Protecting Your Prostate: What Every Man Should Know About Diet and Prostate Cancer

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If you are hoping to live a long, highly functional life then knowing a few things about prostate health is an essential part of the game plan. I say that because prostate cancer is the second leading cause of cancer death among men in the Canada, the United States and other developed countries. Even if you don’t develop prostate cancer, 50-60% of men have enlarged prostates by age 40-59 and 80% will have enlarged prostate problems if they live to be age 80. Having an enlarged prostate (known as BPH or benign prostatic hyperplasia) makes urinating very difficult because the enlarged gland presses against the urethra, blocking the flow of urine from the bladder through the urethra. The urethra is the hollow tube that allows urine to travel from the bladder and exit the body through the opening at the head of the penis. An enlarged prostate also triggers frequent urination pit stops (because complete voiding of the bladder is no longer possible), including sleep interruptions as you get up to urinate a number of times through the night. The problem can become extremely severe requiring medical interventions that are no walk in the park, such as the TURP procedure (The transurethral resection of the prostate (TURP), involves the use of an instrument that is inserted up the urethra to remove the section of the prostate that is blocking urine flow. TURP usually requires hospitalization and is done using a general or spinal anesthetic).

Prostate Enlargement And Cancer Share The Same Biology

        An important observation is that the high incidence of benign prostatic hyperplasia, which occurs inCanadaand other developed countries, involves many of the same biological steps that lead to prostate cancer. Some experts have suggested that the high incidence of BPH in the United States and Canada is the canary in the mine shaft, or the harbinger that should alert us to the fact that something we are doing wrong in our lifestyle behaviours is causing the high incidence of BPH and also causing Canadian men to die of prostate cancer at level that is 80% higher than occurs in other parts of the world.

 If you justsit back and listen to the media, you would be inclined to think that prostate enlargement and prostate cancer are primarily determined by your genetic inheritance. However, if you have followed the research published in the Journal of The National Cancer Institute, The American Journal of Clinical Nutrition, and the journal, Nutrition and Cancer, for the past 25 years as I have, you would be aware that 75-80% of prostate cancer cases are avoidable via more prudent dietary and lifestyle practices. Renowned Harvard researcher, Dr. Walter Willett MD, MPH, is one of the more recent investigators to highlight this observation in the Journal of The National Cancer Institute. Evidence also points to the fact that developing an enlarged prostate is not necessarily an inevitable part of aging, if take some proactive lifestyle measures.

So, What Diet and Lifestyle Factors Are Crucial To Prostate Health

           The evidence to date suggests that avoiding prostate problems through diet and lifestyle involves the following proactive initiatives: 

