Article ID # 20060604
Preventing Prostate Problems
by H.K. Jones
Energy Times, June 4, 2006

The prostate can be an ornery organ. Between simple inflammation and outright cancer lies a nonmalignant but vexing disorder called BPH-excessive prostate growth that affects more than 50% of men over 50. Find out how BPH disrupts the "call of nature" and how diet and supplements can help you go with the flow.

You have to get up several times in the night to trek to the bathroom. During the day you continually feel the call of nature and always keep an eye open for the nearest men's room.

Sound familiar? Welcome to benign prostatic hyperplasia, or BPH. Benign means "not cancer" and hyperplasia means "excessive growth," and while BPH is not linked to prostate cancer and does not raise your chances of getting cancer, the symptoms for both can be similar-and vexing. Although prostate miseries rarely show up before a man hits age 40, more than half of men in their 60s and as many as 90% in their 70s and 80s show some signs of BPH. The question is: What can you do to help prevent and treat this "leaky" situation?

Prostate 101
The prostate is located just below the bladder and surrounds the urethra, the tube that carries urine out of the bladder. The gland's primary job is producing fluid for semen. Normally the prostate is quite small, about the size and shape of a walnut, but with time and age it can enlarge. Like a clamp on a garden hose, an enlarged prostate puts pressure on the urethra and interferes with the normal flow of urine. The blocking of the urethra and the gradual loss of bladder function, which results in partial emptying of the bladder, are responsible for many of the problems associated with BPH. Aside from the seemingly constant need to urinate many times during the day and night, other symptoms include difficulty in starting urine flow and dribbling after urination ends. The size and strength of the urine stream may decrease and you may feel that your bladder is not empty, even after just going.

While it is extremely common for the prostate to enlarge with age (as common as gray hair in fact), the exact cause is not well understood. The only established risk factors for BPH are age and family history. Researchers believe, however, that over time the prostate becomes more vulnerable to the effects of male hormones, including testosterone. Throughout their lives men produce both testosterone and small amounts of estrogen (a female hormone). With advancing age, levels of testosterone decline and estrogen increase. What's more, amounts of a form of testosterone called dihydrotestosterone (DHT) also rise. DHT stimulates cell growth and, in turn, prostate enlargement. By inhibiting DHT breakdown, estrogen has the same effect.

An Ounce of Prevention...
Diet strongly influences sex hormone production, including testosterone. So it isn't surprising that researchers have found cutting down on meats and dairy products, and pumping up the vegetables, can turn down hormonal stimulation of the prostate and help stave off problems. In fact, daily meat consumption triples the risk of prostate enlargement, regular milk consumption doubles the risk and failing to consume vegetables regularly nearly quadruples the risk. It's also no surprise that prostate dysfunction is more common in Western countries that emphasize animal-derived foods than in Asia, where diets include more fruits and vegetables. That may help explain why prostate cancer, which like BPH is hormonally influenced, has an incidence rate of 102.1 of every 100,000 men in the US compared with a rate of 0.5 in Qidong County in China-the lowest in the world. The lab-coat crowd thinks that excess calorie consumption may directly stimulate prostate enlargement through excess body fat; fat tissue produces estrogen, which contributes to prostate enlargement. Obesity also contributes to diabetes, in which the body cannot control glucose (blood sugar) properly; a study in the Journal of Clinical Endocrinology and Medicine (4/11/06 online) found a link between high glucose levels and BPH. In addition, they suggest that keeping active may help you stay a step ahead of BPH by directly affecting hormone levels and by helping with weight maintenance.

Going All Natural
A wide variety of conventional treatments are available for an enlarged prostate including medication and surgery. But lots of men are turning to natural treatments for BPH, and with good reason. According to clinical herbalist Jennifer Chesworth, founder and managing director of Herbalists Without Borders, "Historically, herbs have been used to treat the symptoms of BPH, and recent research supports these folk remedies." (It's always best to get professional help in finding a natural therapy that works for you.)

