How To Lower Prostate Cancer Risk…

Former US president Joe Biden’s recent diagnosis of aggressive prostate cancer has thrust this common men’s health concern back into the spotlight…and into the realm of well-intentioned but often confusing “advice.” 

Here’s what the science really says about what drives prostate cancer risk…and what, if anything, you can do about it.

The two faces of prostate cancer

Autopsy studies show that over 50 percent of men over 90 harbor prostate cancer cells…yet most never knew it. 

You have two “types” of prostate cancer; indolent tumors you’ll never die from and fast-growing cancers that demand urgent treatment. 

The three uncontrollable drivers

Decades of epidemiology confirm that age, ethnicity, and family history are by far the strongest predictors of both overall and aggressive prostate cancer:

1. Age: Risk rises sharply after 50, with most diagnoses in men over 70.
   
   

2. Ethnicity: Black men face roughly twice the lifetime risk of white men for both slow and aggressive forms .
   
   

3. Family history: A first-degree relative diagnosed before 60…or a BRCA2 mutation in the family…significantly increases your odds.
   
   

These three account for the bulk of the risk, and sadly aren’t modifiable.

Modifiable factors: What the evidence shows

Researchers have long hunted for lifestyle levers, but the picture is murky:

• Body weight: There’s consistent evidence that obesity correlates with higher rates of aggressive disease , although it’s unclear whether this reflects biology or lower screening uptake.
  
  
  

• Sexual Activity: A landmark JAMA study found men reporting ≥21 ejaculations per month at ages 20–49 had a 31 percent lower risk of prostate cancer compared to those with 4–7 per month. While fascinating, this association does not prove causation…and more research is needed before prescribing a “prostate-protective” sex regimen.
  
  

Bottom line: no single diet or supplement has emerged as a proven guard against the aggressive form.

Actionables to reduce your risk

Even though you can’t erase your baseline risk, you can tilt the odds:

1. Maintain a healthy weight. Having some oversight over total caloric intake on a weekly basis and aiming for at least 150 minutes/week of moderate exercise.
   
   

2. Eat for anti-inflammation. Focus on whole grains, vegetables, and fatty fish. Limit processed meats and keep dairy intake moderate.
   
   

3. Stay sexually active. The evidence on ejaculation frequency is intriguing…moderation and comfort are key.
   
   

4. Discuss screening early. If you’re over 50 (or over 45 with Black ancestry or a family history) talk to your GP about PSA testing and digital rectal exams.
   
   

5. Use a risk calculator. Prostate Cancer UK’s online tool takes under a minute and can help guide when to start screening (handy even if you’re not in the UK

P.S As an aside…if you want short, snappy info on gut health & microbiome tips once a week (a 1-2 minute read!) join here:

P.P.S Only join if you REALLY REALLY care about your gut health and or microbiome! (otherwise ignore this please)

Stop Being A Control Freak…

I used to believe that life was an intricate blueprint I was born to draft in full: every meeting scheduled, every meal precalculated, every outcome anticipated. 

My prefrontal cortex (that relentless control tower in my bone dome) hummed with endless to-do lists and “what-ifs,” leaving my amygdala fluttering like an overeager hummingbird. 

Then I learned about Maktub; the Arabic word for “it is written”...and its cultural cousins, “Que será, será” and “Amor fati.” Basically….you cannot micromanage every atom of your existence.

The cognitive toll of total control

Neuroscience suggests that our brains have limited bandwidth. 

Every time you try to forecast outcomes or iron out uncertainty, you recruit the frontoparietal network (your mental CPU) for decision-making. This results in “decision fatigue.” The more menu options you agonize over, the worse your later choices become. 

Acceptance as liberation

Recognizing that some currents flow beyond my paddle lifted a tremendous weight. 

In Eastern philosophy, surrendering to the river’s speed doesn’t mean drowning in complacency but it means learning to steer with grace, making minor course corrections rather than battling every eddy. 

Instead focus on the concept of “locus of control”: bring your attention to what you can actually influence….your efforts, your attitude, your next breath….while letting go of what you can’t: the weather, other people’s moods, the stock market’s mood swings.

