Prostate Health

Introduction

What should I know about Prostate Health?

The prostate is a walnut-sized organ that lies just below the bladder, surrounding the urethra. The function of the prostate is to enhance the motility of sperm cells by secreting a thin, alkaline fluid into the urethra. Inflammation of the prostate (prostatitis) and benign prostatic hyperplasia (BPH) are common afflictions of men over the age of 50. (1) Prostate cancer is the leading form of cancer among men.

Prostatitis is inflammation caused by an infection of the prostate. Acute bacterial prostatitis is a sudden condition caused by bacterial invasion. Abscesses may form, and the potential for infection is high. Chronic bacterial prostatitis can result from enlargement of the prostate and the trapping of bacteria in the urethra. Chronic prostatitis is a major source of urinary tract infections among men.

Benign prostatic hyperplasia (BPH)

Hyperplasia describes the overgrowth of tissue. Benign prostatic hyperplasia is the non-cancerous overproduction of prostate cells that result in enlargement of the prostate. This condition, which commonly afflicts men over the age of 50, can lead to a range of uncomfortable symptoms and increases the propensity toward bladder infections. The exact mechanism that stimulates prostatic hyperplasia is not completely understood although hormonal changes are thought to play a significant role as well as body fat. (2)

Prostate cancer

Prostate cancer is the most common form of cancer in men. It is primarily diagnosed in men over 65, although it may begin much earlier. It is a very slow growing form of cancer. Prostate cancer often metastasizes to other tissue, including the brain, lungs, lymph nodes, and bones. Early detection is critical in order to increase the chances for survival. Examinations are recommended routinely for all men over the age of 40.

Statistic

Cancer Research UK, 2006.

  • Worldwide, more than 670,000 men are diagnosed with prostate cancer every year, accounting for one in nine of all new cancers in males.

  • It is the second most common cancer in men after lung cancer.

Second Report of National Cancer Registry in Malaysia, 2003.

  • In 2003, there were 602 cases reported (6.4%) making prostate cancer the 6th most common cancer among males in Malaysia.

  • The age specific incidence rate rises sharply after the age of 60.

  • The overall age standardized incidence was 10.3 per 100,000 population.

National Vital Statistics Reports, Vol. 48, No. 11.

    The annual number of deaths from Prostate Cancer are 32,203 (1998).

Vital and Health Statistics Series 10, No. 200.

    Cases of Prostate Disease Reported Annually: 2.8 million (1996).

Vital and Health Statistics Series 13, No. 143.

    Number of Ambulatory Care Visits for Prostate Cancer: 2.5 million (1997).

Campbell's Urology (7th ed.). Philadelphia: W. B. Saunders Company.

    The prevalence of Enlarged Prostate (BPH) is more than 50 percent of men age 51-60; 90 percent of men past age 80. The number of hospital discharges involving a diagnosis of BPH (1996) were 351,000 hospitalizations.

Signs and Symptoms

[span class=alert]The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.[/span]

In cases of sudden prostate swelling there will be a sudden onset of fever, chills, lower back pain, and pain in the groin area. Increased number of trips to the restroom for urination and burning with urination are likely experienced. These trips to the restroom for urination are hurried and necessary. The man will also note an increase in the number of trips to the restroom at night.

With long-term prostate swelling, there will be an increased number of hurried and necessary trips to the restroom for urination. Difficulty in starting the urine stream may also be experienced. The individual may also note puss or oozing from the penis.

Benign Prostatic Hypertrophy (BPH) is generally experienced by older men. Initially, no symptoms may be present. Eventually there will be an increase in the number of hurried and necessary trips to the restroom for urination, both day and night. There will likely be an increased difficulty in starting the urine stream as well as a decrease in the force of the urine stream resulting in dribbling and the loss of ability to completely empty the bladder. Persistent bladder infections can also occur.

Prostate cancer, like BPH, may initially have no symptoms. Eventually there will be an increased number of trips to the restroom for urination which are hurried and necessary. An increase in the number of trips to the restroom at night, difficulty in starting the urine stream and a decrease in the force of the urine stream will be experienced. Cancer differs from BPH in that the individual will experience fatigue, nausea, weakness, back pain, hip pain, and swollen lymph nodes. There will likely be discomfort in the area between the scrotum and the anus and eventual weight loss. Blood may be present in the urine.