One of the most well-known and popular herbs for pesky prostate problems is saw palmetto, a short palm tree common to the southeastern coastal region where Native Americans used its berries to remedy urinary problems. Today, manufacturers concentrate the berry's active ingredients by extracting its oil. "Saw palmetto has been clinically proven to inhibit the enzyme involved with converting testosterone to dihydrotestosterone (DHT)," says Chesworth. In fact, in an investigation involving more than 1,000 men, these powerful berries improved urine flow and other BPH symptoms just as well as the often-prescribed medication PROSCAR (finasteride).

Another herbal heavyweight is pygeum, an indigenous African remedy obtained from tree bark. Studies indicate that pygeum is effective in treating BPH, as this herb also contains chemicals that inhibit DHT-associated prostate enlargement.

Though the evidence is much stronger for saw palmetto and pygeum, a few other natural substances may also help relieve a balky prostate. Pumpkin seeds, for example, have long been used as a folk remedy in treating prostate disorders. According to Chesworth, "Research now indicates pumpkin seeds promote urine flow and may reduce hormonal damage to prostate cells, which could lower the risk of prostate cancer." The dietary supplement beta-sitosterol is also believed to relieve BPH symptoms, although the way it works is not exactly known. Same goes for the roots (not the leaves) of the nettle plant, widely used in Europe to treat BPH. Rye grass pollen extract is thought to affect testosterone, relax the muscles of the urethra and increase the bladder's ability to force out urine.

Prostate Cancer Prevention: An Update
Most male urinary distress, especially among older men, is caused by BPH. But unfortunately more than 234,000 men this year will learn that their prostates have been invaded by cancer and more than 27,000 will die of this disease, the most malignancy-related deaths among men with the exception of those caused by lung cancer. The good news is that although the incidence of prostate cancer keeps rising the death rate keeps dropping. One factor that helps explain both trends is widespread screening for a protein called prostate-specific antigen (PSA), since increasing PSA levels can indicate the presence of cancer long before symptoms develop. It isn't a foolproof indicator, though, as a variety of conditions, including both BPH and simple inflammation (called prostatitis), can boost PSA. Researchers are looking for more reliable cancer indicators-for example, mutations in the BRAC2 gene commonly associated with increased breast cancer risk have recently been linked to a greater risk of prostate cancer as well. In the meantime, the American Cancer Society (ACS) recommends annual PSA and digital rectal exams (DREs) starting at age 50; what's especially important is PSA velocity, or how quickly PSA increases between tests.

Exercise and a sensible diet should be a part of every man's cancer prevention game plan. After following more than 47,600 individuals for 14 years, researchers from the Harvard School of Public Health concluded that regular vigorous activity can slow cancer progression in older men (Archives of Internal Medicine 5/9/05). As for what to put on your plate, the ACS endorses a diet that emphasizes legumes (beans and peas), vegetables, fruits and whole grains, and cuts back on foods of animal origin.

Plants contain phytonutrients, compounds that provide a wealth of disease-fighting properties. One of the best-known is lycopene, the red stuff in tomatoes that has shown a special talent for fending off prostate cancer. In the latest research, a combination of lycopene and vitamin E has shrunk prostate tumors in the lab (Journal of Nutrition 5/06). In fact, vitamin E itself is being intensely studied in combination with other nutrients: It has helped defend smokers (and those who have recently quit smoking) against prostate cancer when teamed with beta carotene and is currently being featured in the large-scale Selenium and Vitamin E Cancer Prevention Trial (SELECT) with the antioxidant mineral selenium. Eating the right fats-specifically the omega-3 fatty acids found in flax seeds and fish oil-also appears to help fend off prostate cancer. So does making green tea one's beverage of choice; in one study tea's phytonutrients helped reduce risk among men at high risk for developing the disease. So load your plate with vegetables and select some supplemental help, should you need it. The idea is to make those mad dashes to the restroom a thing of the past.

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