Does Red Meat Give You Colon Cancer?

Have you heard? There’s a new “red meat will kill you” study. This time, it’s colorectal cancer.

Here’s the press release.

Here’s the full study.

I covered this a couple Sundays ago in “Sunday with Sisson.” If you haven’t signed up for that, I’d recommend it. SWS is where I delve into my habits, practices, and observations, health-related and health-unrelated—stuff you won’t find on the blog. Anyway, I thought I’d expand on my response to that study here today.

How the Study Was Conducted

It’s the basic story you see with most of these observational studies. Around 175,000 or so people were asked to recall what they ate on a regular basis—a food frequency questionnaire. This is the exact questionnaire, in fact. The research team took the answers, measured some baseline characteristics of all the subjects—socioeconomic status, exercise levels, whether they smoked, education level, occupation, family history of colorectal cancer, and a few others—and then followed up with participants an average of 5.7 years later to see how many had developed colorectal cancer.

What the Study “Showed”

Those who had moderate amounts of red meat had a 20% higher chance of getting cancer.

And in the end, the increased risk was a relative risk. It wasn’t a 20% absolute increase in risk. It was a relative increase in risk. The subjects started with a 0.5% risk of getting bowel cancer. In those who ate the most processed meat and red meat, that risk increased 20%—to 0.6%!

From 0.5 to 0.6%. Sure, that’s an increase, but is it something to overhaul your entire diet for? To give up the best sources of zinc, iron, B vitamins, protein, carnosine, creatine? All that for a measly 0.1% that hasn’t even been established as causal?

Study Findings Most News Outlets Won’t Include

One head scratcher that leaps out: the link between unprocessed red meat and colon cancer was not actually statistically significant. Only processed meat was significantly linked to colon cancer.

Another head scratcher: red meat, whether processed or unprocessed, had no significant association with colorectal cancer in women. Why didn’t they highlight the fact that in women, eating red meat was completely unrelated? That’s half the world’s population. That’s you or your mom, your daughter, your grandmother, your girlfriend. And unless they were to look at the full study and read the fine print, they’d never know that red meat actually had the opposite relationship. You’d think the authors would want to mention that in the abstract or see that the press releases and media treatments highlighted that fact.

It’s probably because mentioning that red meat was neutral in women and had no statistically significant link to colon cancer in men and women would have destroyed their case for red meat as an independent carcinogen. See, carcinogens are supposed to be carcinogens. There are many meaningful differences between men and women, but a poison is a poison.

What’s the proposed mechanism for red meat triggering colon cancer in men but not in women? If they didn’t have one (and I imagine they wouldn’t have mentioned it if they did), then there’s probably something else going on.

Besides, the literature is far from unequivocal.

What Other Research Says About Red Meat and Bowel Cancer

In analyses that include consideration of cooking methods and other mitigating factors, red meat has no relationship with colon cancer.

Or what about this study, where colon cancer patients were more likely to eat red meat, but less likely to have type 2 diabetes? Should people avoid red meat and work toward getting diagnosed with type 2 diabetes?

Or how about this study, which found no difference in colorectal cancer rates between people who ate red meat-free diets and people who ate diets containing red meat? Shouldn’t the diet without any red meat at all have some effect?

Or this classic study, where rats on a bacon-based diet had the lowest rates of colon cancer. In fact, bacon protected them from colon cancer after they were dosed with a colon cancer promoter, while rats on normal “healthy” chow were not.

The Blind Spot In Red Meat Research

I don’t need to go into all the confounding factors that might predispose conventional red meat lovers to bowel cancer. Nor will I mention that it’s impossible to fully control for variables like the buns and bread and fries you eat the red meat with and the industrial seed oils it’s cooked in.

That last bit is crucial: the seed oils. It’s what nearly every cancer researcher misses. It’s not just a minor variable; it’s quite possibly the most important determinant of whether meat is carcinogenic in the colon or not. Heme iron—the compound unique to red meat that usually gets the blame for any increase in cancer—is most carcinogenic in the presence of the omega-6 fatty acid linoleic acid.

In one study, feeding heme iron to rats promoted colon cancer only when fed alongside high-linoleic acid safflower oil. Feeding MUFA-rich and far more oxidatively-stable olive oil alongside the heme prevented the colon carcinogenesis.

