Preventive medicine and men’s health in urologic oncology: Part I

Abstract

Welcome to the second part of this unique two-part series. Part I included a review of statins for chemoprevention, obesity and its impact in urologic oncology, and important serum markers and risk assessment for men. In an attempt to remain consistent with the theme of part I, there are several other unique articles in part II. An emerging novel issue in oncology and cardiology is the potential for omega-3 fatty acids from the diet and dietary supplements to reduce risk—not only in men’s health, but for a variety of medical conditions. This is what makes this intervention so important—the ability to impact a diversity of morbidities and possibly all-cause mortality. This should be a primary pursuit of oncologic research in the future, because as life expectancy continues to increase it is the agents that have a so-called 2-for-1 effect that have the greatest potential to impact medicine, rather than an intervention that just shifts the burden of disease from one area of medicine to another. Therefore, another article on statin drugs and cholesterol lowering was included because these agents and their potential pleiotropic effects, including their potential impact after a diagnosis of cancer, need to be discussed. Finally, a review on promoting general men’s health after receiving hormone suppressive therapy for prostate cancer is also included. This article has important applications in medicine because of the stage migration that has occurred in prostate cancer. Several decades ago, the issue of maintaining overall health during androgen suppression was not actually an issue because most men were not offered this treatment until late in disease progression. However, the situation currently is very different, due to the fact that many men are opting for this treatment earlier in the course of prostate cancer. This has offered a potential survival advantage, but with a critical catch. Quality of life and side effects of this treatment have become a primary focus of this treatment, as should be the case because men are receiving it for longer and longer periods of time than ever before. Osteoporosis, hot flashes, weight gain, cholesterol changes, cognitive effects and others are now being appropriately debated, along with what to do about these emerging issues the longer a man remains on hormone suppression. The concern of what to tell patients about actions they can take during this time to prevent complications is just as critical. Thus, what needs more attention is how to potentially prevent these complications, which means that preventive medicine has numerous roles in the field of urologic oncology, not just in outright prevention of disease, but again in preventing complications of beneficial treatments. Men are living longer and better today thanks to ongoing developments in research and beneficial lifestyle changes.