Opportunities for prevention of prostate cancer: genetics, chemoprevention, and dietary intervention.

At least five susceptibility loci for the development of prostate cancer have been identified in the last several years. Although the specific genes involved have yet to be fully characterized, these discoveries hold promise for the identification of individuals at risk for prostate cancer years before development of the disease. Individuals identified as at risk through simple genetic screening (ie, a test on peripheral blood) could have a modified screening schedule, be entered into clinical trials of chemoprevention or dietary modification, and/or be treated according to the clinical characteristics of the cancer associated with a particular gene. Several large chemoprevention trials that exploit underlying pathogenetic mechanisms for the development of prostate cancer are currently underway or about to open. The future of prostate cancer is in the genes and our ability to manipulate the molecular events they cause.