Worried About Prostate Cancer? Here’s What to Know.

Summary

Chasing Life: Worried About Prostate Cancer? Here’s What to Know

Episode Release Date: May 27, 2025
Host: Dr. Sanjay Gupta

In this insightful episode of Chasing Life, Dr. Sanjay Gupta delves into the critical topic of prostate cancer, addressing common concerns and providing valuable information to help men navigate their health decisions. With a focus on recent developments and personal questions from listeners, Dr. Gupta offers a comprehensive guide to understanding prostate cancer risk, screening, and prevention.

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Introduction: The Importance of Prostate Cancer Awareness

The episode opens with Dr. Gupta acknowledging the recent news of former President Joe Biden's diagnosis with an aggressive form of prostate cancer. This high-profile case has understandably raised public concern and prompted many to seek clarity on prostate cancer risks and management.

“One in eight men will be diagnosed in their lifetime. It is the second leading cause of cancer death in American men.”
— Dr. Sanjay Gupta [01:03]

Dr. Gupta emphasizes the significance of prostate cancer awareness, highlighting its prevalence and the pressing need for informed decision-making regarding screening and prevention.

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Screening for Prostate Cancer: Who and When?

One of the most pressing questions addressed is who should be screened for prostate cancer and at what age. Dr. Gupta outlines the varying recommendations from major medical organizations, noting the lack of consensus which often leaves men uncertain about when to begin and cease screening.

“The U.S. Preventive Task Force says stop screening after age 70... Prostate cancers are typically slow-growing.”
— Dr. Sanjay Gupta [02:00]

Recommendations Breakdown:

• U.S. Preventive Task Force:

  • Start Screening: Generally at age 50 for men at average risk.
  • Stop Screening: After age 70, considering the slow progression of most prostate cancers and the potential for unnecessary procedures due to false positives.

• Alternate Guidance:

  • Start Screening: At age 50 for average-risk men.
  • Continue Screening: Until life expectancy is reduced by less than 10 years, which may extend beyond age 70 for healthier individuals.

Dr. Gupta underscores the importance of personalized medical advice, advising listeners to consult with their healthcare providers to determine the best screening regimen based on individual health profiles and family history.

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Family History and Genetic Risk Factors

Addressing the role of genetics, Dr. Gupta discusses how family history significantly impacts prostate cancer risk. Men with a father or brother diagnosed with prostate cancer face a more than double risk of developing the disease themselves.

“Having a father or brother with prostate cancer more than doubles a man's risk... even higher if multiple relatives are affected, especially at a young age.”
— Dr. Sanjay Gupta [07:15]

Key Points:

• Increased Risk:

  • Father or Brother: Doubles the risk.
  • Multiple Relatives: Further increases risk, particularly if diagnosed at a younger age.

• Racial Factors:

  • Higher Prevalence: Black men are more frequently diagnosed with prostate cancer compared to white men.

• Hormonal Influence:

  • Testosterone Conversion: Testosterone is converted into a chemical that aids in normal prostate growth but may also contribute to cancer development in susceptible individuals.

For men with a strong family history or other high-risk factors, Dr. Gupta recommends starting screening earlier, such as at age 45 or even 40, to ensure timely detection and management.

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Diet and Prostate Cancer Risk: The Role of Folate

A listener from Niceville, Florida, inquires about dietary choices that may reduce prostate cancer risk. Dr. Gupta addresses the complex relationship between diet and cancer prevention, acknowledging the challenges in nutrient-specific studies.

“Foods high in folate, such as green vegetables and beans, have pretty good evidence for lowering prostate cancer risk.”
— Dr. Sanjay Gupta [09:20]

Key Dietary Insights:

• Folate-Rich Foods:

  • Sources: Green vegetables (e.g., spinach, broccoli), beans, and orange juice.
  • Benefits: Studies indicate that adequate dietary folate intake may reduce the risk of developing prostate cancer.

• Folic Acid Supplements:

  • Risks: Contrarily, supplementation with synthetic folic acid has been linked to an increased risk of prostate cancer in some studies.
  • Recommendation: Emphasize obtaining folate from natural food sources rather than relying on supplements.

Dr. Gupta advocates for a balanced diet rich in natural folate as a preventive measure against prostate cancer, cautioning against the overuse of supplements which may have unintended adverse effects.

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Treatment Insights: A Look at President Biden’s Case

Drawing from the example of President Biden, Dr. Gupta explains hormone-sensitive prostate cancer and its treatment options.

“Cancer cells were hormone-sensitive, meaning hormones were fueling the cancer’s growth. Blocking hormones can treat or halt its progression.”
— Dr. Sanjay Gupta [07:15]

Treatment Modalities:

• Hormone Therapy:

  • Mechanism: Blocks hormones that promote cancer growth.

• Chemotherapy and Radiation:

  • Application: Particularly targeted when cancer has metastasized to bones, as in President Biden’s case.

Dr. Gupta highlights the importance of individualized treatment plans, especially for advanced-stage prostate cancer, to effectively manage and control the disease.