Sudden prostate swelling

  • Sudden onset of fever
  • Chills
  • Lower back pain
  • Pain in the groin area
  • Burning with urination
  • Increased number of trips to the restroom for urination
  • Trips to the restroom for urination are hurried and necessary
  • Increase in the number of trips to the restroom at night

Long-term prostate swelling

  • Increased number of trips to the restroom for urination
  • Trips to the restroom for urination are hurried and necessary
  • Increased difficulty in starting the urine stream
  • Puss or oozing from the penis

Benign Prostatic Hypertrophy (BPH)

  • Initially, no symptoms may be present
  • Trips to the restroom for urination are hurried and necessary
  • Increase in the number of trips to the restroom at night
  • Increased difficulty in starting the urine stream
  • Decrease in the force of the urine stream
  • Dribbling
  • Loss of the ability to completely empty the bladder
  • Persistent bladder infections

Prostate cancer

  • Initially, no symptoms may be present
  • Increased number of trips to the restroom for urination
  • Trips to the restroom for urination are hurried and necessary
  • Increase in the number of trips to the restroom at night
  • Increased difficulty in starting the urine stream
  • Decrease in the force of the urine stream
  • Fatigue
  • Nausea
  • Weakness
  • Back pain
  • Swollen lymph nodes
  • Discomfort in the area between the scrotum and the anus
  • Hip pain
  • Weight loss
  • Blood may be present in the urine

Treatment Options

Conventional

Treatment for acute prostatitis is directed toward preventing abscesses and infection. Since there is poor infusion of drugs from the blood into the prostate fluid, treatment is challenging. High doses of broad- spectrum antibiotics are given orally for up to two weeks. If the condition does not improve, intravenous administration may be necessary. Treatment of chronic prostatitis is primarily aimed at treating the symptoms. If urinary tract infection occurs, antibiotics are given. Sometimes low doses of antibiotics are given over an extended period to prevent urinary tract infections.

Treatment of prostate cancer is determined by the stage of the disease. If the cancer is limited to the prostate, radical prostatectomy is usually performed, with or without radiation therapy. A recent study found, however, that men who had their prostates removed after diagnosis did not survive appreciably longer than those who’s cancers were monitored without intervention. (3) Hormonal therapy with estrogens may be used to suppress all andronergic activity in the prostate. Orchiectomy may be considered, as over 90 percent of testosterone originates in the testicles.

Nutritional Suplementation


Zinc

Zinc concentration in the prostate gland is much higher than in other tissues in the human body. In fact, it is estimated that the prostate gland uses ten times more zinc than any other organ. Adequate zinc levels help to prevent enlargement of the prostate gland. Zinc not only prevents prostate enlargement; studies report it also helps to shrink a gland that is already swollen. (4)

Taking zinc alone isn’t enough to insure prostate health. Vitamin B6 influences zinc absorption. Apparently vitamin B6 helps convert zinc to a form that is more absorbable by the tissues in the prostate. (5) Studies indicate that vitamin B6 is deficient in the diet of many Americans, which may be contributing to low zinc status and increased prostate problems.


Lycopene

Lycopene is a dietary component that seems to provide specific protection against prostate cancer. An evaluation of the Health Professionals Follow-Up Study reported a lower prostate cancer risk associated with the greater consumption of tomatoes and related lycopene-containing food products. (6) In another study, significantly lower serum and tissue lycopene levels were observed in men with prostate cancer compared to controls. (7)

Tomatoes are the primary dietary source of lycopene. Lycopene concentration is highest in cooked tomato products. It is estimated that a minimum of 4-6mg daily intake of lycopene is needed for prostate protection.


Selenium

The following study suggests that selenium supplementation may provide significant protection against prostate cancer. In a double-blind, placebo-controlled study, 978 men with a history of either a basal cell or squamous cell carcinoma were randomized to either a daily supplement of 200mcg of selenium or a placebo. Patients were treated for a mean of 4.5 years and followed for a mean of 6.5 years. The results indicated that selenium treatment was associated with a significant (63 percent) reduction in the secondary endpoint of prostate cancer incidence during 1983-93. Restricting the analysis to the 843 patients with initially normal levels of prostate-specific antigen (PSA), only four cases were diagnosed in the selenium-treated group, whereas 16 cases were diagnosed in the placebo group after a two-year treatment lag. Compared to placebo controls, the individuals taking selenium also had 58 percent less colorectal cancer and 45 percent less lung cancer. (8)


Vitamin E

The results of a study that evaluated the incidence of prostate cancer and deaths among male smokers who took vitamin E indicated that men taking 50mg of vitamin E daily had a 32 percent lower incidence of prostate cancer, and a 41 percent reduction in deaths from prostate cancer. (9) In a similar study, among current smokers and recent quitters, men who consumed at least 100 IU of supplemental vitamin E per day had a significant reduction in the risk for metastatic or fatal prostate cancer compared with nonusers of supplemental vitamin E. (10)