The middle path: Agency with acceptance

Letting go isn’t throwing your hands up and surrendering to fate.

It’s more like piloting a sailboat: you adjust your sails to the wind’s whims, while steering toward your destination. You set your goals, but you don’t drag them behind like an anchor. 

A personal evolution

I’ll admit it: I was obsessive about optimizing every second; sleep cycles tracked, steps counted, emails triaged by urgency, importance, and caffeine tolerance. 

But over time, my sleep apps and spreadsheets started feeling like guillotines. When I embraced a little “It is what it is,” I noticed something pretty cool: my creativity soared, my stress decreased and I laughed at my own catastrophizing of previous months.

Today, I still sketch blueprints for my life; ambitious, audacious plans. 

But alongside them sits a humble admission that some chapters are already written, and resistance only breeds frustration. I’ve learned that true power lies in the tactical adjustments we make midstream: pausing to breathe, recalibrating when the unexpected currents rush us off course.

So here’s to less micromanagement, more surrender. After all, if Maktub means it’s already written, your job is not to demand a rewrite but become the best editor of the lines still unwritten!

A Menu For A Healthy Life…

When I was in medical school I feared cancer as the worst condition someone could have. But as I learned more about physiology and saw patients as a junior doctor I realised that there are a whole host of conditions like dementia which we don’t really have cures for and I feared this above all.

Alongside this heavy hitter; stroke and depression are close “allies” to dementia…a true axis of evil. Three unwanted musketeers. Yet a new meta-review in the Journal of Neurology, Neurosurgery and Psychiatry shows there are 17 modifiable factors that overlap across all three. 

It’s a bit of a dense read so I’ll try to summarise what I thought were some key findings from it that can actually help you and are easy to action!

The top culprit: High blood pressure

The scientists crunched 182 meta-analyses and then ranked each factor by disability‐adjusted life years (DALYs). Topping the list was hypertension. 

Midlife blood pressure spikes damage tiny cerebral vessels, driving up your risk of stroke, vascular dementia and even late-life blues. 

Checking your numbers and sticking to meds if prescribed isn’t glamorous, but it’s the #1 thing you can do for your brain.

The other 16 players

Some other factors here are “protective,” some are “risk enhancers,” and all backed by solid data..

Protective behaviours

• Low alcohol intake
  
  

• Regular cognitive workouts (reading, puzzles, languages)
  
  

• Diet rich in veggies, fruit, fish, dairy & nuts
  
  

• Moderate-high physical activity
  
  

• Strong social ties & sense of belonging
  
  

Risk factors

• Obesity (high BMI)
  
  

• Hypertension, high blood sugar & cholesterol
  
  

• Smoking history
  
  

• Poor sleep or oversleeping
  
  

• Diet high in red meat, sweets, sodium
  
  

• Hearing loss & kidney dysfunction
  
  

• Chronic pain, depressive symptoms, stress
  
  

• Loneliness or social isolation
  
  

Each of these stacks risk across two or all three conditions…so the good news is that targeting one often nudges another. For example if you are lowering salt in your diet to tame blood pressure…you’ll likely shed pounds, sleep better, and even brighten your mood.

Why is this important? 

• 80% of strokes are preventable by risk-factor control.
  
  

• 45% of dementias could be averted with lifestyle tweaks (according to the Lancet Commission)
  
  

• 35% of late-life depression links back to modifiable habits.
  
  

None of these lifestyle factors are magic bullets but think of it more of a buffet of small wins adding up to an enormous payoff.

Actionables: Your first three moves

It’s overwhelming to tell someone to focus on SEVENTEEN factors to modify. But if you had to pick 3 that are the most important and “easiest” to start with, I’d go with these:

1. Check & control your BP. Aim for <130/80 mmHg. Track it at home or at the pharmacy…and if it’s high, see your doctor.
   
   

2. Move your body, feed your mind. Pick one simple habit: a 20-minute walk after breakfast or a five-minute puzzle ritual mid-afternoon. Consistency beats intensity.
   