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Conclusion: Empowering Informed Health Decisions

As the episode wraps up, Dr. Gupta reiterates the importance of proactive health management and encourages listeners to engage in open conversations with their healthcare providers about prostate cancer screening and prevention strategies.

“Hope that helps... It’s complicated when it comes to prostate cancer, but worth talking to your doctor about it.”
— Dr. Sanjay Gupta [02:00]

Key Takeaways:

• Screening: Start at age 50 for average-risk men; earlier for those with higher risk factors.
• Family History: Significant influence on personal risk; necessitates tailored screening approaches.
• Diet: Emphasis on natural folate sources to potentially lower prostate cancer risk.
• Personalized Care: Consulting with healthcare providers is crucial for making informed decisions based on individual health profiles.

Dr. Gupta concludes by inviting listeners to continue seeking knowledge and support, reinforcing the mission of Chasing Life to disseminate actionable health insights.

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Produced by: Aaron Mathewson, Jennifer Lai, Grace Walker, Lori Galleretta, Jesse Remedios, Sofia Sanchez, and Kira Dehring.
Medical Writing: Andrea Kane
Senior Producer: Dan Bloom
Executive Producer: Steve Lichtai

For more information or to submit your health questions, visit asksanjayn.com or call 470-396-0832.

Transcript

[Carl Zimmer]

Chasing Life is supported by the World as yous'll Know It, a podcast about the forces shaping the future. In this season, host and science journalist Carl Zimmer speaks to some of the most respected scientists in the field of aging research about the massive changes in human longevity and what comes next. Is our lifespan set or will a breakthrough add decades to our lives? Can older brains be rewired to function like younger ones? Which so called biohacks actually work? The world as you'll know it is available now.

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[Sanjay Gupta]

Welcome to paging Dr. Gupta, one of my favorite times of the week. Thanks so much for joining us. I get a chance to hear from you, which I really enjoy. I also get a chance to try and answer the health questions that you've been thinking about. And I just want to say thank you for sending in so many thoughtful, personal questions, timely questions. For example, you've probably seen the sad headlines. Former President Joe Biden diagnosed with an aggressive form of prostate cancer, stage 4 prostate cancer. Cancer that has already spread to his bones. It's tough news for sure. And he and his family were thinking a lot about them. We know that they are reviewing treatment options right now. It has generated a lot of questions about prostate cancer. And no surprise, I mean, one in eight men will be diagnosed in their lifetime. It is the second leading cause of cancer death in American men. So let's try and get to as many of these questions as we can. Kira, who are we hearing from first?

[Kira]

Hey, Sanjay, first up, our question is coming from Robert in Seattle asking who should screen for prostate cancer and when.

[Sanjay Gupta]

Okay, Kira, thank you. And Robert from Seattle, thank you. This is really the crux of the whole issue. Who should be screened and when. And a lot of major medical organizations don't necessarily agree with each other when it comes to these recommendations in terms of when to start screening and perhaps most importantly, when to stop screening as well. Now, the U.S. preventative Task Force, they basically say Stop screening After age 70. That's the recommendation. Why? A couple reasons. One is that, you know, typically prostate cancers are slow growing. So if you're already in your 70s, the question is, will this prostate cancer be likely to grow fast enough to be a problem in your lifetime? That's sort of how they approach this. The second thing I think is the fact that the PSA test, the screening blood test, is not a perfect test. It has a high rate of false positive results, up to 70%, according to the American Urological Association. Someone whose results show elevated levels may then need a procedure, a biopsy, to rule out cancer. And most of those patients, the biopsy will come back negative. To give you some context, for people who get a biopsy of their prostate because of an elevated PSA, only about a quarter of them, 25%, will subsequently be found to have cancer. Okay, so that means for a lot of people, they got a procedure that really was not necessary, and they had a lot of concerns and anxiety and worry as well. But that is sort of an explanation as to why the Preventative task Force says 70 years old. Now, as I said, a lot of organizations don't necessarily agree with that. When we looked at all the various recommendations, I think the way that we sort of landed on this was to say that screening should start at age 50 for men who are at average risk of prostate cancer and should continue to the point where you're expected to live at least 10 more years. Now, obviously that's a hard thing to know, and that's why you should talk to your doctor about this. But if you still have at least 10 years of life, if you get into your 70s and you're healthy, no heart disease and no other cancers or dementia, you may say, look, I think I could live a long time still, or at least more than 10 years, I should continue to get screened. It's complicated when it comes to prostate cancer, but worth talking to your doctor about it. When it comes to Biden, for example, keep in mind that he's 82 years old. Average life expectancy for a man in the United states is about 76. But, you know, if you go into your 70s and you're pretty healthy, you may want to consider the screening. Now, the screening typically involves a physical exam, a PSA blood test. We know in the case of President Biden, he also had imaging which showed that the prostate cancer had actually gone to his bones as well. But again, just to reiterate, for most men, Robert, starting around age 50 and continuing till at least the point where you have 10 years of additional life expectancy. Hope that helps. All right, stick around because right after the break, we're gonna answer more of your questions, including how family history factors in and what role your diet may play in lowering risk.

