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Sunday, November 30, 2014


Russell Setright

As with any disease the best approach is prevention. We know that by improving lifestyle and diet the incidence of many prostate conditions may be reduced. However many people find the changes for a variety of reasons not easy.

Epi­demiology studies have been carried out on prostate conditions and these studies have found that many men who have this disease are usually diagnosed at an advanced age, and if cancer usually die not of prostate cancer, but of some other complaint.
Human and animal studies have been undertaken examining the effect of dietary and lifestyle influences on prostate conditions. The most likely dietary chemoprotectors are in the Asian diet, and include the phytoestrogens found in soya bean products such as tofu.

Studies found that genistein, the major phytoestrogen from soya bean when added to the diet, may reduce the symptoms and incidence of some prostate conditions such as benign prostatic hyperplasia (BPH) (1)(2) It is also suspected that the high-fat diet and red meat of Western men increases the incidence(3), but not all studies find a connection with dietary fat. Surprisingly, some types of seaweed eaten by the Japanese seem to increase the risk of adverse prostate conditions. This may be the result of the high heavy metal content of some seaweeds. Cadmium, at least, is suspect­ed of causing prostate cancer. Vegetarians have a lower risk of devel­oping this cancer.

Benign prostatic hyperplasia is the result of excessive production of prostate cells, and this in turn is due to the overproduction of the hormone 5-dihydrotestosterone. This overproduction may be inhibited by zinc. Vitamin E, evening primrose oil, and fish oils also help to keep the prostate in good condition. The herbs saw palmetto and ginseng may be helpful in reducing symptoms of BPH, and pumpkin seeds, red clover and soy products contain beneficial phytoestrogens.

Changing the diet that may also reduce the symptoms of BPH and should be low in fat and red meat, high in fibre, fruit, and vegetables, especially soya bean products, turmeric, cooked tomato products, green tea and the spice turmeric.

Useful dietary supplements include zinc, natural vitamin E, selenium, fish oil, lycopene, saw palmetto, Nettle,  vitamin D3 and pumpkin seeds (lightly roasted) can be eaten as a snack(3)(4)

1.     Wong WC, Wong EL et al. Isoflavones in treating watchful waiting benign prostate hyperplasia: a double-blinded, randomized controlled trial. J Altern Complement Med. 2012 Jan;18(1):54-60. doi: 10.1089/acm.2010.0077.
2.     Geller JSionit L et al, Genistein inhibits the growth of human-patient BPH and prostate cancer in histoculture Prostate. 1998 Feb 1;34(2):75-9.
3.     Kristal ARArnold KB et al, Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trialAm J Epidemiol. 2008 Apr 15;167(8):925-34. doi: 10.1093/aje/kwm389. Epub 2008 Feb 7.;
4.       Morgia GCimino S, et al. Effects of Serenoa repens, selenium and lycopene (Profluss®) on chronic inflammation associated with benign prostatic hyperplasia: results of "FLOG" (Flogosis and Profluss in Prostatic and Genital Disease), a multicentre Italian studyInt Braz J Urol. 2013 Mar-Apr;39(2):214-21. doi: 10.1590/S1677-5538.IBJU.2013.02.10.

A little about two of the herbs mentioned

SERENOA (Serenoa repens)
One of the most commonly used herbs is saw palmetto (Serenoa repens) and also, one of the most effective. Serenoa has been found to have a 5-alpha-reductase inhibitory action that reduces the amount of dihydrotestosterone produced in the body; increased levels of dihydrotestosterone are associated with the incidence of BPH.

Serenoa may also help tone the male reproductive system particularly the prostate. Clinical studies have reinforced its traditional use. Standardised extracts of Serenoa have been shown to be superior to placebo and equivalent to the drug finasteride with fewer side-effects (Carrora et al, Prostate 1996).

Serenoa and prostatitis.
As mentioned before selenium and lycopene have been found to have positive effects in relation to prostate health. This combination was evaluated in a study was undertaken to evaluate the efficacy and safety of Serenoa repens + selenium and lycopene versus S. repens alone for the treatment of category IIIa chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

The study used the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), to evaluate maximum peak flow rate, and PSA measurements at baseline and at weeks 4, 8 and 8 after the end of treatment.

The results found the NIH-CPSI score decreased significantly in both groups and a 51.64% decrease in the total score in the Serenoa+ group and 26.06% in the Serenoa group. Also, PSA and white blood cell count decreased significantly in the Serenoa + group.

The authors concluded that Serenoa plus selenium and lycopene therapy that is safe and well tolerated. It ameliorates symptoms associated with IIIa CP/CPPS (Morgia G, et al. Urol Int.2010;84(4):400-6. Epub 2010 Mar 24).

Another study evaluated the use of Serenoa extract in 120 men with mild to moderate BPH induced urinary symptoms.

Statistically significant improvements in the International Prostate Symptom Score, quality of life, International Index of Erectile Function and reduction in residual urinary volume were observed during the study period. The mean prostate volume at 24 months was 36 ml, compared to 39.8 ml at baseline (Sinescu I, et al. Urol Int.2011;86(3):284-9. Epub 2011 Feb 8)

These studies confirm the use of Serenoa, selenium and lycopene in combination for the symptomatic relief of BPH. However, some studies found Serenoadid not offer a statistically significant improvement in some of the symptoms of BPH.

NETTLE (Urtica dioica)
Nettle leaf is a herb that has a long traditional use as an adjuvant remedy in the treatment of arthritis in Germany.
Nettle root extracts have been extensively studied in human clinical trials as a treatment for symptoms of benign prostatic hyperplasia (BPH). These extracts have been shown to help relieve symptoms compared to placebo both by themselves and when combined with other herbal medicines.

A 6-month, double-blind, placebo-controlled, randomized, partial crossover, comparative trial of Urtica dioica with placebo in 620 patients was conducted. PSA, urine flow. Residual urine volume, prostate symptoms score, testosterone levels, and prostate size were evaluated .

At the end of 6-month trial, 81% in the Urtica dioica group reported improved lower urinary tract symptoms compared with 16% patients in the placebo group With the exception of PSA and testosterone level which remained unchanged in both groups, all other symptoms tested reduced significantly in the Urtica group compared to the placebo group.

A modest decrease in prostate size as measured by transrectal ultrasonography was seen in Urtica dioica. No side effects were identified in either group. (Safarinejad MR. J Herb Pharmacother. 2005;5(4):1-11)

Another study using a herbal formula that included Serenoa and Urtica reported a significant benefit, with special reference to an improvement of pain, urgency, strangury and nocturia (night urination). (Pavone C, et al. Urologia. 2010 Jan-Mar;77(1):43-51).

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