Let’s face it—you’re a busy guy with a lot on your mind. When you do think about your health, you probably think about the big stuff, like heart disease or Alzheimer’s. You know you’ve got a prostate somewhere down there, but you might not give it much thought. But your prostate is important.
Slightly larger than a walnut, the prostate gland is an essential part of a man’s reproductive system, and its main function is to secrete and store a clear fluid that is part of semen. This little gland can behave itself for years. But eventually most men discover it isn’t their heart that’s giving them problems, it’s their prostate. And the ailments aren’t just a passing nuisance.
The Problematic Prostate
According to the American Cancer Society, more than 2 million men suffer from prostate cancer. Of those, about 30,000 will lose their lives this year, making prostate cancer the second deadliest cancer in men (after lung cancer). But prostate cancer isn’t the only problem men can face. Fifty percent of all men will experience an enlarged prostate—a noncancerous condition known as benign prostatic hyperplasia (BPH)—by the time they hit their 60th birthday, and almost 90 percent of men older than 80 will be diagnosed with the condition.
BPH is a very inclusive boys’ club. To be eligible, you need only be a man older than 50. Yet other factors also can play a role in BPH. A family history of the condition can increase your risk. Race can make a difference: Asians have a lower incidence of BPH than Americans, but Europeans have a higher incidence. And African-Americans tend to develop symptoms earlier. BPH progresses very slowly in most men, and symptoms don’t usually occur until late in the game. However, as your prostate enlarges, you might begin to experience leaking or dribbling urine; a hesitant, interrupted or weak stream of urine; the urge to urinate often; and a frequent need to go to the bathroom throughout the night. Symptoms can become so uncomfortable that men who haven’t seen a doctor in years will make an appointment to have the problem checked out.
Even if you don’t have symptoms, it’s a good idea to have your PSA levels checked soon after you turn 50. PSA stands for a substance produced by the prostate known as prostate specific antigen. In normal men, a small amount of this antigen continuously leaks into the bloodstream, and doctors can measure levels with a simple blood test. A high PSA level can indicate an enlarged prostate. Getting an early diagnosis can substantially lower the risk of developing complications, such as urinary tract infection or even kidney damage. Moreover, a PSA is the most reliable test available for the detection of early prostate cancer.
Since BPH can’t be “cured,” most treatments focus on reducing the symptoms. The two most popular drugs for prostate enlargement are finasteride (Proscar) and dutasteride (Avodart). Although both of these drugs can reduce prostate size and ease urinary symptoms, they can have unfortunate side effects including erectile dysfunction, diminished libido, breast enlargement and allergic reactions.
Advanced cases of BPH might require surgery—something most men would rather avoid. Surgical options include cutting away the excess prostate tissue to relieve the pressure or removing the prostate gland itself. While this may solve the problem, it can trigger other troubles, such as infection, retrograde ejaculation, impotence and incontinence—incentive enough to catch this common condition in its early stages.
Does BPH increase your chance of getting prostate cancer? Fortunately, there isn’t a strong relationship between BPH and cancer. But the same things that put you at risk for BPH—race, family history and being a man older than 50—also put you at an increased risk of prostate cancer. While you can’t do much about these risk factors, there are others you can control. Scientists have recently discovered that weight plays an important role in the development of this disease. In one recent American Cancer Society study of nearly 70,000 men, researchers found that obesity not only increases the risk of prostate cancer, it boosts the likelihood of getting more aggressive forms of the disease.
Because prostate cancer often doesn’t show symptoms until it has reached an advanced stage, it’s prudent to have regular prostate exams that include a PSA test and a digital rectal exam. If your doctor notices something amiss, he will likely schedule a biopsy to be sure. Although prostate cancer will strike one in six men at some point during their lifetime, it isn’t inevitable. Along with routine exams, there are several things you can do to prevent both BPH and prostate cancer from becoming part of your future.
