Prescription Alternatives
Page 50
Surgical and radiation treatments carry a high risk of permanent side effects such as urinary and rectal problems and impotence. One study showed that men who get external beam radiation treatment for prostate cancer have a 70 percent higher risk of rectal cancer than those who had surgery. The only treatment that causes these problems temporarily (vs. permanently) is androgen (male hormone) suppression with drugs, but the lack of hormones quickly increases the risk for diabetes and heart disease, similar to what happens when a woman gets a hysterectomy and loses her hormones. At best, androgen suppression is a temporary fix. When it’s stopped, the cancer often comes back, and with a vengeance.
That leaves “wait and watch,” which isn’t a bad option if the cancer is small and localized, and if you can stand it. It’s estimated that 80 to 96 percent of men have a bit of prostate cancer when they die, meaning it’s a very slow-growing cancer that often does no harm. Thanks to research on prostate cancer risks, we have a pretty good idea of what blocks or feeds prostate cancer growth—more about that shortly.
The Psa Test
The PSA test isn’t faring any better than prostate cancer hormone research and treatment. According to the AHRQ:
The lifetime risk of being diagnosed with prostate cancer has nearly doubled to 20 percent since the late 1980s, due mostly to expanded use of the prostate specific antigen (PSA) blood test. But the risk of dying of prostate cancer remains about 3 percent. Therefore, considerable overdetection and overtreatment may exist. The U.S. Preventive Services Task Force, a panel of outside experts convened by AHRQ that makes independent evidence-based recommendations, maintains there is insufficient evidence to recommend for or against PSA testing for routine prostate cancer screening. PSA tests can detect early-stage cancer when it is potentially most treatable but also lead to frequent false-positive results and identification of prostate cancers unlikely to cause harm.
Doctors like to say they have to treat all discovered prostate cancer because they don’t know which ones will cause harm, but thanks to recent research on prostate cancer risk factors, we know a lot more about what drives prostate cancers to grow.
The Good News About Prostate Research
The good news about prostate research is that a lot has been done to examine non-hormone-related risk factors for both benign prostatic hypertrophy (BPH) and prostate cancer, including lifestyle, nutrition, and diet. This research gives us an abundance of information that can be used to prevent and treat prostate problems ranging from a little bit of trouble urinating to prostate cancer.
What Causes Prostate Enlargement?
Some scientists believe that when testosterone production declines, other male hormones synthesized from testosterone not only decline but are thrown out of balance, causing prostate enlargement. Unfortunately much of the research on this question has been done either with excessively high doses of testosterone or synthetic testosterones that can create numerous side effects, so it has given us few useful answers. We need studies done with real human testosterone in physiologic (the same as the body would make) doses.
Dihydrotestosterone (DHT) is a hormone synthesized from testosterone that is thought to contribute to prostate enlargement. The drug Proscar (finasteride) is supposed to keep testosterone from producing DHT. However, this drug has only been partially successful in treating prostate enlargement and has side effects, including a very high price tag. Adverse reactions may include impotence, decreased libido, and decreased volume of ejaculate (which most men don’t think are minor problems!). The most frequent adverse effect of Proscar is breast enlargement, which is also not a minor problem.
Among Japanese men who traditionally eat a diet low in fat and high in soy products, prostate problems are rare, as is the case in other cultures that favor low-fat diets. However, a study of Japanese men who moved to Hawaii and presumably began eating a typically high-fat American diet showed that they had prostate problems at the same rate as Americans. A study of 51,000 American men between the ages of 40 and 75 who were followed for two to four years showed that prostate cancer was directly related to total fat consumption, with red meat showing the strongest association with advanced cancer. Another study in Italy comparing 271 men with prostate cancer to 685 men who did not have the disease concluded that a high dietary consumption of milk was a significant indicator of prostate cancer risk, even in men who also ate a lot of whole grains and fresh vegetables.
