So, Dr. Scholz, today I want to talk about risk and family history when
it comes to prostate cancer. So, first of all, can we talk about
what would kind of cause just the risk of prostate cancer in general?
Yeah, people that are at higher risk are probably age is the number one thing.
99% of men that get prostate cancer are over age 50. So, as we get older
it gets more common. Dr. Klotz likes to say that you can put a percentage sign after your age
and that's how likely it is that you harbor prostate cancer and of course that's including
these little tiny harmless grade sixes that you don't even want to know about
(more consequential prostate cancers are nowhere near that common). So, you have age,
the other thing, of course, race. African-Americans are at higher risk; Latinos
are at a somewhat lower risk than Caucasians. Then, family history which I think we're going
to talk a little bit about today. If you have a brother or a dad, then your risk goes up
quite a bit. There's a genetic mutation called BRCA or "Braka" (phonetic spelling) that increases
men's risk of getting prostate cancer. And lastly, we're talking about dietary practices—being
overweight—all of these things can predispose to a higher risk of getting prostate cancer.
I have a lot of guys who I've talked to who their dad has had a certain type of
prostate cancer—maybe a Gleason 9 or 10—and they think they're exactly going to get that
exact type of prostate cancer because their father had it. So, can you explain
why would that be? Is that possible, and if not, how is prostate cancer so different?
Well, it's like inheriting anything. You know, if your dad is a famous race car driver, has
amazing skills, and you're his son there's no guarantee you're going to be able to go out
and win races in Nascar. However, it is possible that you will and so inheritability is kind of a
hit and miss thing. We do know that if someone's father had a very aggressive cancer diagnosed at
an early age that their sons will be at somewhat increased risk of having a similar problem and of
course they need to screen more carefully. Things have changed so much, so what might have been a
sad story for someone's father 20 years ago—when we had no technology to treat people with—could
be quite a bit different even though they caught the same kind of cancer,
but there's no way you can say well he had it, therefore, I will have it—just
like you can't say that about anything you would inherit from your parents.
So, this is a question a patient asked me not too long ago and really they found out
that their father had prostate cancer and they were kind of worried that they were
going to get it and they were wondering about diet. So, they wanted to start a
vegan diet or vegetarian diet and stay away from red meat just because their father had
prostate cancer and they knew about that family history. Is that something you would suggest?
I think that it will make a difference. The, you know,
telling people what to eat is fraught with all kinds of challenges. It would be wonderful to say,
"Oh, if you just eat a vegan diet you'll never have a problem, of course, there's
a lot of great things that happen with good diets. I mean, less heart disease,
reduction of cancers across the boards, and, yes, probably it would help reduce the risk somewhat.
It's not going to be a get out of jail free card where nothing bad will ever happen to
you if you eat the right diet, but if you want to play the odds and if it's not as challenging
for you to decide what you're eating like it is for so many people, why not? Yeah, do it.
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