Prostate Cancer and Lifestyle;smoking, alcohol, family planning, sex, infections – many questions unanswered
When it comes to prostate cancer, risk factors relating to the allegedly unhealthy lifestyle of affected patients are also discussed again and again. Many of these assumptions could, however, be refuted beyond any doubt. For others, studies have not yet found conclusive evidence, or important investigations are still ongoing.
Prostate Cancer and Lifestyle; Smoking, alcohol
A connection between prostate cancer and tobacco consumption was long considered unlikely. But now there are studies that indicate at least a weak connection: the risk increases, not only in healthy people, but also in those who are already sick and who continue to smoke despite therapy.
More research is needed here.
Prostate cancer and alcohol consumption are also obviously linked, although an influence may only become statistically significant with high alcohol consumption. Researchers are establishing a connection among other things via testosterone and other hormones: Alcohol influences hormonal control circuits, at least in heavy drinkers.
Prostate Cancer and Lifestyle Chronic inflammation
The influence of chronic prostate inflammation is not yet fully understood. The risk of sexually transmitted diseases is also unclear. However, chronic inflammation does not seem to have a measurably increased risk. Researchers are discussing this question, among other things, because circumcision, the removal of the foreskin, could lower the risk of infections and therefore also affect the risk of cancer. There is still a lack of meaningful data.
Benign prostate enlargement
What about the benign enlargement of the prostate that is found in many men from middle age?
There are still unanswered questions, but the following applies: The available data tend to speak against it, if only because so-called benign hyperplasia is so common. If it were a strong risk factor, far more men would get prostate cancer than there is. At most, a common cause can be found in the persistent influence of the male sex hormone testosterone.
Too much sex or abstinence? Infection? These risks have been refuted!
Among the factors that, according to the current state of research, do not increase the risk
- no, little or particularly pronounced sexual activity
- Infection with human papillomavirus as a cause of prostate cancer is also excluded.
Contraception – and then prostate cancer?
During a vasectomy, men can cut the spermatic ducts for contraception or “sterilization”. The sexual functions remain unaffected. It has long been debated whether a vasectomy could increase the risk of prostate cancer. To this day, a risk cannot be completely ruled out. But if it is there at all, it is at least very small.
What do the studies say on this subject? The statements made so far are contradictory. Here are two examples: A large study investigated this question based on the fate of almost 50,000 Americans over a period of around 24 years. The results indicated that especially very aggressive tumors may be slightly more common in men after vasectomy. In contrast, the risk of less aggressive prostate tumors, which in the patients remained limited to the organ itself within the observation period, was not statistically influenced.
Prostate Cancer and Lifestyle
Another, very comprehensive re-evaluation of already published studies came to the result: There is a trend, but it is not statistically reliable – an increase in risk is unlikely, even if it is still not completely excluded.
None of these studies can offer proof of a causal risk: They are based on observation and not on laboratory tests or similar direct evidence.
Specialists are discussing in particular whether men who are sterilized differ in other ways from men who do not: One possibility would be more frequent visits to the doctor so that prostate cancer is more likely to be diagnosed in them. Another would be lifestyle differences: Men with very low testosterone levels may also indirectly have less interest in permanent birth control.
It also remains unclear to this day what exactly could happen biologically after sterilization in the prostate tissue that would then affect the risk.