By far, the most common cancer for men of all races in the United States is prostate cancer. It affects nearly twice as many men as the second most common form, lung cancer.

For this reason, it is essential that men understand how to prevent prostate cancer, how to screen for it, and how to treat it if it is diagnosed.

How to Prevent Prostate Cancer

*To prevent cancer, the key is to avoid risk factors and increase protective factors.

Diet: Changes in diet can significantly reduce the risk of prostate cancer. For the greatest reduction in risk, introduce the following changes into your diet:

• Eat cooked tomatoes. Lycopene is an antioxidant with proven cancer-fighting properties. The most common source of lycopene in the diet is tomatoes. Lycopene availability is increased with cooking, which means that eating spaghetti sauce is an excellent way to reduce your chances of getting prostate cancer. Pile on the sauce!

• Eat fish. Several studies have found an association between eating fish and reduced rates of developing prostate cancer. Try to eat fish—especially fatty ones like salmon and mackerel, several times a week. To maintain the nutritional value, cook fresh or frozen fish by baking or broiling, not using high heat, which can destroy the fatty acid content.

• Drink coffee. Men who drink six or more cups of coffee a day have a reduced risk of getting prostate cancer, especially the more lethal kinds. Introduce more coffee in your daily routine to prevent prostate cancer; just don’t load it up with sugar!

• Eat leafy greens. Most people know that you are supposed to be eating several servings of fruits and vegetables a day as part of a healthy diet. Make sure that some of those servings are leafy greens like spinach. Eating several servings a week of leafy greens can cut your risk of prostate cancer.

• Foods to avoid. It’s not just about adding or increasing specific foods with nutritional benefits to your diet. You should also cut back on—or eliminate, certain foods that are harmful or provide limited nutritional benefit. These include carbohydrates with a high-glycemic index (like white bread and table sugar), corn oil, and red meat that has been cooked “well-done.” These foods either increase inflammation or promote the development of carcinogens, both of which can increase the risk of prostate cancer.

Ejaculation: There is evidence that men who ejaculate several times a week on average have a lower risk of getting prostate cancer than men who ejaculate less. Ejaculation can occur with sexual intercourse or masturbation. This could be due to a cleansing effect, with the removal of toxins or carcinogens from the prostate. Especially for older men, who are at a higher risk of getting prostate cancer, consider increasing the frequency of ejaculation in order to lower your risk.

Chemoprevention: There is evidence that the 5-alpha reductase inhibitors finasteride and dutasteride can reduce the incidence of prostate cancer. Have a discussion with your primary care physician or urologist about their risks and benefits to see if you are a candidate to take them.

Supplements: There is no strong evidence for a significant role of supplements in preventing prostate cancer. However, a major study showed that high doses of Vitamin E increase the risk of prostate cancer. Try to get your nutrients from your diet and avoid high doses of vitamins.

How to Screen for Prostate Cancer

PSA: PSA stands for prostate-specific antigen. It is increased in the blood in men who have disease of the prostate. A high PSA could be due to cancer or to a benign condition like inflammation or enlargement of the gland. Currently, there are conflicting recommendations about whether men should get their PSA levels checked. Some physicians still believe it plays an important role in screening for prostate cancer, so if you are over 40 years of age, talk to your doctor. Be sure to tell your doctor if you have a history of prostate cancer in your family.

Digital rectal exam: This is a simple physical exam to determine whether the prostate is enlarged or has any nodules that can be felt. An enlarged prostate does not mean there is cancer; enlargement of the prostate can also occur in the condition called benign nodular hyperplasia. Since it can still provide helpful information, make sure you get a digital rectal exam from your doctor if you are older than 40 years of age.

Biopsy: A biopsy of the prostate might be recommended if screening shows atypical findings, such as a PSA that is high without explanation. Biopsy is usually how prostate cancer is diagnosed for the first time. Do not ask for a biopsy without having first undergone PSA testing.

How to Treat Prostate Cancer

Pathology report: You have gotten a biopsy, and the report comes back: you have prostate cancer. The first thing you should do is get a copy of the pathology report. Read it, and ask your doctor to explain things that you don’t understand.

Surveillance: Not everyone who is diagnosed with prostate cancer on biopsy needs to be treated right away. Some patients with less aggressive cancers monitor it with repeat PSA tests, digital rectal exams, and biopsies. If you have been diagnosed with a less aggressive prostate cancer, decide with your doctor if you want to be treated or to monitor it.

Radiation therapy: If you have decided to explore your treatment options, meet with a radiation oncologist. There are a number of radiation therapies available. The doctor will explain your options.

Prostatectomy: Prostate cancer used to be commonly treated with surgical removal of the prostate. This is not as common now but is still an important option. If you are weighing your treatment options, talk to your urologist about the risks and benefits of prostatectomy.

Chemotherapy: If you have more advanced disease, such as spread to other parts of your body, you will want to consider chemotherapy. Talk to a medical oncologist about your options for chemotherapy, which can limit and slow the spread of cancer.

Hormonal therapy: If you have advanced disease, you should also talk to your doctor about hormonal therapy, which prevents the hormone testosterone from helping the cancer grow.

By following the above recommendations, men can take charge of their health by taking concrete steps to lower their chances of getting prostate cancer, understand how to screen for it if they are over 40 years of age, and understand how to treat it if they are diagnosed.