Feeding the Beast
After maintaining a healthy weight, eating a healthy diet is the next most important step you can take to protect yourself from prostate cancer. A growing number of studies show a direct link between a diet filled with saturated fat and the incidence of prostate cancer. A large U.S. study found that men who eat a lot of animal fat, particularly from red meat, are at increased risk of developing advanced prostate cancer. Saturated fat not only increases the male hormones that promote the development of prostate cancer, it also triggers an enzyme known as alpha-methylacyl-CoA racemase that fuels the spread of the disease.
Perhaps the most convincing evidence comes from a randomized, controlled trial by the University of California, San Francisco. The researchers divided 93 men with prostate cancer into two groups: One group ate a vegan diet and one followed the typical American diet. After one year, the PSA levels had decreased in the vegan group while the levels increased in the control group. Tumor growth in the vegan group was also inhibited by an impressive 70 percent compared with only 9 percent in the men who hadn’t made any changes. Based on these findings, the researchers concluded that eating meat triples the risk of prostate enlargement, and a diet low in fruits and vegetables nearly quadruples the chances of developing prostate cancer.
Milk, butter and eggs fall into the same category as meat—high in fat and laced with synthetic hormones. Harvard researchers have found that men with a high intake of both meat and dairy have twice the risk of metastatic prostate cancer. Even if you wean yourself off of meat, their study showed that dairy, by itself, boosts the odds that prostate cancer will spread. Meat and dairy also might set the stage for BPH. Several studies show that men who regularly eat butter and meat have a distinctly higher risk of an enlarged prostate. Refined carbohydrates like processed cereal and white bread also can contribute to the development of BPH.
So, what can you eat? According to a study at the University of California, Los Angeles, a lowfat, high-fiber diet can slow the growth of prostate cancer by up to 30 percent. But even if you aren’t battling cancer, a healthy diet based on fruits, vegetables, whole grains, nuts and legumes can help guard against future prostate problems. Adding soy to your diet also can offer protection. Soy products contain isoflavones, plant-based compounds that can reduce your PSA levels and your risk of BPH and prostate cancer. New findings show that eating just two servings of soy a day can reduce a man’s risk of prostate cancer by 14 percent. And a joint study by New York Presbyterian Hospital and Columbia University School of Medicine suggests that a high intake of soy might be why Asian men have a lower incidence of BPH than other populations.
Exercise Your Options
Along with a healthy diet, regular exercise can reduce the risk of BPH by up to 25 percent. It also can have a powerful impact on prostate cancer. One prospective trial by researchers from Harvard School of Medicine discovered that exercise can slow the progression of prostate cancer and help older men survive advanced cases of the disease. According to the study, men 65 years or older who engaged in at least three hours of vigorous physical activity each week had a 70 percent lower risk of being diagnosed with advanced or fatal prostate cancer.
Although medical science hasn’t determined exactly how exercise protects the prostate, researchers think that because exercise balances hormone levels, it might reduce long-term exposure to high testosterone levels.
Over the past decade, science has uncovered a number of natural dietary supplements that contribute to a healthy prostate. Many of these, such as vitamin D, can help prevent prostate problems. Others, like saw palmetto, can help alleviate problems once they occur. Here are some of the most effective prostate protectors:
Vitamin D. Researchers have identified a specific compound in vitamin D that retards prostate growth much the same way prescription drugs do—but without the side effects. Known as BXL628, this compound inhibits human prostate cell growth in lab experiments. But does it work on real men? To find out, Italian researchers conducted a double-blind clinical trial on 119 men with BPH. Fifty-seven of the men were given 150 micrograms of BXL628 and 62 got a placebo. After 12 weeks, the men taking the vitamin D compound experienced a 3 percent drop in prostate growth. Those taking the placebo saw the size of their prostate increase by more than 4 percent.
More recently, a joint study by Harvard Medical School and Brigham and Women’s Hospital in Boston monitored more than 47,000 men for 14 years and discovered that those with the highest levels of vitamin D were 17 percent less likely to develop prostate cancer. Researchers recommend supplementing with 1,500 IU of vitamin D every day to achieve the necessary amount of vitamin D.
