Can I prevent prostate cancer?

Written in association with: Mr Marc Laniado
Published: | Updated: 12/09/2023
Edited by: Nicholas Howley

Prostate cancer is on the rise in the UK, with 47,700 men diagnosed each year. With so many men affected, we asked prostate cancer expert Mr Marc Laniado if there’s anything you can do to reduce your own risk – and whether it’s worth having regular check-ups.

 

How can I reduce my risk of prostate cancer?

There are many ways to reduce your risk of developing prostate cancer and benign prostatic hyperplasia (BPH), including:

  • Increasing your exercise levels to 5 hours a week.
  • Losing weight and keeping your body mass index (BMI) to between 20 and 25.
  • Adopting a Mediterranean diet with food that does not cause inflammation.
  • Reducing the consumption of total protein, especially from dairy products and red meat.
  • Increasing the consumption of fruit and vegetables containing polyphenols (cruciferous vegetables, lycopenes, concentrated tomato sauces).
  • Having about 250mg daily of omega-3 fatty acids from marine sources (e.g. krill) – but do not take it in excess.
  • Reducing alcohol consumption and stopping smoking.
  • Keeping vitamin D levels at least reasonable, which usually means having vitamin D supplements from autumn to spring.

 

Are there any drugs doctors can prescribe?

Some drugs have been shown to reduce the chance of needing surgery for problems due to BPH including finasteride and dutasteride.

These shrink the prostate slowly over time by about 20%. Sometimes that is enough to avoid urinary symptoms or needing an operation. They also reduce the chance of low-risk prostate cancer, although there has been controversy over the potential of getting higher risk prostate cancer.

These drugs can cause some sexual side effects such as reduced quality of erections, semen volume and libido. Many men choose not to take the drugs because of the sexual side effects.

 

Should I have my prostate regularly checked?

There is no national screening programme for prostate cancer or benign prostatic enlargement (BPH) in the UK or any other country.

Currently, there is no recommendation for this by official bodies in the UK such as NICE or the British Association of Urological Surgeons. There are many reasons for this, which include the variability in the quality of tests and treatment available throughout the country.

Studies show that regular testing for prostate cancer compared to no testing prevents some lives being lost to prostate cancer. Saving lives is obviously good, but the problem is that testing and what follows must be performed well to avoid causing more harm than good. Screening for early prostate problems needs to be carried out in a way that is sensitive, safe, and personalised to the individual men.

If you have urinary symptoms or a family history of prostate problems and are in good general health, then annual checks by a GP may be sensible from age 45 years up to about 70 to 75 years providing your general health is good.

By Mr Marc Laniado
Urology

*Please note that Mr Laniado is still consulting (both face-to-face and remotely) during COVID-19*

 

Mr Marc Laniado offers men with prostate enlargement or early prostate cancer treatments that benefit with less chance of side-effects. He uses the most advanced techniques that have a consistently better success rate. These are personalised to the individual needs and values of each man he sees.

 

Prostate cancer:

  • highly accurate diagnostic tests with the least side-effects (enhanced MRI, transperineal prostate biopsies, and genomic testing)
  • treatments for early prostate cancer that can preserve bladder control and erections more consistently than conventional treatments (focal therapy by HIFU, Retzius-sparing prostatectomy with nerve-sparing (NeuroSAFE), and seeds, a.ka. brachytherapy)
  • active surveillance: close monitoring for men who do not need immediate treatment

Prostate Enlargement (BPH):

  • minimally invasive treatments for small to medium-sized prostate that can improve urinary symptoms and maintain erections & ejaculation (Rezum and UroLift)
  • treatments for large prostates that improve urinary symptoms with a faster and more comfortable recovery (Aquablation, laser prostatectomy, HoLEP)
  • assessment for Prostate Artery Embolisation (PAE) 

 

He is a highly experienced urologist and works full time in the direct clinical care of men with prostate problems. Annually, he performs about 100 Retzius-sparing prostatectomies, as well as HIFU,  and 100 or more treatments for BPH.

 

He is the joint chairman of the prostate cancer multidisciplinary team for private patients at the Wellington Hospital and the Princess Grace Hospital where he operates and sees patients. He also sees patients at The London Clinic.

 

Mr Laniado was appointed as a consultant in 2002 and started performing conventional robotic prostatectomies in 2008. In 2016, He switched to the Retzius-sparing approach because of the much better bladder control and recovery of erections with similar cancer outcomes. He trains surgeons learning how to perform Retzius-sparing prostatectomies at the Royal Berkshire Hospital. NHS patients consult with him at the Royal Berkshire Hospital and Wexham Park Hospital (Frimley Health), where he is the lead for urological cancer.

 

Mr Laniado graduated from Guy's Hospital Medical School in 1989, having previously gained a BSc in physiology. Following specialist urology training in London, he became a Fellow of the Royal College of Surgeons (Urology) in 2000, going on to complete his MD in prostate cancer research, Fellow of the European Board of Urology in 2002, and become an international member of the American Urological Association. Before taking up his career as a consultant, Mr Laniado extended his knowledge and skills on a Visiting Fellowship at the Cleveland Clinic Foundation in the USA, where he trained in minimally invasive surgical techniques. 

 

Mr Laniado chooses treatments wherever possible for prostate problems that maximise the benefit-to-risk ratio, which are often less readily available. However, it is not possible to completely eliminate the chance or impact of after-effects after treatment, although the risk and impact are minimalised as much as possible.

 

 

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