Prostate Tidbits: Guarding the Prostate by Knowledge and Action

According to the Internet news server, Medical News Today, in the article What's Good for the Heart May Be Good for the Prostate, Feb. 14, 2008,scientific evidence compiled by the Fred Hutchinson Cancer Research Center in Seattle, Washington, shows that a heart healthy diet low in fat and red meat intake, which includes a high vegetable and lean protein intake and which includes moderate alcohol consumption may also be good for the prostate. The research was detailed by lead author of the study, Alan Kristal, Dr.P.H., and published online in the American Journal of Epidemiology.

The study explained that benign prostatic hyperplasia, or BPH, is a condition which causes frequent and painful urination and affects about half the population of men fifty years of age and nearly one hundred percent of the male population who have attained the age of seventy years.

Dr. Kristal's research found that BPH risk was decreased by 32% in men who ate four or more servings of vegetables a day and 38% by men who drank moderately (no more than two alcoholic drinks per day). The study found that obesity increased the risk of developing BPH; a high-fat diet (in which 40% or more calories come from fat) increased risk by 31%, daily consumption of red meat by 38%, These results were obtained by studying a group of 4,770 men for a period of seven years, while 876 of them developed symptoms of BPH. The researchers found that consuming lean protein in amounts equal to 20% of total daily calorie consumption reduced risk by 15%. The article quotes Kristal as saying,"We don't really know how it's working but it's pretty clear that eating a high amount of fat and it doesn't appear to matter what kind of fat increases the risk of BPH." The body's overall inflammatory response is thought to increase because of high fat intake. The study found no dietary supplements that could be associated with reduced risk of BPH.

Other studies have, however, found supplements and herbs, including Saw Palmetto to be effective at reducing the risk of prostate problems, though it should be noted that saw palmetto can vary greatly in potency dependent upon the brand used and frequency of use.

In a quote from a major study of saw palmetto users reported in Nutrition & Cancer; 2006, Vol. 55 Issue 1, p21-27, (Copyright © 2006, Lawrence Erlbaum Associates, Inc.) researchers said, "No other epidemiological study of saw palmetto use and risk of prostate cancer has been published to our knowledge; however, several lines of evidence suggest that saw palmetto may be protective against prostate cancer."

In an article entitled The Other Prostate Problem . . ., by Pat Hagan of the London (UK) based Daily Mail (12/21/2004) states, "HIGH-FAT diets are thought to increase the risk of BPH. Eating lots of fruit and vegetables may reduce your chances."

The following quote was taken from Urology Times Vol. 35, p3-6, 4p; in the article Modern Health for Men, "The condition (BPH) can cause discomfort and lower urinary tract symptoms of varying intensity that can be treated through medications or surgery. However, men with milder symptoms can be cured through changing simple lifestyles such as adjustments to diet through limiting caffeine consumption, drinking green tea and taking herbal supplements."

The exact herbal supplements were not named in that particular article.

In a March 15, 2007 article in Urology Times entitled, Experts: Complementary and Alternative Medicine Therapies Show Great Potential in Urology quotes Mark A. Moyad as saying,"Ninety-nine times out of 100, if it's heart healthy, it's prostate healthy," Mark A. Moyad, MD, MPH, is Phil F. Jenkins Director of Preventive and Alternative Medicine in the Department of Urology, University of Michigan Medical Center, Ann Arbor, MI.

The article goes on to explain that therapies that reduce cardiovascular risk also reduce the risk of prostate cancer. Among those therapies are caloric restriction, supplementing with fish oil and omega-3 fatty acids, flaxseed, multi-vitamins, selenium, calcium, vitamin D, pomegranate juice, pumpkin seed, stinging nettle, African stargrass (Hypoxisrooperi), quercetin with bromelain and papain, and rye and grass pollen preparations. The article was written by Penny Allen.

Urology Times has also reported on PC-SPES, a mixture of eight Chinese herbs, which reportedly looked promising but was later found to be tainted with dangerous substances (which, readers may know, is not uncommon with Chinese herbs, as other news stories have recently confirmed).

The same journal in 2004 (Sep2004, Vol. 32 Issue 13, p6-8, 2p) reported that minor gains were made using Saw Palmetto instead of tamsulosin, the drug often used to relieve symptoms of BPH .

In a 2005 study headed by AJ Gross, tamsulosin was found slightly more effective than phytotherapy (for a group of patients who had a poor response to at least 4 weeks of phytotherapy). The study was outlined in the medical article Prostate Cancer & Prostatic Diseases, published online on May 10, 2005.

According to the article by AJ Gross, in some countries such as Germany and France, phytotherapy is widely used; "However, scientific evidence regarding the efficacy (and tolerability) of phytotherapy from placebo-controlled, randomized trials with long-term follow-up is largely lacking," the article goes on to say. The study was sponsored by Boehringer Ingelheim Pharma GmbH & Co. KG.

Tamsulosin is not without its dangers, however.

