Sperling Prostate Center

Family History of Prostate Cancer? This Can Help Lower Your Mortality Risk

The American Cancer Society (ACS). The National Cancer Institute (NCI). The American Society of Clinical Oncology (ASCO). Chances are, you’ve heard of at least one of these esteemed organizations—especially if you or a loved one has had cancer.

Here’s one you may not know about, despite the fact that it’s over 100 years old: The American Association for Cancer Research (AACR). Founded in 1907, the 34 charter members were scientists and physicians concerned about the quality of research being done on the many types of cancer, as well as disseminating high level innovative research information so it was available to all who needed it. According to the AACR website, the need was clear: “At the turn of the century many scientists believed that the cure for cancer was imminent. The newspapers were filled with claims of causes and cures that were quickly disproven…”

The 47,000 members of AACR have been involved in every major advance against cancer. This includes understanding what is called the epigenetics of cancer. In simple terms, this refers to the study of changes in gene activity “which are not caused by changes in the DNA sequence. It is the study of gene expression, the way genes bring about their phenotypic effects.” This means that there are genes that can be upregulated (switched on) and downregulated (switched off) to create a variety of characteristics such that organisms with the same genetic sequence, such as the DNA in a dog breed like collies, don’t all look alike. Some may have short hair, some may have blue eyes, etc.

Influencing your prostate cancer risk level

The AACR hosts an annual meeting attended by tens of thousands, both member and non-members. The 2021 meeting occurred as a virtual event spanning two sessions: April 10-15 and May 17-21.

During the first session, research fellow Anna Plym, Ph.D. (Brigham and Women’s Hospital and Harvard T. H. Chan School of Public Health) presented “Genetic Prostate Cancer Risk may be Offset by Healthy Lifestyle.” She pointed out that genetic factors (heritable traits) account for about 58% of the variability in prostate cancer risk. A way to evaluate the degree of heritable traits is the polygenic risk score (PRS) in which the higher the score, the greater the risk of developing prostate cancer.

Her research team’s data was a population of almost 10,443 men from the Health Professionals Followup Study for whom genotype data (blood samples or cheek cells for genomic analysis of PRS) was available. Within that group, 2,100 were diagnosed with prostate cancer (18 years’ average follow-up), and of those nearly 240 whose death was attributable to their cancer (22 years’ average follow-up).

The team used a validated lifestyle score (healthy weight, vigorous physical activity, nonsmoking, diet high in tomatoes, fatty fish, and less intake of processed meat) that can be applied in relation to lethal prostate cancer. A score of 1-2 meant least healthy, 3 was moderately healthy, and 4-6 was most healthy). They correlated lifestyle scores with PRS values for overall and lethal prostate cancer cases.

They found that men in the highest genetic risk quartile had a 5.4-fold greater risk of overall prostate cancer and a 3.5-fold greater risk of lethal disease compared with men in the lowest genetic risk quartile. For those in the highest risk quartile, those with high lifestyle scores had roughly half the risk of developing lethal disease than men with low lifestyle scores—and this was statistically significant. However, this did not generalize to the overall prostate cancer cases, where there was no clear correlation between healthy lifestyle and less chance of prostate cancer-specific mortality.

According to Dr. Plym, it’s not entirely clear why the association between healthy lifestyle and reduced mortality risk showed up only for the men with the greatest genetic risk. She stated, “The decreased risk of aggressive disease in those with a favorable lifestyle may suggest that the excess genetic risk of lethal prostate cancer could be offset by adhering to a healthy lifestyle.” She added:

The study adds to a wide body of cancer prevention research that shows the benefit of a healthy lifestyle, including not smoking, maintaining a healthy weight, getting regular exercise, and eating a healthy diet…Our findings add to current evidence suggesting that men with a high genetic risk may benefit from a targeted prostate cancer screening program, aiming at detecting a potentially lethal prostate cancer while it is still curable.

Our Center’s philosophy of men’s health embraces the whole person, not just each patient’s prostate. Our blogs contain research-backed content on the importance of a healthy lifestyle and promoting cancer-free wellness through nutrition, exercise, stress management, healthy relationships and mental attitude.

We acknowledge the work of AACR and its members in connecting the science dots with the lifestyle dots on the journey to vanquish cancer.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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