What lies behind the prostate test?
The prostate is a gland of the male reproductive system, of the size of a walnut, found just below the urinary bladder, which secretes a juice that is 50 to 70% of the semen. The need to undertake the prostate tests which men are commonly supposed to do in order to detect presence of prostate cancer after 50 years of age has been shattered by recent research. In 2010 even the Dr. Ablin himself, the doctor who invented such test in 1970, attacked the prevention philosophy which presses men, even those who are perfectly healthy, to undertake these tests. These blood exams, called PSA (prostate specific antigen), are never 100% sure (they diagnose only 3.8 % of cancers) and they can often detect problems that are not real or of a different form and concern than a cancer. Levels of PSA > 4 ng/mL are considered abnormal by the majority of urologists and doctors, but 80% of men with levels between 4 and 10 ng/mL have either a BHP(1) (benign prostatic hyperplasia), which is not a cancer but an inoffensive enlargement of the prostate, or no conditions at all. In fact, the levels of PSA can be increased by the use of over-the-counter drugs like Ibuprofen, as well as by infections!
Early screening and results that suggest the (3.8%) possibility of cancer often lead to unnecessary treatments: painful, dangerous and expensive exams (biopsies) and potentially dangerous treatments (prostectomy, followed by hormonal therapy that reduces testosterone). These procedures would be mostly useless, as stated by a research published in 1993 in the highly respected medical journal The Lancet: in this research, 33% of autopsies on a pool of men showed presence of prostate cancer but only 1% of such individuals died from it. Also, according to two studies found in the New England Journal of Medicine, prevention through PSA does not reduce (in USA) the rate of mortality of men older than 55 years of age, or slightly reduces the rate of mortality (in Europe), but in this case 48 men over 100 would need to be operated to save 1 life; the other 47 will undertake a surgery that most probably will make them impotent, even without need! And also, according to a research published in 2008, only 2% of men with intermediate-risk prostate cancer and 5% of men with high-risk cancer die in the 10 years after diagnosis. Men with a low-risk prostate cancer live at least 10 years longer than men who are never diagnosed. Why would such a cancer have a minimal risk of causing premature death? In the prostate, like in all organs, there are always sick and possibly carcinogenic cells, but a well functioning immune system constantly eliminates them. With age, the number of carcinogenic cells can increase, especially in the prostate. But this growth is so slow in this gland that the 80% of men with prostate cancer do not even realize they have it. Prostate cancer treatment can cause permanent damage, including impotence (50 % of cases), heart attacks, incontinence and even death: and these risks are related to a treatment of a disease that is statistically unlikely to kill them. Dr. Ablin never stated that PSA tests could detect prostate cancer and even less that they could make a difference between a high-risk cancer and a low-risk cancer. He believes that the present enhancement of such testing is driven by economical interests. * BHP is very common, 50% of men over 50s are touched by it and almost all men at 80-90 years of age have it. It usually does not cause major problems, except for some cases of urinary dysfunctions. Even if a minimal issue compared to cancer, it has to be considered that some of these dysfunctions could lead to infections, inflammation or calculi in the bladder. However, it is interesting to note that 10% of problems of urinary functions are the result of undesired effects of some drugs (ex. treatment for asthma and emphysema, antidepressants, anti-allergy or anti-hypertension).
What causes BPH? “DHT” (di-hydrotestosterone) is considered being the culprit. With age, production of testosterone decreases and DHT replaces it and increases. This DHT is responsible for the proliferation of prostate cells after puberty, proliferation that takes off with such increased levels of the hormone with age. Another hormone, oestradiol, also stimulates cell proliferation; such hormone is present in men as in women and it is produced by fat cells, which explains how being overweight is a risk in prostate cancer. Diabetes also increases the risk of BPH. What to do to prevent both BPH and prostate cancer? As any other condition, there is a genetic component in the prevalence of prostate enlargement and prostate cancer. However, controlling the environmental factors (diet, lifestyle, emotional status) can change the chances.
So, the recommendations for keeping your risks low:
- keep a stable weight, exercise regularly. Eat healthy: i.e.:
- decrease consumption of farmed animal products (milk products, salted meat and meat from battery beef) that have been related with a 31% increase of risk of BPH.
- replace red meat with fish or vegetable proteins (they reduce growth of prostate by15%)
- eat many fresh fruits and vegetables, especially apples, broccoli, green beans, bell peppers and red onions, and drink green tea: catechines and quercitine contained in high amounts in green tea and red onions and in these vegetables limit the activity of the enzyme that synthesizes dehydrotestosterone, and thus prevents overgrowth of prostate cells. Quercitine would also reduce night time needs to urinate; as a plus it is also a strong anti-inflammatory.
- consume capsules of the mushroom Reishi, which has been proven to block cancerous growth in breast, prostate, bone marrow, lungs, liver and bones, even when cells become resistant to chemotherapy. Reishi is considered by science to be a natural chemotherapeutic agent
- increase fiber intake (insoluble and from legumes) that was found to be inversely associated with prostate cancer risk
- avoid coffee, heavy alcohol and sodas which irritate the bladder. Two glasses of wine protect prostate, with an associated 33%lowered risk of BPH
- use the power of medicinal plants: the plant saw palmetto contains anti-inflammatory components and molecules that inhibit transformation of testosterone into DHT. Also nettle (Urtica dioica) contains steroids that inhibit enzymes in the prostate and limits or reduces the prostate volume while relieving symptoms. Another plant product, rye flower pollen (Secale cereale), inhibits DHT formation and growth of prostate cells
- supplement with key vitamins and minerals: vitamin E (α-tocopherol, contained in wheat germ, leafy vegetables and seeds) plays a key role in the regulation of cell growth and differentiation and has been studied as a potential chemo-preventive agent for prostate cancer. Using magnesium regularly prevents cancer growth. Magnesium chloride allows the body to better face carcinogenic aggressions.
ALWAYS ask your doctors what values really means. There are alternative tests that can be done to assess the condition of the prostate.
Some references: Lifetime occupational physical activity and incidental prostate cancer (Canada). Cancer Causes Control. 2000 Dietary Total and Insoluble Fiber Intakes Are Inversely Associated with Prostate Cancer Risk Journal of Nutrition 2014 Genetic Variants Reflecting Higher Vitamin E Status in Men Are Associated with Reduced Risk of Prostate Cancer, Journal of Nutrition 2014 Ganoderic acids suppress growth and invasive behavior of breast cancer cells by modulating AP-1 and NF-kappaB signaling. International Journal of Molecular Medicine, 2008
The development of human benign prostatic hyperplasia with age. Journal of Urology 1984
The prevalence of prostatism: a population-based survey of urinary symptoms. Journal of Urology 1993
Obesity and benign prostatic hyperplasia: clinical connections, emerging etiological paradigms and future directions - Journal of Urology 2013
Diabetes and benign prostatic hyperplasia/lower urinary tract symptoms--what do we know? Journal of Urology 2009
Contribution of common medications to lower urinary tract symptoms in men. Archives of Internal Medicine 2011
Physical activity, obesity, and lower urinary tract symptoms. Eur Urolology 2011