Monday, February 11, 2008

Will I Get Prostate Cancer?

They say that if you're a male and you live long enough, you'll develop prostate cancer. But it probably won't be the cause of death. They'll just find it at autopsy. (Worldwide, 30% of men older than 50 have 'latent' prostate cancer.) You're much more likely to have died of heart disease. Not too comforting a thought, is it? You'd prefer to die of 'very old age' without either heart disease or cancer.

No one wants to develop heart disease, but it's a much less frightening concept than prostate 'cancer.' Too many men you know are having 'prostate problems' these days. It's frightening to think that the changes in bladder function might be a bothersome condition called BPH, an anatomical problem that develops when the prostate (a walnut sized gland at the base of the bladder) enlarges. In the process, BPH impedes urine flow, resulting in an inability to completely empty the bladder, frequent and/or painful urination, and even incontinence. Or it might be cancer of the prostate.

Environment (e.g., drugs, chemicals) and diet both play a role in the development of prostate cancer. Epidemiological studies provide clear evidence of this, thereby providing insight into how the incidence can be reduced. For instance, there are approximately 75,000 cases of prostate cancer in the United States each year - representing 18% of all new cancers. This rate of clinically evident prostate cancer is 120 times higher than found in China, even though men in both countries exhibit the same 30% rate of latent cancer found at autopsy.

What causes this transformation from abnormal cells to life-threatening disease? And what does this tell us about how we should live? It tells us a lot about the impact of our diet upon our health, in this case the effect it appears to have on the progression of prostate cancer. And on its prevention.

There are two ways to reduce your risk of prostate cancer: One, alter the type and amount of fat intake in your diet. Two, increase your consumption of foods and botanicals that have been shown to protect the prostate gland against cellular injury. These are important steps to take, and can be valuable even if you already have prostate involvement. At the same time, you should also be taking advantage of medical screening and diagnosis, such as yearly PSA (prostate specific antigen) blood tests to monitor the health of your prostate.

I. Alter The Type and Amount of Fat In Your Diet

The results of two major epidemiological studies, one in Hawaii and one on US health professionals, both implicated dietary fat as a major risk factor for prostate cancer. The recommendations from both studies are to reduce the total amount of fat in your diet. Currently in the US, 37% of our calories are obtained from fat. To reduce the risk of prostate cancer (and perhaps other cancers, as well), it is important to reduce that percentage to less than 20%. The data are not conclusive about whether the best percent is 20% vs. 15% vs 10%. But at least it can be said that men in the US consuming an average diet must cut their fat at least in half (from 37% to 20%) to reduce their risk.

These two studies, as have many other, implicated animal fats as being particularly important in the development of prostate cancer. The saturated fats in beef and milk caused substantial increases in relative risk of developing prostate cancer. It would be wise, therefore, for men to alter their intake of high-animal fat foods as well. Substituting fish and fowl for high fat meats appears to make a big difference in risk. (Read the article "How Much Meat Can I Eat?" for some good ideas.)

It has also been reported that a particular type of fat (alpha-linolenic acid) can increase risk of prostate cancer. This fat is found in vegetable sources as well, such as soy and rapeseed oils. Further research is required on this point, however, since soy has also been shown to have beneficial anti-cancer effects for other organs.

How can fat in the diet affect the risk of developing prostate cancer - or any cancer, for that matter? Because of their biochemical effects, which is true for all nutrients and botanicals. For instance, reducing total fat in the diet - and in particular the type of fat consumed, will reduce the amount of sex steroid hormone produced. This in turn reduces the amount of stimulation to the prostate gland, decreasing the risk of overstimulation. Reducing the amount and type of fat also leads to a reduced synthesis of biochemical compounds called 'eicosanoids.' These compounds can lead to inflammation of the prostate, in essence setting up a pattern of constant irritation - and increased likelihood of transformation to cancer.

II. Use Foods and Botanicals For Protection

Certain foods and botanical supplements have been shown to protect against the adverse biochemical effects that chemicals, fats and hormones can have on sensitive cells - such as the prostate. These include anti-oxidants (e.g., Vitamin C, Vitamin E, selenium) and the active compounds in natural substances such as Saw Palmetto and Nettle.

Just as there is a mechanism of injury by which fats and chemicals have their negative effects, there is also a preventive mechanism by which these nutrients and botanicals provide protection. For instance, Vitamin C and selenium protect against the effects of free radicals, parts of the fat molecule that break away and injure adjacent tissue. Saw Palmetto inhibits the enzyme (5-alpha reductase) that produces dihidrotestosterone in the gland, a hormonal stimulant of the prostate. Nettle is thought to work in a similar way, to inhibit the level of testosterone stimulation to the prostate, preventing its enlargement.

Prudence dictates a change in the way men eat, so they can reduce their risk of prostate cancer. It's also smart to use nature's resources - such as the botanicals - to further reduce the risk. Living a long and healthy life should be the goal. Watching your fat intake isn't too big a price to pay, is it?

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