1. Eat less animal fat, except fish. The Health Professionals Follow-Up Study and other research indicate that regular consumption of beef, pork, egg yolks and high fat dairy products increases risk of prostate cancer. This may due to the fact that these foods can over stimulate the testosterone pathway. Testosterone and its related compound dihydrotestosterone (DHT) stimulate the spread of prostate cancer (making it more aggressive from a metastasis standpoint), and/or increase exposure to environmental pesticides and other carcinogens that are trapped in the fatty tissue of animals that we eat. In contrast, a Swedish study and other observational and experimental data suggest that the omega-3 fats from fish can help to reduce risk of prostate cancer. Thus, eating fish 2-3 times per week is considered to be a prudent strategy, as well as switching from red meat and pork to chicken and turkey breast, and using only 1% or non fat milk or yogurt and no cheese above 3% milk fat (and there aren’t many of those). Of course, ice cream, butter, cream, and whipped cream are considered highly undesirable in this regard (in case there was any doubt)
2. Eat cruciferous vegetables daily. A number of studies have shown that men who eat cruciferous vegetables regularly (broccoli, Brussels sprouts, cabbage, cauliflower, bok choy) have a lower incidence of prostate cancer. Experimental studies have supported this contention. An active ingredient in cruciferous vegetables can help the body detoxify cancer-causing agents and helps to prevent the build up of dangerous hormones that are associated with prostate cancer. A number of studies, including one the cancer journal Oncogen (2001) demonstrated the indole-3-carbinol can inhibit the growth of prostate cancer cells and encourage them to commit suicide as well; an effect known as apoptosis or programmed cell death. So, make a point of choking back at least ½ cup of one cruciferous vegetable per day if you are typically a meat and potato kind of guy.
3. Consume soy products a few times per week. Let me alert you to the fact that in countries in the world where prostate cancer incidence is 80% lower than inCanada, soy products are a main staple of the diet. Countless studies show that constituents of soy, especially soy isoflavones, block the formation and effects of hormones linked to prostate cancer, and induce programmed cell death of prostate cancer cells. More recently, soy isoflavone supplementation has shown benefit in slowing the rise of PSA in patients with existing prostate cancer, thereby, improving the management of their disease and reducing risk of metastasis (Hussain M, Banerjee M, Sarkar FH et al. Soy isoflavones in the treatment of prostate cancer. 2003. Nutr and Cancer, 42;2: 111-117). So, have some roasted soy nuts, include tofu in a stir fry, eat a vegeburger (instead of a ham burger), or drink some soy milk, but get some soy isoflavones into your body 3-4 times per week. I personally aim for a soy product each day.
4. Watch your alcohol intake. The Harvard Alumnin Study and other studies suggest that men who have more than 3 drinks per week, on average, during their mid-life years, have a significantly higher incidence of prostate cancer than men who drink less or completely abstain. Alcohol is a known carcinogen, and is linked to 3% of all cancer cases, in general. I highly recommend that you keep your intake below 3 drinks per week. This practice is also likely to reduce development of prostate enlargement, as alcohol increases the formation of certain hormones (prostaglandins) that cause prostate enlargement and swelling.
5. Eat tomatoes, stay trim and exercise. Tomatoes contain lycopene, an antioxidant that concentrates in the prostate gland and has shown prostate cancer protective effects in experimental studies and human correlation studies. Maintaining a waist line below 36 inches also seems to be good advice and men who are more aerobically fit, in some studies, have been shown to have lower prostate cancer incidence. So, eat tomatoes (especially cooked tomatoes), stay trim and get involved with endurance exercise. If you haven’t started exercising yet then consider getting started out doors this summer with roving (see details on the next page)
6.  Take a prostate support supplement if you are 40 years or older. In both prostate enlargement and prostate cancer a hormone that is largely incriminated in these problems is dihydrotestosterone (DHT). Evidence suggests that as we age the enzyme (5-alpha-reductase), converts testosterone to DHT in the prostate gland, becomes more aggressive. This results in higher DHT levels within prostate cells after age 39.  DHT promotes faster replication of prostate cells, which results in prostate enlargement (due to an increased number of prostate cells) and a greater risk of mutations occurring that lead to prostate cancer. DHT is so intimately associated with prostate cancer growth that medical therapies are primarily aimed at blocking the effects of DHT in cases where prostate cancer has spread beyond the prostate gland. (if the cancer is contained within the prostate gland then removal of the prostate or prostate destruction of some kind is usually the recommended treatment). The point of the story is that certain herbal agents are known to block the conversion of testosterone to DHT and to provide additional protective influences on the prostate. These herbs have shown good success in reversing mild to moderate BPH, but should also be considered useful on a more preventive basis once a man is 40 years of age or older, in my opinion. The natural ingredients in a prostate support formula should effective dosages and standardized grades of: saw palmetto; pygeum africanum; beta-sitosterol; soy extract; stinging nettle; and lycopene. Taking a supplement of this nature each day helps to prevent the dangerous build up of DHT in the prostate gland, provide additional antioxidant support and counter aging effects on the prostate gland.

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          Although prostate health has direct links to diet and lifestyle, this does not suggest that medical screening is not necessary. On the contrary, the combination of healthy lifestyle practices and early detection for prostate cancer go hand-in-hand in a prudent prostate prevention program. The key thing to know is that if you catch prostate cancer before it spreads beyond the prostate gland then it is virtually 100% treatable and non-life threatening. If you catch it after it spreads beyond the prostate gland then it’s a whole different kind of fight. Cancer cells confined to the prostate gland are not life-threatening in and of themselves.  Prostate cancer is only going to end your life if you allow it to spread through the lymphatic and blood vessels to other tissue sites. So, the way that you catch it early is by seeing your doctor and requesting a PSA blood test (prostate specific antigen). This should be performed yearly after age 50, or during your 40’s if your biological father or a brother developed prostate cancer. A family history of this nature doubles your chances of developing prostate cancer, so you have to be more vigilant by starting PSA testing earlier in life. 

How To Interpret Your PSA Score 

PSA (Prostate Specific Antigen) – this is a blood test that can screen for the presence of prostate cancer. Picking up prostate cancer in the early stages enables doctors to prevent it from spreading outside the prostate and becoming a lethal disease. Presently, one in eight men in most developed countries develops prostate cancer and it is the second leading cause of cancer death in men after lung cancer.

• The 2007 National Comprehensive Cancer Network (NCCN) guideline recommends offering a baseline PSA test and digital rectal exam (DRE) at ages 40 and 45 and annual PSA testing and DRE (digital rectal exam of the prostate) beginning at age 50 through age 80, along with information on the risks and benefits of screening.
• However, annual PSA testing and DRE should begin at age 40 for African-American men, men with a family history of prostate cancer, and men with a PSA ≥ 6 ng/mL at age 40 or PSA > 6 ng/mL at age 45
• Biopsy is recommended if DRE is positive or PSA ≥ 4 ng/mL, and biopsy considered if PSA > 2.5 ng/mL or PSA velocity ≥ 0.35 ng/mL/year when PSA ≤ 2.5 ng/mL.
• SomeU.S.radiation oncologists and medical oncologists who specialize in treating prostate cancer recommend obtaining a baseline PSA in all men at age 35 or beginning annual PSA testing in high risk men at age 35.
• As a rule, a PSA below 2.0 ng/mL is very low risk for prostate cancer, however, if the PSA rises by more than 0.75ng/mL within a 12-month period (although still within the ideal range between 0 – 2.0 ng/mL), then prostate cancer should be suspected and investigated.