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INTRODUCTION

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Over the past 50 years, the perception of prostate cancer in the USA has undergone radical change in the medical community. In the 1950s, the diagnosis of prostate cancer carried with it a high association with morbidity and mortality; patients commonly presented with metastatic disease and 75% of all treated patients died within 3 years [1]. In contrast, the past 25 years have seen the advent of widespread prostate cancer screening with prostate-specific antigen (PSA) as well as optimized surgical, radiotherapeutic and pharmacological treatments. Since the mid-1990s, the overall 5-year survival rate for men in the USA diagnosed with prostate cancer has exceeded 98% [2]. As a result, prostate cancer is currently viewed as an eminently treatable disease given proper screening and management.

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Despite the significant improvement in the diagnosis and treatment of patients with prostate cancer, there has been relatively little success in the prevention of this malignancy. Consequently, prostate cancer stands as the most common non-cutaneous malignancy in the USA with an estimated 234 460 new cases in 2006 [3]. The slow progress in preventing prostate cancer results from, for the most part, the ongoing struggle by researchers to identify the factors that affect the development of prostate cancer.

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While the details of prostate carcinogenesis remain elusive, studies on the epidemiology of prostate cancer have yielded the greatest amount of information regarding potential risk factors as well as preventative agents. To date, the most well-established prostate cancer risk factors include age, family history and race. While such endogenous risk factors are immutable, recent epidemiological studies have strongly suggested that exogenous risk factors, including environmental exposure as well as lifestyle, may also significantly influence the development of prostate cancer [4, 5]. Therefore, while genetic factors predispose an individual to prostate cancer, environmental triggers are also probably necessary for the manifestation of this malignancy. Furthermore, prostate cancer develops slowly, taking years or decades to become clinically manifest, leaving abundant time for preventative intervention strategies. This chapter summarizes the available data on nutrition and lifestyle interventions in the prevention of prostate cancer.

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NUTRITION

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Over the past several decades, there has been dramatic progress in the understanding of the molecular processes underlying carcinogenesis (Figure 1.1). More recently, it has become clear that dietary factors are able to modulate the events preceding tumorigenesis. As a result, there is considerable interest in determining what nutritional components might modify the risk of prostate cancer. Migratory and epidemiological studies have implicated a ‘Western diet’, characterized by a high intake of red meat, dairy produce and animal fat, in the development of prostate malignancy (Figure 1.2) [4, 6, 7]. As helpful as these studies have been in elucidating the relationship between diet and prostate cancer, they must be interpreted with caution. Even a statistically significant correlation between an exposure ...

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