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Why men get cancer more than women and how they can manage their risk

Men and cancer risk
Doctors have known for decades that men are more likely to develop cancer than women. Now they may know why.

Doctors have known for decades that men are more likely to develop cancer than women. Men have a one in two chance of being diagnosed with cancer during their lifetimes; for women, the chance is one in three, according to the National Cancer Institute (NCI).

Scientists once believed that the increased risk was tied to lifestyle differences. For decades, men were heavier smokers and drinkers, and their work environment may have raised their risk. For instance, men who work in factories may have been exposed to carcinogens, such as asbestos and other industrial toxins or fumes. But even as more women started smoking, drinking and joining the workforce, the incidence of cancer remained consistent. For decades, no one could pinpoint the cause for the disparity.

Then, in a 2016 study led by the Broad Institute of MIT and Harvard and several hospitals, investigators uncovered a genetic explanation for the difference. Females, as it turns out, carry an extra copy of certain protective genes in their cells that men don’t have. These genes act as an additional line of defense, preventing cells from growing out of control and causing cancer. These protective cells aren’t entirely responsible for cancer’s bias toward males, but scientists believe they account for some of the gender imbalance, especially for cancers that occur two to three times more often in men vs. women, including head and neckesophageal and bladder cancers.

Even though men may not have the protective genes that women have to reduce their risk of cancer, they can take certain steps that may help them take control of their risk. In this article, we’ll explore the five most common cancers among men and steps they can take to lower their risks. These cancers include:

We’ll also review specific steps men can take to make healthy lifestyle changes that may reduce their cancer risks.

If you or a loved one have been diagnosed with prostate cancer or another cancer common to men and are interested in getting a second opinion, call us or chat online with a member of our team.

Prostate cancer

Prostate cancer is the most common non-skin cancer and the second leading cause of cancer death among American men. Since the introduction of the prostate-specific antigen (PSA) blood test in the 1990s, the death rate has declined significantly. NCI estimates that the five-year survival rate for men diagnosed with early-stage prostate cancer is 98 percent, and 90 percent of all cases are now diagnosed at an early stage, when the cancer has not spread beyond the prostate gland.

“PSA screening was once controversial,” says Shawn Blick, MD, Urologic Oncologist and Men’s Health Specialist at City of Hope Phoenix. “There used to be concerns about over-diagnosis and treatment, but the data shows that PSA screening improves the chances of survival. Additionally, the emergence of active surveillance or ‘watchful waiting’ means that a man diagnosed with early-stage, localized prostate cancer may not need surgery or any treatment for many years or in his lifetime.”

How to reduce your risk

  • Get screened as recommended by your doctor. The age you should begin screening and the frequency of your screenings may be different if you’re of African-American or Caribbean descent, since prostate cancer tends to develop earlier and is more prevalent in men of these ethnicities.
  • Know your family history. Having a brother or father with prostate cancer doubles your risk. Also, inherited genes (including the BRCA1 or BRCA2 genes linked to breast and ovarian cancer and genes associated with Lynch syndrome) may increase your risk and affect your screening schedule.
  • Maintain a healthy weight. A higher body-mass index (BMI) is associated with advanced prostate cancer, according to the American Institute of Cancer Research (AICR).
  • Exercise regularly. Engage in 150 to 300 minutes of moderate physical activity or 75 to 150 minutes of vigorous activity every week. Work in your yard, paint your house, bike, hike, walk around the block, play with your children or grandchildren, dance or participate in sports. All types of physical activity have health benefits.

“Being overweight or obese makes it easier for cancer cells to grow and multiply,” says Nathan Schober, MS, Dietitian and Certified Cancer Exercise Trainer at City of Hope Atlanta. Research shows that excess body fat (called visceral fat), deprives the body’s cells of oxygen, resulting in inflammation. Long-term inflammation disrupts how healthy cells divide and die, which may increase your risk of developing cancer.

