Could I have prevented prostate cancer?
Why did my prostate cancer develop? Could I have done something to prevent it?
Professor Norman Maitland, University of York:
One question lots of men ask is ‘why does prostate cancer develop?’ That sort of gets translated into ‘why me?’ And my feeling is that some of it is actually just bad luck. I have a metaphor that I use, and that is that it's a bit like playing darts. If you're throwing darts at a dartboard and you stand in the normal position, your chance of hitting the bull - i.e. getting cancer - is quite low, certainly for me when I play darts. But if you have the wrong diet, or the wrong lifestyle, you take a step towards the dartboard. With prostate cancer, the problem is we don't fully understand what gives you the steps forward yet. It could be in your diet, and it's very hard to pin down dietary effects. It could be in your genes, you could be born with a predisposition to develop prostate cancer. What's at issue is what proportion of men have a predisposition, and we're not absolutely clear on that yet. Could you prevent it? Well this, I guess, is the million dollar question.
Professor Kenneth Muir, University of Manchester:
Whenever we develop a condition, be it a serious condition like prostate cancer, or even a headache, we look at our lifestyle and what we might have done that may have caused that disease. With prostate cancer, there are two issues though. The first is that maybe having a prostate cancer per se isn’t that bad. Increasingly, we're learning that many prostate cancers will not really impact on our length or quality of life. The key issue though is what leads a man to develop aggressive prostate cancer. And that's really an emerging concept, so the studies looking at that are still at an early stage. What we do know is that the environment and your lifestyle do impact on risk. But to be honest with you, we just don't know what the important elements within the environment and your lifestyle are yet, so we can't really tell you what's caused your prostate cancer.
If we're going to be serious about looking at the causes of prostate cancer, we really need to do very large scale studies, because as well as lifestyle, genetic makeup makes a difference too. But to look at the relative contributions of genetic makeup and lifestyle, we need large amounts of data, and those data sets really just don't exist. That's in sharp contrast to something like breast cancer, where there are data sets of hundreds of thousands of women. And that sort of size of data is what you need to tease out all of these different elements.
Read about a recent report from the World Cancer Research Fund about lifestyle risk factors for prostate cancer.