Other studies have linked prostate cancer to exposure to herbicides that are typically used in agriculture, forestry, and in cities and suburbs to control weeds. Many pesticides are potent estrogen mimics.
Western Lifestyles Create a Convergence of Risk Factors for Prostate Problems
If we wanted to make a sweeping generalization about prostate cancer, we could say that the biggest risk factor for both having it and dying from it is living in the United States, Canada, and most of Europe. Asian men have, by far, the lowest incidence of prostate cancer and the lowest risk of dying from it (unless they move to the United States—then it goes up). Our Western lifestyles increase prostate cancer risk pretty much the same way they increase breast cancer risk: we eat too many bad fats and sugars and not enough fiber and veggies, we don’t exercise enough, we’re too fat, and we’re bombarded with xenoestrogens everywhere from pesticides and tap water to meat and perfumed garbage bags. This lifestyle leads to chronic inflammation.
Preventing Chronic Inflammation
Inflammation plays an important role in prostate cancer. One of the primary causes of inflammation in the prostate is too much of certain fats and oils. The saturated fat found in meat is one culprit. We want to emphasize that the key concept is excess; there’s no evidence that having a steak, lamb chop, or bacon now and then does any harm. Ironically, the other fatty acid culprit is at the other end of the saturation spectrum—the omega-6 unsaturated oils such as corn, cottonseed, safflower, and soybean. These are the oils found in chips, cookies, mayonnaise, salad dressings, and countless processed food products. The third culprit in prostate inflammation is (you guessed it) refined carbohydrates, especially the fatty carbs like French fries and the sweet carbs like cookies and doughnuts.
Both types of fatty acids (in excess) and refined carbohydrates cause the body to set up a multilayered defense system to break down and dispose of them. In the normal workaday world of the body, this is no big deal. But when you overload the system, it overcreates enzymes known as 5-LOX, COX-1, and COX-2. These enzymes, in turn, wreak all sorts of havoc further along the biochemical pathways. Part of the collateral damage of this havoc is inflammation—in the heart, the blood vessels, the joints, and the prostate in particular. In fact, not only does this havoc do damage, it actually feeds and protects cancer cells in the process. To add insult to injury, literally, it also pushes estrogens down more destructive pathways. Again, these are normal biochemical processes that run amok when they become overloaded. As we age we become increasingly susceptible to these types of inflammation and the DNA damage they cause, which can be the first step in the creation of a cancer.
Weapons against LoX and CoX
You can help your body reduce LOX and COX damage with some targeted supplement choices. The idea here, however, is not so much to try to help your body get over the shock of a burger and fries every other day, as to add a weapon to a prostate health arsenal that is already well stocked with overall good lifestyle choices. In other words, make the lifestyle changes and take these next suggestions as an extra layer of protection.
One of the easiest ways to block LOX and COX damage is to eat fish a few times a week or take fish oil supplements. Many people like flax oil as a source of beneficial oils, but we don’t recommend it. It’s so extremely unsaturated that unless you grind the seeds and eat them right away, it’s pretty much guaranteed to be rancid, which is like throwing the doors wide open for LOX and COX damage. Even when you grind the seeds, flax still has to go through conversion processes in the body to have benefit. In the hardw
are or paint store, flax oil is known as linseed oil and is used as a wood varnish, a carrier for oil paints, and glazing putty. If you put a coat of linseed oil on wood and leave it in the sun, it’ll harden in a few hours. That type of oxidation reaction is good for protecting wood but may not be so good for protecting the body. And yes, the lignans in flax are phytoestrogens that can be beneficial, but there are other ways to get lignans (whole grains, broccoli, pumpkin seeds, sesame seeds, soybeans, chia seeds).
Another way to combat LOX and COX damage is to take an anti-inflammatory drug such as aspirin or ibuprofen. Remember, though, that when taken regularly, these drugs carry the risk of gastrointestinal bleeding, which kills more than 10,000 people a year. Use them with discretion. If you have a sensitive stomach, this is probably not a good choice for you.