“In general, anything that’s good for your heart is also good for your prostate,” Dr. Blick adds. “Good lifestyle choices, such as exercising, eating a healthy diet and managing your stress, will help reduce your risk for prostate disease.”

Lung cancer

Lung cancer is the second-most common non-skin cancer among American men and the deadliest cancer for men and women, accounting for almost 25 percent of all cancer deaths. But the number of new lung cancer cases has decreased significantly (down 40 percent since 1965). Experts attribute the decline to people quitting smoking as well as advances in early detection and treatment.

Most people diagnosed with lung cancer are 65 or older; a small number of people diagnosed are younger than 45. Firefighters, miners and others exposed to asbestos or high concentrations of radon are at greater risk of developing lung cancer.

How to reduce your risk

  • Don’t smoke. Studies show that men who smoke are 23 times more likely to develop lung cancer. If you currently smoke, ask your doctor to work with you to develop a plan to quit.
  • Know your family’s history. Studies show that having first-degree relatives (parent, sibling or child) with lung cancer increases your risk for the disease. The risk applies whether you’ve smoked or not, although the risk is lower for those who never smoked.
  • Avoid radon exposure. Radon is a colorless, odorless, radioactive gas that can attach to dust and be inhaled. When trapped indoors, such as in a basement, it may increase your risk for lung cancer. Reduce your risk by testing your home, and if needed, having it treated.
  • Get screened. If you’ve smoked a pack or more of cigarettes a day for many years and you’re between the ages of 50 and 80, even if you’ve quit within the past 15 years, schedule a low-dose CT scan. Also, first responders, firefighters and anyone exposed to chemical toxins should talk to his or her doctor about screening.

Colorectal cancer

In recent years, the risk of developing colorectal cancer has increased, particularly among younger adults. While 90 percent of the cases still occur in people aged 50 or older, colorectal cancer has been increasing 1 percent to 3 percent annually in younger men and women. The dramatic rise prompted the American Cancer Society (ACS) to decrease its recommended age to start colorectal screening, from age 50 to 45.

Colorectal cancer is the third-most common non-skin cancer in the U.S., with people of African-American, American Indian, Alaskan Native and Jewish descent at increased risk. Certain health conditions, such as inflammatory bowel disease (IBD)—including ulcerative colitis or Crohn's disease—or type 2 diabetes also raise your risk for the disease.

How to reduce your risk

  • Maintain a healthy weight. Obese men have about a 50 percent higher risk of colon cancer and a 25 percent higher risk of rectal cancer. Obesity is defined as having a BMI of 30 or greater.
  • Limit alcohol intake. According to AICR, strong evidence indicates that moderate to heavy alcohol consumption (more than one ounce per day) increases the risk colorectal cancer.
  • Don’t smoke. According to a report by ACS, the International Agency for Research on Cancer found definitive evidence that smoking tobacco causes colorectal cancer.
  • Know your family’s history. Men with a first-degree relative who’s had colorectal cancer have two to four times the risk of developing the disease. The risk is greater if a family member was diagnosed before age 50 or if you’ve had multiple relatives affected by colorectal cancer or colon polyps.
  • Get screened. Starting at age 45, or younger if any of the risk factors above apply to you, talk to your doctor about which screening method is right for you.
  • Eat a balanced diet. The AICR advises a diet rich in non-starchy vegetables, fruits (including those with vitamin C, such as oranges and tomatoes), foods made from whole grains, dairy (including milk and cheese) and fish (for its omega-3 fatty acids and vitamin D). The organization also recommends limiting red meat (beef, pork and lamb) to no more than 12-18 ounces per week and avoiding processed meats, which is anything salted, smoked or cured.

“Processed meat is categorized in the same group as asbestos and smoking when it comes to cancer risk,” Schober cautions, advising that men try to work as many colors (of plant-based foods) as you can into your diet. “Non-starchy vegetables and fruits, like broccoli, cauliflower, pumpkin and grapefruit, contain phytonutrients (antioxidants) that provide additional benefits and can’t be found in supplements or vitamins. For example, indole-3-carbinol, which is found in cruciferous vegetables, has been shown to increase the body’s capacity to rid itself of toxins and help prevent cancer cells from developing.”