Herbal Suplementation


Saw Palmetto

Saw palmetto is used in men suffering from benign prostatic hyperplasia (BPH). (11) , (12) , (13) Several studies have reported the effects of saw palmetto as being as least as good as the common drugs used to treat BPH. (14) , (15) Patients pretreated with saw palmetto undergoing a prostate operation seemed to experience a reduced risk of complications in comparison to the control group. (16) It has also been recommended for nocturnal enuresis and other urinary tract disorders. (17)


Pygeum

Pygeum grows mainly in Southern Africa, Madagascar, and some areas of Central America. Today, a lipophilic extract is used and confirmed as a treatment for benign prostatic hyperplasia (BPH). Pygeum bark is currently indicated for benign prostatic hyperplasia, dysuria, diurnal and nocturnal pollakiuria, prostatitis and prostatosis, and adenomatous fibrosclerosis. (18) Pygeum is reported to improve prostate functionality through a hormonal-like mechanism and reduces the inflammation often connected with BPH.


Stinging Nettle

Stinging nettle root has been reported to be beneficial in the treatment of benign prostatic hyperplasia (BPH). (19) , (20) Stinging nettle root is reported to inhibit sex hormone binding globulin which has an effect on the androgenic receptors of the prostatic cytosol and inhibits the effects of estrogen. (21) , (22)

Diet & Lifestyle

Dietary fat: There are many studies that discuss how various factors related to diet and nutrition influence cancer. Although only a small amount of this research relates directly to the prevention or treatment of prostate cancer, the following reviews what has been reported.

Most studies that have evaluated the relationship between dietary fat and prostate cancer report that diets high in total fat are associated with an increased rate of prostate cancer. (23) , (24) Even though there are some inconsistencies, there is the suggestion that diets high in saturated fat and/or animal fat increase the risk of prostate cancer. (25) , (26) In studies on dietary meat intake, three of four cohort studies and four of five case-control studies report an increased risk of prostate cancer with higher meat consumption.

References

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  3. View Abstract: Matos-Ferreira A. New review of radical prostatectomy. Actas Urol Esp. Oct1997:817-21.
  4. View Abstract: Fahim MS, et al. Zinc arginine, a 5 alpha-reductase inhibitor, reduces rat ventral prostate weight and DNA without affecting testicular function. Andrologia. Nov1993;25(6):369-375.
  5. View Abstract: Evans GW, Johnson EC. Effect of iron, vitamin B-6 and picolinic acid on zinc absorption in the rat. Journal of Nutrition. Jan1981;111(1):68-75.
  6. View Abstract: Clinton SK, et al. Cis-trans lycopene isomers, carotenoids, and retinol in the human prostate. Cancer Epidemiol Biomarkers Prev 1996 Oct;5(10):823-833.
  7. View Abstract: Rao AV, et al. Serum and tissue lycopene and biomarkers of oxidation in prostate cancer patients: a case-control study. Nutr Cancer. 1999;33(2):159-64.
  8. View Abstract: Clark LC, et al. Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trial. Br J Urol. May1998;81(5):730-4.
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  10. View Abstract: Chan JM, et al. Supplemental vitamin E intake and prostate cancer risk in a large cohort of men in the United States. Cancer Epidemiol Biomarkers Prev. Oct1999;8(10):893-9.
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  19. View Abstract: Krzeski T, et al. Combined Extracts of Urtica dioica and Pygeum africanum in the Treatment of Benign Prostatic Hyperplasia: Double-blind Comparison of Two Doses. Clin Ther. 1993;15(6):1011-20.
  20. View Abstract: Wagner H, et al. Biologically Active Compounds from the Aqueous Extract of Urtica dioica. Planta Med. 1989;55(5):452-54.
  21. View Abstract: Hryb DJ, et al. The Effect of Extracts of the Roots of the Stinging Nettle (Urtica dioica) on the Interaction of SHBG with Its Receptor on Human Prostatic Membranes. Planta Med. 1995;61(1):31-32.
  22. View Abstract: Gansser D, et al. Plant Constituents Interfering with Human Sex Hormone-binding Globulin. Evaluation of a Test Method and Its Application to Urtica dioica Root Extracts. Z Naturforsch [C] 1995;50(1-2):98-104.
  23. View Abstract: Hayes RB, Ziegler RG, Gridley G, et al. Dietary factors and risks for prostate cancer among blacks and whites in the United States. Cancer Epidemiol Biomarkers Prev. Jan1999;8(1):25-34.
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