Another study had similar results, finding that meats containing medium to high amounts of heme—beef and beef blood sausage—promoted carcinogenic conditions in the colon when the fat sources were linoleic acid-rich corn and soybean oil.

And most recently is this paper. Mice were split into three groups. One group got heme iron plus omega-6 PUFA (from safflower oil). One group got heme iron plus omega-3 PUFA (from fish oil). The third group got heme iron plus saturated fat (from fully hydrogenated coconut oil, which contains zero PUFA). To determine the carcinogenicity of each feeding regimen, the researchers analyzed the effect the animals’ fecal water (which is exactly what it sounds like) had on colon cells. The fecal water of both PUFA groups was full of carcinogenic indicators and lipid oxidation byproducts, and exposing colonic epithelial cells to fecal water from PUFA-fed mice was toxic. The coconut oil-derived fecal water had no markers of toxicity or lipid oxidation.

I never see these (animal) studies cited in observational studies of meat and colon cancer. I think that’s a huge blindspot, and it’s one of the reasons I rarely put any stock in these scary-sounding studies.

That’s it for today, folks. Thanks for reading. Now go enjoy a steak.

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References:

Bylsma LC, Alexander DD. A review and meta-analysis of prospective studies of red and processed meat, meat cooking methods, heme iron, heterocyclic amines and prostate cancer. Nutr J. 2015;14:125.

Alsheridah N, Akhtar S. Diet, obesity and colorectal carcinoma risk: results from a national cancer registry-based middle-eastern study. BMC Cancer. 2018;18(1):1227.

Rada-fernandez de jauregui D, Evans CEL, Jones P, Greenwood DC, Hancock N, Cade JE. Common dietary patterns and risk of cancers of the colon and rectum: Analysis from the United Kingdom Women’s Cohort Study (UKWCS). Int J Cancer. 2018;143(4):773-781.

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The Definitive Guide To Autophagy (and 7 Ways To Induce It)

Biological systems are self-maintaining. They have to be. We don’t have maintenance workers, mechanics, troubleshooters that can “take a look inside” and make sure everything’s running smoothly. Doctors perform a kind of biological maintenance, but even they are working blind from the outside.

No, for life to sustain itself, it has to perform automatic maintenance work on its cells, tissues, organs, and biological processes. One of the most important types of biological maintenance is a process called autophagy.

Autophagy: the word comes from the Greek for “self-eating,” and that’s a very accurate description: Autophagy is when a cell consumes the parts of itself that are damaged or malfunctioning. Lysosomes—members of the innate immune system that also degrade pathogens—degrade the damaged cellular material, making it available for energy and other metabolites.  It’s cellular pruning, and it’s an important part of staving off the worst parts of the aging process.

In study after study, we find that impairment to or reductions of normal levels of autophagy are linked to almost every age-related degenerative disease and malady you can imagine.

  • Cancer: Autophagy can inhibit the establishment of cancer by removing malfunctioning cellular material before it becomes problematic. Once cancer is established, however, autophagy can enhance tumor growth.
  • Diabetes: Impaired autophagy enables the progression from obesity to diabetes via pancreatic beta cell degradation and insulin resistance. Impaired autophagy also accompanies the serious complications related to diabetes, like kidney disease and heart failure.
  • Heart disease: Autophagy plays an important role in all aspects of heart health.
  • Osteoporosis: Both human and animal studies indicate that autophagy dysfunction precedes osteoporosis.
  • Alzheimer’s disease: Early stage Alzheimer’s disease is linked to deficits in autophagy.
  • Muscle loss: Autophagy preserves muscle tissue; loss of autophagy begins the process of age-related muscle atrophy.

Okay, so autophagy is rather important. It’s fundamental to health.

But how does autophagy happen?

The way it’s supposed to happen is this:

Humans traditionally and historically lived in a very different food environment. Traditionally and historically, humans were feasters and fasters. While I don’t think our paleolithic ancestors were miserable, wretched, perpetually starving creatures scuttling from one rare meal to the next—the fossil records show incredibly robust remains, with powerful bones and healthy teeth and little sign of nutritional deficits—they also couldn’t stroll down to the local Whole Foods for a cart full of ingredients. Going without food from time to time was a fundamental aspect of human ancestral life.