Some supplement formulas are specifically designed to douse LOX and COX inflammation. Most notable are New Chapter’s Zyflamend and Life Extension’s 5-Loxin. Zyflamend is a blend of herb and spice extracts that has been well researched and shown to have benefit. For details, please visit the New Chapter website.
And remember, our old friend estrogen is potently inflammatory in excess. It doesn’t take much estrogen to make a man estrogen dominant, in this case meaning too much estrogen relative to testosterone and progesterone. In women and men, fat cells are estrogen factories, which is part of why obesity is a risk factor for prostate problems.
For more details on xenoestrogens and how to avoid them, please visit the “Resources and Recommended Reading” section at the back of this book.
Lifestyle reminder
Just a reminder that you can take handfuls of supplements every day to keep your prostate healthy, but if you’re overloading it with an excess of “bad” fats, sugar, and refined carbohydrates and not getting any exercise or sleep, they won’t have much effect. Good prostate health requires a multifaceted approach with a healthy lifestyle, hormone balance, avoidance of xenoestrogens, and—last but not least—supplements as needed.
Drugs for Treating an Enlarged Prostate
Examples of 5-alpha Reductase Inhibitors
Finasteride (Proscar)
Dutasteride (Avodart)
What Do They Do in the Body? They block or inhibit an enzyme called 5-alpha reductase, which converts testosterone to dihydrotestosterone (DHT), lowering levels of DHT in the blood serum.
What Is It Prescribed For? Symptoms of benign prostatic hypertrophy (BPH) or enlarged prostate.
What Are the Possible Side Effects? Liver damage, impotence, decreased libido, decreased volume of ejaculate, breast tenderness and enlargement, and rash.
CAUTION!
Think Twice About Taking These Drugs If . . .
You are having sex with a woman who might become pregnant. Any exposure to these drugs, even in minute amounts, can cause abnormalities in the male fetus; do not use. Give the natural remedies a good try before resorting to these drugs.
Examples of Alpha-1 Blockers
Alfuzosin (UroXatral)
Doxazosin (Cardura)
Prazosin (Minipress)
Tamsulosin (Flomax)
Terazosin (Hytrin)
What Do They Do in the Body? Alpha-1 blockers, also called alpha-adrenergic antagonists or alpha-adrenergic antagonists, help block the effect of the adrenal hormone norepinephrine (noradrenaline), which contracts smooth muscles and constricts small veins and blood vessels. This improves blood flow and helps the smooth muscles of the bladder neck and prostate to relax. These drugs (e.g., Cardura, Minipress, Hytrin) are also used to lower blood pressure, although these days they are usually not a first choice for treating hypertension.
What Are They Prescribed For? Symptoms of benign prostate hypertrophy (BPH), or enlargement of the prostate, such as reduced urine flow, urinary frequency, weak stream, hesitancy, and incomplete emptying.
What Are the Possible Side Effects? Dizziness is a common side effect of this drug, especially when it’s first taken and when standing up from a sitting or lying down position. This can be dangerous in many situations, including driving. It may also predispose to falls when getting up at night to urinate, a common occurrence in men with prostate enlargement. Other side effects include fainting, excessively low blood pressure (this can cause dizziness), weakness, upper respiratory tract infection, headache, fatigue, edema (water retention), weight gain, rapid heartbeat, liver damage, increase in LDL (bad) cholesterol, runny nose, priapism (erection lasting more than four hours), rash, hives, itching, and flushing. Less frequent side effects include generalized pain, abdominal pain, indigestion, constipation, nausea, impotence, bronchitis, and sore throat.
CAUTION!
Think twice about using this drug if you have liver or kidney disease, as it could make it worse.