Bladder cancer

Bladder cancer is the fourth-most common cancer in men, and males are nearly four times more likely than females to be diagnosed with the disease, according to NCI. About 9 out of 10 people who are diagnosed with bladder cancer are over age 55. Caucasians are also more likely to get bladder cancer than African Americans or Hispanic Americans.

While screenings aren’t available, research shows a direct connection between a sedentary lifestyle and the risk of bladder or kidney cancer.

How to reduce your risk

  • Get moving! Whether it’s walking, swimming, going to the gym or hitting a nature trail, find something you like to do. You’ll be more likely to stick to it.
  • Stop smoking. Cigarette smoking is the single greatest risk factor for developing bladder cancer, according to ACS.
  • Stay hydrated. Each person has unique hydration needs based on variables that include age, gender and weight. A good rule of thumb is to aim for at least 64 ounces a day, or eight cups. 
  • Protect yourself against workplace toxins. Ask your employer for protective gear if you work around chemicals that have been linked to bladder cancer, including those found in paint, hair dye, rubber, leather, textiles and diesel fuel.

Melanoma

Melanoma, a form of skin cancer, is the fifth-most common cancer in the United States and is more prevalent and deadly in men. “White adolescent males and young adult men are about twice as likely to die of melanoma as are white females of the same age. By age 50, men are also more likely than women to develop melanoma,” the American Academy of Dermatology website says. “This number jumps by age 65, making men two times as likely as women to get melanoma.”

Studies show that men are less likely to apply sunscreen, but this fact alone doesn’t account for the differences, according to experts. Men’s skin has less fat beneath the surface and contains more collagen and elastin than women’s skin. Research has shown that these differences make men’s skin more likely to be damaged by the sun’s ultraviolet (UV) rays.

While you can’t change how your skin reacts to the sun, protection may reduce your risk of melanoma and other skin cancers.

How to reduce your risk

  • Apply sunscreen (SPF 30 or greater) daily even on cloudy days and in winter.
  • Avoid the sun’s strongest rays (typically from 10 a.m. to 2 p.m. in summer).
  • Wear a wide-brimmed hat and sunglasses.
  • Wear long sleeves and pants when possible.
  • Check your skin regularly for any new or unusual growths, or changes in the size, shape or color of an existing spot. If you find anything suspicious, discuss it with your primary care doctor or a dermatologist.

“Preventative medicine just makes sense,” says Dr. Blick. “That includes making the necessary lifestyle changes to protect your health and reduce your risk of cancer and other diseases.”

Since making lifestyle changes is difficult for most people, Schober shares the following tips, noting that what’s important is finding what works for you.

Tips for making healthy lifestyle changes

  • Set SMART goals (Specific. Measurable. Achievable. Realistic. Time-bound) and write them down. Check your progress regularly.
  • Share your goals with a buddy who’ll hold you accountable. Set up a weekly time to call or text to update him or her on your progress. Setting deadlines will help keep you on track.
  • Make small, gradual changes to increase your chances of success. A short walk or exercising to an online video for five to 10 minutes a day is an easy way to get started.
  • Change your mindset. Instead of focusing on what you shouldn’t eat, drink or do, think of yourself as someone who wants to be healthy and live a full life.
  • Try “habit stacking.” Identify a current habit you already do each day and stack your new behavior on top. For example, when you sit down to dinner, always put veggies on your plate first. Or, whenever you see a set of stairs, take them instead of using the elevator.
  • Use a mobile health app. From free food and exercise trackers like MyNetDiary or MyFitnessPal to fee-based lifestyle approaches like Noom, a mobile app may provide the feedback and encouragement you need to make healthy, sustainable lifestyle changes.

If you or a loved one have been diagnosed with prostate cancer or another cancer common to men and are interested in getting a second opinion, call us or chat online with a member of our team.