk.

Men who have low blood levels of vitamin D are at increased risk for prostate cancer and specifically for the type of prostate cancer that kills (Clinical Cancer Research, May 1, 2014). Vitamin D plays several critical roles in how cells develop and grow. Vitamin D helps to regulate how stem cells change into prostate cells and the rate that normal cells turn into cancer cells. Adding vitamin D to prostate cells in a petri dish slows their rate of growth. Perhaps not having enough vitamin D can cause normal cells to become cancerous.

Researchers found that almost all of 667 men referred for prostate biopsies because of high blood PSA tests or abnormal prostate exams had low levels of vitamin D. Their levels of hydroxy vitamin D were usually below 20ng/ml. Normal is 30 to 80. Furthermore, 44 percent of the men with prostate cancer had very low levels of vitamin D compared to 38 percent of those who tested negative. The lower the level of vitamin D, the more likely the cancer was to kill them.

Trichomonas Vaginalis and Prostate Cancer
Trichomonas is a germ acquired through sexual relations. Researchers at the University of California grew human prostate cells in a test tube, and found that adding a protein secreted by Trichomonas vaginalis to tissue cultures of benign prostate cells caused the cells to grow larger and faster (Proceedings of the National Academy of Sciences, May, 2014). Adding the same protein to cancerous prostate cells caused both increased growth and invasion into other tissues. It also caused inflammation that is associated with increased cancer risk.

This research shows that Trichomonas can cause cancer in a petri dish; the next step is to show if it can cause cancer in living animals. A previous study showed that 25 percent of men with prostate cancer were infected with Trichomonas, and that men who had Trichomonas in addition to prostate cancer had more aggressive tumors that were more likely to kill them (Journal of the National Cancer Institute, September 11, 2009).

Trichomoniasis Symptoms and Treatment
Trichomoniasis is the most common non-viral sexually-transmitted disease. When men are infected they may have itching, tingling or irritation inside their urinary tube; burning after or during urination or ejaculation; a discharge dripping from the penis; or no symptoms at all. Women may have itching, burning, or soreness in the vagina or urinary tube; vaginal redness or rawness; blood spotting between periods; burning during or after urination; a fishy odor; discomfort during intercourse; belly pain; yellow, green, or colorless discharge from the vagina; or no symptoms at all. Your doctor can look at the discharge under a microscope to make the diagnosis, but most doctors do not do this. Since Trichomoniasis is easy to cure, many doctors treat patients with any of the symptoms even if they have not confirmed the diagnosis. You will be given 500 mg Metronidazole pills three times a day for five days. Your regular partner must be treated at the same time, as well as any other partners of both of you, even though they may have no symptoms at all. The disease is so contagious that failing to treat all partners will prevent you from getting rid of this germ. After you are cured, you are just as susceptible as ever to getting re-infected with any new exposure.

 

Dr. Gabe Mirkin is a resident of The Villages. Learn more at www.drmirkin.com

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