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[Sanjay Gupta]

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[Sanjay Gupta]

All right, let's check that next page. Kira.

[Kira]

So we have Noel here who said my father had prostate cancer. Does this increase my risk of getting the disease?

[Sanjay Gupta]

All right, Noel, the short answer is yes, it does. Having a father or brother with prostate cancer more than doubles a man's risk of developing this disease. The risk is higher for men who have a brother with the disease than it is for those who have a father with it. But the risk is even higher, though, if you have several affected relatives, particularly if those relatives were young when the cancer was found. Okay, so age. This cancer is rare in men younger than 50 years of age. So if you have somebody who's diagnosed early, it does increase the risk for other family Members race more often in black men than in white men. Hormones. Testosterone is changed into a chemical that's important for normal prostate growth, but it can also cause the prostate to get bigger. And that could play a part in the development of prostate cancer if you are at higher risk. So in those cases, probably want to start the screening even earlier. Age 45, for example, for men at high risk of developing prostate cancer, and age 40 for men who are at even higher risk, meaning you have more than one first degree relative with prostate cancer at an early age. One thing I should point out, for example, with regard to president Biden, they learned that the cancer cells were hormone sensitive. Okay, now what does that mean? That means they have these hormone receptors on the cancer cells, which means these hormones are probably fueling the cancer, causing it to grow. By blocking the hormones, hormone therapy, you could actually start to treat the cancer or at least stop it from growing. You combine that with chemotherapy and radiation. And the radiation is specifically for the component that's in the bones of this cancer. That might be the sort of treatment that ultimately he gets. All right, Kira, I think we got time for one last question.

[Kira]

Okay, Sanjay, this last one is coming from Jeff in Niceville, Florida, wanting to know if there are any dietary foods that can help reduce the risk of prostate cancer.

[Sanjay Gupta]

Niceville, Florida. I love it. What a great name. Diet. Okay, so let me preface by saying this. Food studies, when it comes to preventing cancer or increasing the risk of cancer are really hard to do. Quick, what did you have for dinner last Tuesday? Right. My point is that most people don't remember what they ate. They don't journal their food. It is hard to sort of look at food as a specific sort of thing and say, here are the foods that increase your risk or lower your risk. Having said that, when it comes to prostate cancer, there is something that a lot of studies do focus on, and that is foods high in folate. It's a kind of vitamin B that occurs naturally in some foods. Green vegetables, beans, orange juice. And there's pretty good evidence that folate can actually lower your risk of prostate cancer. One thing I do want to note though, is that folic acid is a man made form of folate, which is found in vitamin supplements and certain foods. But it's not a good substitute when it comes to reducing your risk of prostate cancer. There was a study from the journal of the National Cancer Institute that found that the risk of prostate cancer was lower in men who had enough folate in their diets. However, the risk of prostate cancer was actually increased in men who took 1 milligram supplements of folic acid. Unclear why. It could be that people who take folic acid are also less likely to get enough folate in their diet, thinking, hey, I'm supplementing. Why do I need to take more folate? That's not a good approach. You really want to get your folate in your diet if you're thinking about reducing your risk of prostate cancer and you want to make sure you're doing it from real food. So green vegetables, beans are really good. Spinach, broccoli and black eyed peas. Hope that helps. We should all be getting more folate in our diet whether we're concerned about prostate cancer or or not. Thanks to everyone who reached out with questions. Again, we got a lot of really personal questions, a lot of stories of your families, and I just want to say that we listen to these questions, we pay attention. Hopefully we're able to provide some good answers for you today. I really do enjoy hearing what's on your mind. If there's something you've been wondering about when it comes to health, here's the place to come. Don't keep it to yourself. Record a voice memoir, email it to asksanjayn.com or give a call 470-396-0832. Leave a message. Thanks for listening. We'll be back next Tuesday. Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Lori Galleretta, Jesse Remedios, Sofia Sanchez and Kira Dehring. Andrea Kane is our medical writer. Our senior producer is Dan Bloom. Amanda Seeley is our showrunner. Dan Dijiula is our technical director and the executive producer of CNN Audio is Steve Lichtai, with support from Jamis Andrest, John Dianora, Hailey Thomas, Alex Manasseri, Robert Mathers, Lainey Steinhardt, Nicole Pessarou and Lisa Namorow. Special thanks to Ben Tinker and Nadia Kanang of CNN Health and Wendy Brundage.

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[Audie Cornish]

This week on the Assignment with me, Audie Cornish. The Sean Diddy Combs trial is now in its second week, and the world is watching closely. We're asking how one man got so powerful that he was able to avoid scrutiny for so long. Like, did the music industry miss something? Did it choose to look away? Now that we know more, what kind of reckoning, if any, is going to happen in the world of hip hop? Listen to the Assignment with me, Audie Cornish. Streaming now on your favorite podcast, Apple.