They worked for their food. I don’t mean “sat in a cubicle to get a paycheck to spend on groceries.” I mean they expended calories to obtain food. They hunted—and sometimes came back empty handed. They dug and climbed and rooted around and gathered. They walked, ran, stalked, jumped, lifted. Movement was a necessity.

In short, they experienced energy deficits on a regular basis. And energy deficits, particularly sustained energy deficits, are the primary triggers for autophagy. Without energy deficits, you remain in fed mode and never quite hit the fasted mode required for autophagy.

Now compare that ancestral food environment to the modern food environment:

Almost no one goes hungry. Food is cheap and plentiful, with the tastiest and most calorie-rich stuff tending to be the cheapest and most widely available.

Few people have to physically work for their food. We drive to the store and walk a couple hundred steps, hand over some money, and—BOOM—obtain thirty thousand calories, just like that. Or someone comes to our house and delivers the food directly.

We eat all the time. Unless you set out to do it, chances are you’ll be grazing, snacking, and nibbling throughout the day. We’re in a perpetually fed state.

The average person in a modern society eating a modern industrial diet rarely goes long enough without eating something to trigger autophagy. Nor are they expending enough energy to create an energy deficit from the other end—the output. It’s understandable. If our ancestors were thrust into our current situation, many would fall all over themselves to take advantage of the modern food environment. But that doesn’t make it desirable, or good for you. It just means that figuring out how to trigger autophagy becomes that much more vital for modern humans.

Here are 7 ways to induce autophagy with regular lifestyle choices.

1) Fast

There’s no better way to quickly and reliably induce a large energy deficit than not eating anything at all. There are no definitive studies identifying “optimal” fasting guidelines for autophagy in humans. Longer fasts probably allow deeper levels of autophagy, but shorter fasts are no slouch.

2) Get Keto-Adapted

When you’re keto- and fat-adapted, it takes you less time to hit serious autophagy upon commencing a fast. You’re already halfway there.

3) Train Regularly

With exercise-related autophagy, the biggest effects are seen with lifelong training, not acute. In mice, for example, the mice who are subjected to lifelong exercise see the most autophagy-related benefits. In people, those who have played soccer (football) for their entire lives have far more autophagy-related markers of gene activity than people of the same age who have not trained their whole lives.

4) Train Hard

In studies of acute exercise-induced autophagy, the intensity of the exercise is the biggest predictor of autophagy—even more than whether the athletes are in the fed or fasted state.

5) Drink Coffee

At least in mice, both caffeinated and decaffeinated coffee induce autophagy in the liver, muscle tissue, and heart. This effect persists even when the coffee is given alongside ad libitum food. These mice didn’t have to fast for the coffee to induce autophagy.

Certain nutrients can trigger autophagy, too….

6) Eat Turmeric

Curcumin, the primary phytonutrient in turmeric, is especially effective at inducing autophagy in the mitochondria (mitophagy).

7) Consume Extra Virgin Olive Oil

The anticancer potential of its main antioxidant, oleuropein, likely occurs via autophagy.

Disclaimer: The autophagy/nutrient literature is anything but definitive. Most studies take place in test tube settings, not living humans. Eating some turmeric probably won’t flip a switch and trigger autophagy right away, but it won’t hurt.

Autophagy is a long game.

This can’t be underscored enough: Autophagy is a lifelong pursuit attained by regular doses of exercise and not overeating every time you sit down to a meal. Staying so ketotic your pee tests look like a Prince album cover, doing epic 7-day fasts every month, fasting every other day, making sure you end every day with fully depleted liver glycogen—while these strategies might be “effective,” obsessing over their measures to hit some “optimal” level of constant autophagy isn’t the point and is likely to activate or trigger neurotic behavior.

Besides, we don’t know what “optimal autophagy” looks like. Autophagy isn’t easy to measure in live humans. You can’t order an “autophagy test” from your doc. We don’t even know if more autophagy is necessarily better. There’s the fact that unchecked autophagy can actually increase existing cancer in some cases. There’s the fact that too much autophagy in the wrong place might be bad. We just don’t know very much. Autophagy is important. It’s good to have some happening. That’s what we have to go on.