Natural Remedies for Prostate Enlargement
There are nutrients and herbs that can dramatically improve the symptoms of prostate enlargement in men over time. Your best bet is to find a formula that combines the following ingredients:
Zinc
Zinc is necessary for the proper function of the prostate gland. In men, higher concentrations of this mineral are found in the prostate than anywhere else in the body. A recent study looked at zinc supplementation in young men and found that when plasma zinc levels were low, there was a corresponding drop in testosterone. Many clinical studies have shown that zinc supplementation can reduce the size of the prostate gland, along with troublesome symptoms.
It’s a good idea for all men to take 10 to 15 mg of zinc daily and include zinc-rich foods in the diet such as oysters (well cooked, please!), lamb chops, and wheat germ. Pumpkin seeds are a good source of zinc and are also rich in the amino acids alanine, glycine, and glutamic acid, which seem to have a positive effect in reducing the size of the prostate. A handful of dried pumpkin seeds a day is plenty. Please don’t get pumpkin seeds that have been roasted in oil and salted—the oil is probably rancid and you don’t need the extra salt. Plain roasted pumpkin seeds have a pleasant, nutty flavor. Pumpkin seed oil capsules are also available.
Selenium
Selenium is another important mineral in male hormone regulation that is found in large amounts in the prostate. Blood levels of both zinc and selenium are low in men who have prostate cancer. Men who live in areas where the soil is rich in selenium tend to have lower rates of prostate cancer. Rich sources of selenium are garlic, shellfish, grains, and chicken. If you’re over the age of 50, you can supplement your diet with up to 400 mcg of selenium daily.
Pygeum Africanum
Pygeum africanum, an evergreen tree from Africa, is an important part of your healthy prostate program. The bark of this tree helps balance hormone levels and reduce prostate inflammation. It also improves the quality and quantity of prostate secretions.
Saw Palmetto
Saw palmetto is the most important prostate herb. An extract made from the berry of saw palmetto (Serenoa repens), also called sabal, a palm tree native to Florida, Texas, and Georgia, has been shown in numerous studies to reduce the urinary symptoms caused by prostate enlargement. Like the previously mentioned drugs, it is a 5-alpha reductase inhibitor that blocks the conversion of testosterone to dihydrotestosterone (DHT), which is associated with prostate enlargement. Unlike the previously mentioned drugs, this herb, taken as directed, has no reported side effects, seems to be more effective, and is significantly less expensive! It’s also possible that it opposes or blocks estrogen. Look for a standardized extract from a reputable company.
The Healthy Prostate Program
The Six Core Principles for Optimal Health have all the elements of a healthy prostate diet. Here is where the special emphasis should be if you’re a man over the age of 50:
Eat More . . .
Fiber
Fish oils or other sources of omega-3 fatty acids
Garlic
Hormone-free chicken (a good source of selenium)
Oysters or lamb chops every other week (a good source of zinc)
Soy products such as miso, tofu, and tempeh (or take in capsule form)
Drink More . . .
Clean water
Avoid . . .
Red meat (unless it is organic)
Vegetable oils and hydrogenated oils (trans fats)
Whole milk (yogurt is OK)
Supplements That Support a Healthy Prostate
Saw palmetto extract
Selenium
Zinc
Lycopene (carrots, tomatoes, tomato sauce)
Milk thistle (helps the liver clear excess hormones)
Vitamin D (men with prostate cancer tend to be low in vitamin D)
Melatonin (helps balance estrogen)
Chapter 19
Synthetic Hormones and Their Natural Alternatives
Hormones play innumerable roles in the everyday workings of your body. Lack of a single hormone can make the difference between well-being and life-threatening illness. Hormonal pathways and interactions are so complex that we have only a weak grasp of exactly how they work. The body uses hormones as one way to maintain homeostasis (balance) in all of its systems despite drastic changes in the environment. For example, your body goes from sleep in a toasty warm bed to rising, bathing, cooking, and eating an assortment of foods. On that same day, you might engage in vigorous exercise, have an emotional conflict with a loved one, relax in the sunshine, and see a sad movie. If you are working in a stressful profession, you might have to work capably while under considerable pressure. All of these activities in some way put a demand on the body to maintain balance.