   

3. Build your social “safety net.” Schedule one weekly catch-up (phone or in-person) with a friend or neighbour. Social contact boosts oxytocin and buffers stress.
   
   

You don’t need to tackle all 17 factors in a single weekend. Choose your favorite “menu item,” savour it until it becomes habit, then sample the next. Small steps are powerful steps!

A Novel Approach For Chronic Back Pain?

I’ve had a few ugly encounters with back pain since the age of 24.

Thankfully most of those years have been pain free but occasionally it does raise its ugly head.

We do however need to move away from perceiving back pain as just a mechanical problem.

For decades, chronic low back pain (CLBP) has been treated like a broken axle in a car…fix the mechanical flaw, and the problem vanishes. But emerging science paints a far more nuanced picture: pain is a multidimensional experience shaped by emotions, cognitive patterns, and daily stressors. 

Before you think I’m getting all pseudosciencey and wishy washy…a pivotal randomized trial underscores why ignoring the brain’s role in pain perpetuates suffering…and how integrating psychological strategies could rewrite long-term outcomes.

The study: Physio vs. Physio + CBT

Researchers compared two groups of CLBP patients over 22 weeks:

• Control group: Standard physiotherapy (stretching, core strengthening, manual therapy).

• Experimental group: Physio + cognitive-behavioral therapy (CBT) techniques (pain neuroscience education, stress management, activity pacing).

Key findings:

• Short-term (6 weeks): Both groups saw similar pain reduction (≈30% improvement on visual analog scales).

• Long-term (16+ weeks): Divergence emerged. By week 10, the control group’s pain scores rebounded toward baseline, while the CBT+Physio group maintained gains, with further 15% improvement by week 22.

The trial reveals a critical insight: pain relief ≠ pain resolution. Standard physio may quiet acute symptoms, but without addressing psychosocial drivers (fear-avoidance beliefs, catastrophizing), pain often resurges. CBT equips patients to:

• Reframe negative thoughts (“My back is fragile” → “Movement is safe”).

• Break the fear-avoidance cycle (avoiding activity → deconditioning → more pain).

• Modulate pain perception via top-down brain regulation 

The biopsychosocial model in action

One of things that also stuck with me from medical school mental health studies was something called the “biopsychosocial” model.

Pain isn’t “all in your head,” but the brain is the body’s pain amplifier. Chronic stress, anxiety, and unresolved trauma lower pain thresholds 

CBT intervenes here, rewiring maladaptive neural circuits. Think of it as software updates for a glitchy pain operating system.

I Hated Sharing A Bed…

I never thought I’d be the kind of person to feign a stomach ache to avoid sharing a bed…but over a year ago there I was, waking at 3am because my beloved “Sleep Squeaker™” was accidentally elbowing me also because their internal thermostat had cranked our shared duvet to sauna mode. 

This went beyond irritation; it was genuine sleep fragmentation which ruined me. 

Why sharing a bed shatters slumber

1. Body heat clash: Our core temperatures dip by ~1 °C at night to signal melatonin release and sleep onset. But two bodies generate more heat, delaying that temperature drop and pushing back REM cycles .
   
   

2. Mismatched circadian rhythms: Say you’re a 10 PM lights-out, 6 AM riser; they’re a 1 AM–9 AM creature of the night. When your melatonin peaks and their cortisol surges, you’re both fighting the biology you’re trying to preserve.
   
   

3. Micro-arousals from motion: Even small movements; leg kicks, mattress dips…can trigger micro-arousals (brief awakenings you don’t remember) that knock you out of deep (slow-wave) sleep, reducing your overall restorative time .
   
   

4. Noise & light intrusions: A sudden snort, a flipping page on their e-reader, or a phone’s blue glow can spike cortisol and fragment your NREM cycles.
   
   

Fixes I dare you to try

After weeks of waking up feeling like a hangover without the fun night before, I implemented a sleep intervention protocol worthy of a mildly deranged neuroscientist:

1. Dual-zone climate control: Invested in a cooling mattress pad on my side, and a separate heated throw for them.
    Science: Localized cooling helps your core temperature drop faster, speeding sleep onset and boosting deep-sleep duration .
   