Lycopene. Found mainly in tomatoes, this nutrient is a powerful carotenoid with potent antioxidant properties. In one review, German investigators discovered that combining one serving of lycopene-rich tomato products with a lycopene supplement protects against the DNA damage that contributes to prostate cancer. Other research shows that 100 mg and 300 mg of lycopene thwarted prostate tumor growth by 55 and 75 percent, respectively. Additional studies suggest that this carotenoid can lower PSA levels by more than 10 percent in men with BPH.
The best dietary source of lycopene is processed tomato products, such as tomato paste and tomato sauce. If you aren’t getting enough lycopene from tomatoes or foods that contain tomatoes, then supplementation is key to increasing your blood lycopene levels. Although early studies suggested that supplemental lycopene wasn’t as effective as eating tomato products, more recent research shows that taking 15 mg of synthetic lycopene each day can have a robust effect on prostate health.
Pomegranate (Punica granatum). This ancient fruit is the newest natural weapon in the war on prostate cancer. Recently, scientists at the University of California, Los Angeles, conducted a clinical trial to explore the effectiveness of pomegranate juice on men who had undergone surgery or radiotherapy for their prostate cancer. Each of the participants had their PSA checked every three months during the study. Meanwhile, they drank 8 ounces of pomegranate juice daily until their disease progressed. Drinking the pomegranate juice significantly lengthened the amount of time it took for the men’s average PSA levels to double. Further research showed that drinking pomegranate juice resulted in a 12 percent decrease in tumor growth and a 17 percent increase in the death of cancer cells.
While drinking a glass of pomegranate juice with breakfast can be a delicious way to kill off cancer cells, its tart flavor isn’t for everyone. Luckily, standardized pomegranate supplements are now available, offering a concentrated dose of this powerful antioxidant in a convenient capsule.
Pygeum (Prunus africanum). Derived from bark of the African plum tree, pygeum is used widely in Europe to treat BPH and other urinary disorders—and for good reason. Pygeum contains phytosterols, which have anti-inflammatory effects and interfere with the formation of hormone-like substances in the body that tend to accumulate in the prostate of men with BPH. This herb also contains ferulic esters, compounds that indirectly control testosterone activity in the prostate.
An evaluation of 18 clinical trials involving more than 1,500 men found that, compared with a placebo, pygeum reduced nighttime urination by 19 percent, improved residual urine in the bladder by 24 percent and boosted peak urine flow by 23 percent. The typical dose used in the trials was either 50 mg twice a day or 100 mg once a day. Although side effects are rare, most herbalists recommend having your doctor monitor your prostate for at least six months if you take pygeum for BPH.
Saw palmetto (Serenoa repens). If you could choose only one herb for BPH, this is it. Used regularly, saw palmetto has been shown to keep BPH symptoms in check. In fact, saw palmetto is so effective that it’s frequently prescribed by European doctors as a first-line treatment for prostate enlargement.
Large clinical trials show that taking 160 mg of saw palmetto a day significantly increased peak urine flow and reduced nighttime trips to the bathroom. Other studies have found that saw palmetto can shrink the size of the prostate. Better yet, 150 men taking a daily dose of the herb for two years reported a noticeable improvement in their sex lives. However, as effective as saw palmetto is, it isn’t for every man with BPH. It appears that urinary symptoms resulting from mild-to-moderate prostate enlargement respond more readily to saw palmetto than symptoms due to severe enlargement. If you suffer from severe BPH, check with your doctor before taking it.
Keeping your prostate healthy requires a combination of maintaining a healthy weight, a prostate protective diet, regular exercise and proactive supplementation. And it’s never too early to start. After all, taking care of your prostate today could help you avoid the problems of tomorrow. •
Kim Erickson is a frequent contributor to Herbs for Health.