Studies of Japanese and American men have borne some interesting results: Incidental prostate cancer is found in as many Japanese men as American men, and both groups of men have about the same life span74 years. Yet hardly any Japanese men die of prostate cancer. Why
Prostate cancer develops in four broad stages: Initiation, promotion, progression, and metastasis, or spread of cancer. These studies of Japanese and American men suggest that whatever causes cancer initiation is the same in all men; the big differences seem to come in promotion, progression, and spread. These studies also suggest that at least some of the elements responsible for these last three stepsturning indolent prostate cancer into a deadly disease are environmental.
It has been shown that, over time, when men change their environment, they assume the cancer risk of the country where they live. So when Japanese men, people at low risk of getting prostate cancer, move to Hawaii or California, their rate of symptomatic prostate cancer escalatesto the level of an American man’s.
For years, scientists have suspected the high-fat Western diet as an obvious environmental culprit in the development of prostate cancer. But it’s not that simple. For example, a high-fat diet is believed to play a big role in other diseases, like colon and breast cancer. The death and incidence rate in prostate cancer is higher among American blacks than American whitesyet the incidence of breast and colon cancer in the two groups is about the same. What accounts for this difference And these statistics raise another question: Are black men somehow more susceptible genetically to prostate cancer than white or Asian men We don’t know. But we do know, sadly, that in this country many black men delay seeking medical care until it’s too late and prostate cancer has spread.
Genetics and environmenttwo definite components of the prostate cancer equation. We’ll examine some genetic issues first and then look at some of the environmental risks in greater detail.
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