Putting These Tips Into Practice

Autophagy happens largely when you just live a healthy lifestyle. Get some exercise and daily activity. Go hard every now and then. Sleep deeply. Recover well. Don’t eat carbohydrates you don’t need and haven’t earned (and I don’t just mean “earned through glycogen depleting-exercise”). Reach ketosis sometimes. Don’t eat more food than you need. Drink coffee, even decaf.

All those caveats aside, I see the utility in doing a big “autophagy session” a few times a year. Here’s how mine looks:

  1. Do a big training session incorporating strength training and sprints. Lots of intense bursts. This will trigger autophagy.
  2. Fast for two or three days. This will push autophagy even further.
  3. Stay busy throughout the fast. Take as many walks as possible. This will really ramp up the fat burning and get you quickly into ketosis, another autophagy trigger.
  4. Drink coffee throughout the fast. Coffee is a nice boost to autophagy. Decaf is fine.

I know people are often skeptical of using “Grok logic,” but it’s likely that most human ancestors experienced similar “perfect storms” of deprivation-induced autophagy on occasion throughout the year. You track an animal for a couple days and come up short, or it takes that long to make the kill. You nibble on various stimulants plucked from the land along the way. You walk a ton and sprint some, then lift heavy. And finally, maybe, you get to eat.

If you find yourself aging well, you’re on the right track. If you’re not progressing from obesity to diabetes, you’re good to go. If you’re maintaining and even building your muscle despite qualifying for the blue plate special, you’ve probably dipping into the autophagy pathway. If you’re thinking clearly, I wouldn’t worry. Obviously, we can’t really see what’s happening on the inside. But if everything you can verify is going well, keep it up.

That’s it for today, folks. If you have any more questions about autophagy, leave them down below and I’ll try to get to all of them in future posts.

Thanks for reading!

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References:

Yang ZJ, Chee CE, Huang S, Sinicrope FA. The role of autophagy in cancer: therapeutic implications. Mol Cancer Ther. 2011;10(9):1533-41.

Barlow AD, Thomas DC. Autophagy in diabetes: ?-cell dysfunction, insulin resistance, and complications. DNA Cell Biol. 2015;34(4):252-60.

Sasaki Y, Ikeda Y, Iwabayashi M, Akasaki Y, Ohishi M. The Impact of Autophagy on Cardiovascular Senescence and Diseases. Int Heart J. 2017;58(5):666-673.

Florencio-silva R, Sasso GR, Simões MJ, et al. Osteoporosis and autophagy: What is the relationship?. Rev Assoc Med Bras (1992). 2017;63(2):173-179.

Li Q, Liu Y, Sun M. Autophagy and Alzheimer’s Disease. Cell Mol Neurobiol. 2017;37(3):377-388.

Jiao J, Demontis F. Skeletal muscle autophagy and its role in sarcopenia and organismal aging. Curr Opin Pharmacol. 2017;34:1-6.

Schwalm C, Jamart C, Benoit N, et al. Activation of autophagy in human skeletal muscle is dependent on exercise intensity and AMPK activation. FASEB J. 2015;29(8):3515-26.

De oliveira MR, Jardim FR, Setzer WN, Nabavi SM, Nabavi SF. Curcumin, mitochondrial biogenesis, and mitophagy: Exploring recent data and indicating future needs. Biotechnol Adv. 2016;34(5):813-826.

Przychodzen P, Wyszkowska R, Gorzynik-debicka M, Kostrzewa T, Kuban-jankowska A, Gorska-ponikowska M. Anticancer Potential of Oleuropein, the Polyphenol of Olive Oil, With 2-Methoxyestradiol, Separately or in Combination, in Human Osteosarcoma Cells. Anticancer Res. 2019;39(3):1243-1251.

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Weekly Link Love — Edition 21

Research of the Week

“Thermally-abused” (great term) soybean oil promotes breast cancer progression.

Big moralizing gods came after the rise of civilizations.

Strong weed linked to psychosis.