   

2. Staggered bedtimes
    Solution: I hit the hay at 10 PM; they catch up later with a reading lamp on.
    Science: Honoring individual circadian timing reduces sleep-onset latency and minimizes wake-after-sleep-onset episodes.
   
   

3. Soundproofing & white noise
    Solution: If needed, ear plugs for me; a white-noise machine for them (keeps their podcasts from becoming my insomnia soundtrack).
    Science: Steady ambient noise masks sudden sounds, reducing micro-arousals by up to 30% .
   
   

4. Separate bedding
    Solution: Two duvets, no tug-of-war.
    Science: Eliminates tugging and prevents heat transfer…so your partner’s toe under your blanket no longer counts as an assault.
   
   

5. Pre-sleep wind-down
    Solution: I adopt a 30-minute ritual of dim lights, light stretching.
    Science: This “buffer zone” helps downshift sympathetic arousal and primes you both for deeper REM cycles.
   

Remember: quality beats cuddles when it comes to restorative sleep. By respecting your unique sleep physiology and your partner’s you’ll both wake up less like the walking dead and more like actual humans ready to tackle the day…

P.S For more deep dives into medical and health topics…check out my podcast “Dr Karan Explores” here:

P.P.S I’m only 40 odd episodes in so it’s a relatively “new” podcast…but if you enjoy my coverage of medicine, science & health then you will love these podcasts. The more you engage, the more it allows me to continue creating longer content like this! So do me a favour and give it a listen!

Creatine & Alzheimer’s?!

A small but intriguing pilot trial published in Alzheimer’s & Dementia: Translational Research & Clinical Interventions (2025) has sparked excitement about creatine monohydrate’s potential role in combating Alzheimer’s disease (AD). 

For 8 weeks, 20 AD patients took 20g/day of creatine monohydrate (split into 10g doses), with pretty wild results:

• Brain creatine levels ↑11% (via MRI spectroscopy).

• Cognition improved in memory, attention, reading, and processing speed.

• No serious side effects; 90% compliance rate.

The study, led by researchers at the University of Kansas, aimed to test feasibility…note this does not prove efficacy. 

But the cognitive gains, while preliminary, suggest creatine might support brain energy metabolism in AD, a disease marked by mitochondrial dysfunction.

Why creatine? 

Creatine isn’t just for gym bros. It’s a critical player in cellular energy, helping regenerate ATP; the body’s fuel currency. In AD:

• Brain creatine levels drop due to impaired metabolism.

• Preclinical studies show creatine reduces amyloid-beta plaques (one of the nasties in Alzheimer’s) and oxidative stress in mice.

This trial is the first to show oral creatine can cross the blood-brain barrier in AD patients, replenishing cerebral stores.

Small study, big questions

While promising, this was a single-arm, open-label pilot with no placebo group. So let’s put a pin on the hype for a second…

• No control group: Cognitive improvements could stem from placebo effect or natural variation.

• Short duration: 8 weeks is too brief to assess long-term safety or sustained benefits.

• High dose: 20g/day (4x typical fitness doses) may cause bloating or GI distress in some.

Why you shouldn’t rush to supplement (yet)

• AD is complex: Creatine addresses energy deficits but not underlying pathology like amyloid plaques.

• Dose concerns: 20g/day is impractical long-term; prior studies use 3–5g for general health.

• No prevention data: This trial focused on symptomatic AD, not early-stage or prevention.

That said, creatine’s safety profile is well-established. For healthy adults, 3–5g/day may support cognitive aging and muscle health, per a 2024 meta-analysis (Frontiers in Nutrition).

Creatine is not a cure for Alzheimer’s and never will be, but this pilot lights a path for future research. For now, focus on proven strategies: aerobic exercise, Mediterranean diets, and cognitive stimulation. And if you’re considering creatine for general health? Stick to 3–5g/day because it’s cheaper, gentler, and still brain-friendly!

If you made it to the end.. well done it’s a hefty read! Send this to one person (or more) you think would enjoy this!