"Chang and Campbell are to be commended for bringing to the attention of the medical and ophthalmic community their report of a possible, newly recognized complication of the oral medication tamsulosin hydrochloride (Flomax), the intraoperative floppy iris syndrome (IFIS)." Chang DF, Campbell JR. Intraoperative Floppy Iris Syndrome Associated with Tamsulosin., Journal of Cataract Refract Surg 2005; 31:664 - 673

Recent research done by June Chan at the American Society of Oncology, showed a 33 to 40% increase in the risk of developing prostate cancer among Chinese immigrants by the third generation of American residence (which may say something alarming about the standard American diet and lifestyle). It was found that factors increasing risk of prostate cancer development included foods high in calcium and possibly processed foods and red meat. The study found that foods rich in lycopene and selenium and possibly legumes, vegetables, vitamin E, antioxidants, fish and marine n-3 fatty acids helped prevent prostate cancer. (N-3 fatty acids is just an alternative name for omega-3 fatty acids, according to Wikipedia. This is confirmed by the American Heart Association, to wit:"Since the first AHA Science Advisory "Fish Consumption, FishOil, Lipids, and Coronary Heart Disease,"¹ important new findings,including evidence from randomized controlled trials (RCTs),have been reported about the beneficial effects of omega-3 (orn-3) fatty acids on cardiovascular disease (CVD) in patientswith preexisting CVD as well as in healthy individuals."© 2002 American Heart Association, Inc. ).

In an April 2000 article by Alexa Williams and Steven K. Clinton for the Journal of Nutrition evidence was presented that carotenoids from fruits and vegetables are beneficial in reducing the risk of prostate cancer.

Another article entitled In The Public Eye, from the June 1999 issue of Urology Times, states that high fluid intake and regular exercise lower the risk of prostate enlargement.

(I might add that it's common knowledge that too much sitting is hard on the prostate, as it can cut off circulation).

In the article By the Way, Doctor, from the May 1999 edition of the Harvard Health Letter, an eight year study was cited as evidence that men who engaged in a regular program of physical activity had a 25% lower risk of developing prostate problems such as BPH than did more sedentary men. The researchers found that, "brisk walking was . . . actually better than jogging or several other high-intensity activities."

The June 1995 edition of Better Nutrition for Today's Living states that zinc supplements can be beneficial, as can essential fatty acids in preventing prostate problems.

From an April 2006 article entitled, Supplements: Discerning Fact from Fiction No Easy Task, written by Urology Times correspondent, Vonne Sleve and available at www.urologytimes.com comes the following information: "According to the Pew Internet and American Life project, more than 93 million Americans searched the Internet for health information in 2005." Much misinformation on supplements and alternative medicine is posted on the Internet, which often reveals no disclosure of possible drug interactions, dangers of specific herbs and supplements, nor bad science used to support claims. Doctors should be a reliable source of information about supplements, so that patients aren't taken in by scientifically unsound claims from advertisers or unqualified sources, e.g. psuedoscientific internet articles. Medline, peer-reviewed journals, Medline Plus, the American Cancer Society, and FDA MedWatch were researched by Anne R Simoneau, M.D., Associate Program Director of Urologic Oncology and Associate Professor of Urology at the University of California who gave the following advice for physicians, which according to the article, Dr. Simoneau discovered through her research and which she presented for readers of the journal: Vitamin E and selenium showed evidence of a decrease in prostate cancer; alpha-tocopherol decreased prostate cancer; saw palmetto improved symptoms associated with mild BPH; lycopene shows promise in preventing prostate cancer; however, only some men (with a specific genotype) benefitted from (supplemental) antioxidants.

In summary, Dr. Simoneau's research found that only some were helped by supplements, while others could actually be harmed by using them, all factors, e.g. drug interactions, considered. Dr. Simoneau was quoted as saying,"Moderation is key. I think the best thing to tell our patients now is to eat a balanced diet, exercise, and let the trials continue. There have been some hard lessons regarding the pitfalls of attempting to recapitulate a healthy diet with a pill." "Some day, we may have more answers, but right now we don't have any when it comes to supplements and prostate cancer--the definitve nutrient, dose, duration, and deleterious side effects."

An abstract for the journal article, Correlations of Dietary Patterns with Prostate Health, from the Department of Pathology, University of Illinois in Chicago (IL, USA), from the journal, Molecular Nutrition & Food Research, January, 2008' Volume 52, pages 114-130, is shown here in its entirety as follows:

"Both genetic and environmental influences may be involved in etiology of prostate health and prostate cancer. These include ethnic origin, family history, smoking, and diet. Adiposity and excess energy (caloric) intake are potentially distinct risk factors and positive associations with prostate cancer risk for both were observed among case-control and cohort studies. Some epidemiological studies support an association between dietary fat, particularly saturated or animal fats, and prostate cancer risk. Of these, several suggest reduced risk with low-fat diets high in n-3 fatty acids and increased risk with high-fat diets rich in n-6 fatty acids. Others suggested association with higher meat intake, possibly due to heterocyclic amines and polycyclic aromatic hydrocarbons, produced during grilling or frying. Positive association of prostate cancer risk with dairy intake could involve alpha-methylacyl-CoA racemase activity (required for beta-oxidation of phytanic acid present in dairy products and red meat) or the suppression of vitamin D activity by calcium. Inverse associations were observed with dietary intake of plant foods. These include cereals, soy products, and fruit and vegetable sources of carotenoids. Numerous plant constituents may act synergistically in the prevention and inhibition of prostate disorders. These diet-risk associations may lead to future individualized diet recommendations based upon genetic polymorphisms."

source of pictures FDA Consumer May/Jun2006, Vol. 40 Issue 3, p18-25, 8p, 4 diagrams, 2c