Reindeer brew alcohol in their bodies to deal with cold winters.

The link between statins and type 2 diabetes is even stronger than we thought.

“Ancient monkey bone tools.” That is all.

Case study: ketogenic diet (plus exercise and time restricted eating) rescues cognition in patient with Alzheimer’s disease.

Paleo ketogenic diets for cancer: more case studies.

Military personnel who maintained strict adherence to a ketogenic diet lost weight, lost visceral fat, and improved body composition without compromising physical performance.

New Primal Blueprint Podcasts

Episode 321: Maria Emmerich: Host Elle Russ chats with keto nutritionist Maria Emmerich.

Health Coach Radio Episode 4: Laura Rupsis: Erin Power interviews her co-host, Laura Rupsis.

Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

Media, Schmedia

Amazon removes some anti-vaccine books. Other tech companies are following suit. Maybe that’s a pretty safe target, but what about when they start targeting “dietary misinformation”?

The BMJ stops carrying infant formula advertisements.

Interesting Blog Posts

Why nutritional psychiatry is the future of mental health treatment.

How we’ll know AI is conscious.

The liver is not a filter.

Social Notes

How I train my abs.

Everything Else

Bhang, a traditional cannabis-infused drink popular during the Indian festival of Holi.

Some doctors are saying you should wean yourself off antidepressants very slowly—over months or years rather than weeks.

The fascinating effect soft foods had on human language.

Tucker Goodrich responds to Gary Taubes on seed oils.

Who were the Neanderthals?

Things I’m Up to and Interested In

Always glad to be included in “hot health trends.”

I’m glad to hear: Scientists come out against the abuse of statistical significance.

Concept I found interesting: A futurist’s dim view of the future smart home.

Guide I’m reading: The EWG’s 2019 guide to pesticides on produce.

I agree: We need to re-assess the impact of intensive grazing on carbon balance.

I’m flabbergasted: You mean I shouldn’t be injecting fruit smoothies into my veins?

Question I’m Asking

What’s your vision of the future—optimistic or dystopian?

Recipe Corner

Time Capsule

One year ago (Mar 17 – Mar 23)

Comment of the Week

“Oh, man. Thanks for the bonus ab workout from the hilarious gummy bear link.”

– Just be careful of overtraining, whitedaisy.

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Weekly Link Love—Edition 20

Research of the Week

Neolithic Brits hosted massive feasts that drew people and pigs from all over the island.

Researchers say they’ve found a cholesterol-lowering drug without the muscle-damaging side effects of statins.

Among people with kidney disease, higher oxalate excretion in the urine predicts kidney disease progression.

“Our estimates imply that prescription opioids can account for 44 percent of the realized national decrease in men’s labor force participation between 2001 and 2015.”

High intensity interval training slows colon cancer cell growth.

After age 70, your fitness is the best predictor of lifespan.

Maternal infection during pregnancy increases the risk of neuropsychiatric disorders in the kids.

New Primal Blueprint Podcasts

Episode 319: Gretchen Rubin: Host Elle Russ chats with bestselling author, happiness expert, and good habit purveyor Gretchen Rubin.

Episode 320: Keto: Tippy Wyatt, Author of Asian Keto and Low Carb Cookbook: Host Brad Kearns chats with Tippy Wyatt in a wide ranging conversation about health, success, family, and balance.

Health Coach Radio Episode 3: Ali Watts: Hosts Erin Power and Laura Rupsis chat with Ali Watts about the differences between being a health coach and running a business.

Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

Media, Schmedia

Parents blame a nearby cell tower for an increase in cancer diagnoses at their elementary school.

“Trip of Passion,” a new film exploring the use of MDMA therapy for PTSD.

Interesting Blog Posts

Why the strange collection of sounds called music is a uniquely human obsession.

How the miniaturization of tools might have made us human.

Social Notes

My pantry staples.

Everything Else

Doctor delivers the bad news to his dying patient via robot.

Medieval diseases returning to Southern California.

Chickens gang up to kill intruding fox.

Things I’m Up to and Interested In

Film project you should back: Defying All Odds, the story of Dr. Terry Wahls astonishing lifestyle-based recovery from multiple sclerosis. This is an important story that people should know about.

