The curious but far from comforting fact about prostate cancer is that many of us men don’t discover we have it until the later stages of its development. Earlier detection would be possible, but delayed diagnosis is primarily the result of inadequate or a lack of a good general health check.

Prostate cancer typically develops slowly over many years, often decades. The exact time varies; some may take 10-30 years from initial cellular changes to the development of a detectable tumour, although aggressive forms can progress more rapidly.

Men may become aware through screening (PSA tests) before symptoms arise, usually starting around age 50 or earlier for high-risk individuals. Without screening, awareness might come when symptoms appear, which often indicates more advanced disease. However, early stages are frequently asymptomatic, emphasising the importance of screening discussions with healthcare providers.

I should also note that awareness doesn’t always mean symptoms. Many men live with low-risk prostate cancer without it affecting their lifespan, especially if it’s monitored through active surveillance.

Copy and paste

In many of his health talks, Dr William Li explains how our bodies form and fight cancers throughout our lives.  

“We form cancers all the time, including in our prostate,” he says. “Our bodies are 40 trillion cells that copy and paste all the time, and when it makes a little mistake or has a mutation, that mistake leads to a microscopic cancer.

“It happens all the time in children and adults, and most of the time, we’ll never notice it. It’s like a pimple that forms on your back. Maybe someone behind you will notice it, but you never know it, and then the body takes care of it all by itself.”

Dr Li is involved in a fascinating field that works to understand the process of angiogenesis – the natural process of forming new blood vessels from existing ones. It is crucial for growth, development, wound healing, and delivering oxygen and nutrients to tissues.

He says work in this area is helping us gain a new understanding of how cancer develops in the human body.

With cancer, “it’s not like we’re just hit with a javelin one day. We’re forming cancers all the time,” Li says. The point he stresses, however, is that none of them are ever a problem “until they develop a blood supply.”

Like every organ, the prostate needs a blood supply, “and prostate cancers can form over the course of a lifetime, but autopsy studies have shown that 50 per cent of men between 50 and 60 years of age already have microscopic prostate cancers.

“Most of them are never going to become a problem. You won’t need chemo; you won’t need surgery because the body, including the prostate itself, can cut off the blood supply and prevent it from taking off. That is the body’s way of stopping tumour angiogenesis.

“We can treat cancers by cutting off the blood supply, but treatments are not as good as foods that can stop angiogenesis to prevent the cancer from growing in the first place.”

This is the point where food becomes medicine.

“There are foods that are natural bio-actives that can cut off the blood supply to tumours, and there’s clinical evidence that shows this works,” Dr Li says.

Looking at lycopene

“The best example, I think, is a substance called lycopene. Lycopene is a carotenoid found in watermelons, tomatoes, guava, pink grapefruit and papaya.  Lycopene is anti-angiogenic, meaning it cuts off the blood supply to tumours. It won’t starve your heart. It won’t starve your wound healing.

“A study of 49,000 men showed that those who ate more cooked tomatoes (over 25 yrs) had a lower risk of developing prostate cancer by 29 per cent.” Further investigation found those with significantly reduced risk ate cooked tomatoes two to three times a week.

“That’s not very often and not very much tomato either. Each serving was only half a cup each time. Now, if I invited you to my house to have some pasta and gave you only half a cup of tomato sauce, you’d ask me for some more.”

Tree nuts, such as walnuts, pecans, almonds, cashews, pistachio, macadamia, are also beneficial.

“They all contain another substance that are the plant version of omega-three fatty acids. The plant version is ALA. The body will convert it to omega-3; once it’s converted, it’s also anti-angiogenic.

“A study of 1253 men in Canada showed that those men who ate one serving of tree nuts every day had a 31 per cent lower risk of developing clinical prostate cancer.”

Dr Li admits that this was not a preventative piece of data, “it’s a correlation, but it shows you that the stuff in our food helps our body’s health defences, including tumour angiogenesis.”

Ferulic acid also helps

He also refers to a much smaller study (340 participants) of men consuming foods containing high amounts of ferulic acid, such as eggplant, spinach, beets and coffee.

“So, the question is: Is diet a reasonable way to prevent slow prostate cancer or maybe both? The answer is yes. A healthy diet that contains foods with lycopene, ferulic acid, caffeic acid, and omega-3s amplifies your body’s anti-angiogenic, cancer-starving system. It can slow down and prevent prostate cancer growth.”

On a broader, more general note, prostate cancer often does not cause noticeable symptoms in its early stages, which is why it can go undetected for years. Symptoms typically appear only when the tumour has grown larger or spread beyond the prostate.

Men are typically encouraged to start regular prostate cancer screening discussions with their doctor around age 50 (or earlier—e.g., age 40–45—for men with a family history or higher-risk individuals, such as African-American men).

Common symptoms include:

• Difficulty urinating (e.g., weak stream, trouble starting or stopping).
•   Increased frequency of urination, especially at night.
•   Blood in the urine or semen.
•   Pain or discomfort in the pelvic area, hips, or back (if the cancer has spread to nearby tissues or bones).
•   Erectile dysfunction or other sexual difficulties.