Article I found fascinating: How the Inuit Teach Their Kids to Control Their Anger

I hope they look further into this: Inactive ingredients aren’t so inactive.

I’m not there yet: At what age do you feel 65?

Question I’m Asking

With “keto bloat,” the media seems primed to launch another barrage of “terrible keto side effect” coverage. Do you think this is legit concern or malicious fear mongering?

Recipe Corner

Time Capsule

One year ago (Mar 10 – Mar 16)

Comment of the Week

“For sure, ground sloth is slow food.”

– Excellent, Walter.

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Better diagnosis to improve breast cancer treatment

Breast cancer patients will soon have a better chance of fighting the disease thanks to new pathology guidelines created by University of Queensland researchers.

The guidelines allow pathologists to identify which patients have more aggressive forms of breast cancer, which means they can be classified appropriately and their treatment can be tailored.

Physical activity

Exercise is one of the best things women can do for themselves, says director of the Program for Young Women with Breast Cancer at Dana-Farber Cancer Institute. It doesn’t mean marathons or hot yoga, but walking three to five times a week can make a huge difference in terms of energy, stamina and how you feel during treatment. Partridge says that while exercising during treatment won’t be easy for every woman with breast cancer, it can be worthwhile if there are days during treatment cycles where women feel up to it.

Minority breast cancer patients tend to have higher rates of adjuvant treatment underuse. We implemented a web-based intervention that closes referral loops between surgeons and oncologists at inner-city safety net hospitals serving high volumes of minority breast cancer patients to assist these hospitals to improve care coordination.

Abstract and Introduction

Breast imaging has made huge advances in the last decade, and along with newer techniques to diagnose primary breast cancer, many novel methods are being used and look promising in detecting distant metastasis, recurrent disease and assessing response to treatment. Full-field digital mammography optimizes the lesion-background contrast and gives better sensitivity, and it is possible to see through the dense tissues by altering computer windows; this may be particularly useful in younger women with dense breasts. The need for repeat imaging is reduced, with the added advantage of reduced radiation dose to patients. Computer-aided detection systems may help the radiologist in interpretation of both conventional and digital mammograms. MRI has a role in screening women at high risk for breast cancer. It also aids in cancer management by assessing response to treatment and can help in deciding appropriate surgery by providing accurate information on the extent of the tumor. Newer diagnostic techniques such as sestamibi scans, optical imaging and molecular diagnostic techniques look promising, but need more investigation into their use. Their roles will appear clearer in coming years, and they may prove to be of help in further investigating lesions that are indeterminate on standard imaging. Other upcoming techniques are contrast-enhanced mammography and tomosynthesis. These may give additional information in indeterminate lesions, and when used in screening they aid in reducing recall rates, as shown in recent studies. PET/computed tomography has a role in detecting local disease recurrence and distant metastasis in breast cancer patients.

Prostate Problems Symptoms and Signs

  • The prostate is a gland that is a part of the male reproductive system that wraps around the male urethra near the bladder.
  • The gland is about the size of a walnut and grows larger as you age.
  • Enlargement of the prostate gland can cause symptoms, for example:
    1. Dribbling urine
    2. Pain or buring during urination
    3. Frequent urination
    4. Blood in the semen or urine
    5. Frequent pain or stiffness in the lower back, hips, pelvic or rectal area, or the upper thighs
    6. Urinary incontinence (the inability to urinate)
    7. Painful ejaculation
  • Common prostate problems in men include:
  • To diagnose the cause of the prostate problem, the doctor will do a rectal exam, patient history and take bacterial cultures if infection is suspected and ruling out prostate cancer.
  • Prostate cancer is common in men over 50, especially in African Americans and in men who eat fatty food and/or have a father or brother with prostate cancer.
  • Initiial procedures and tests to diagnose prostate cancer may include:
    • A rectal exam
    • Ultrasound
    • Assessment of prostate-specific antigen (PSA) levels
  • Prostate cancer is definitively diagnosed by a tissue biopsy.
  • Treatments for prostate cancer may include:
  • Many, but not all, doctors believe that men under the age of 75 should have yearly PSA tests.
  • Identifying prostate problems early is a way to reduce future prostate problems.