Prostate Health If you’re a man over the age of 50, chances are good that you’ve had a PSA test. But is this simple test all it’s cracked up to be? Not according to a study that came out last week in the New England Journal of Medicine. It seems that this widely used blood test misses 82 percent of cancers in men under 60 and 65 percent of cancers in older men. Should you be worried? Absolutely. But there may be even more cause for concern. ------------------------------ Smoke screen --------------------- A PSA screening is designed to look for early signs of prostate cancer by measuring a man’s serum prostate-specific antigen (PSA) levels. PSA is a protein made by prostate cells, in particular prostate cancer cells. But PSA tests haven’t been shown to reduce the death rate from prostate cancer. In fact, researchers at Kitassato University in Japan point out that this diagnostic test can’t clearly distinguish between prostate cancer and benign prostatic hyperplasia (BPH) – an enlarged prostate often characterized by frequent nighttime urination, an increased urgency to urinate or a feeling that the bladder hasn’t been completely emptied. As a result, millions of men undergo needless biopsies. The other problem is that your PSA level may not be the same a year from now. Researchers at the Memorial Slone-Kettering Cancer Center in New York City followed 972 men for four years to see if PSA levels changed from year to year. Over the course of the study, the Slone-Kettering team took five blood samples from each of the subjects and tested them for total and free PSA levels. After the first sample, 109 of the men had levels high enough that most doctors would have automatically recommended a biopsy. But, during subsequent blood tests, half of those men had normal PSA levels! The interesting thing is that earlier research has found that it may not take that long for your PSA levels to change. According to a study of 44 men by a team of doctors at Hacettepe University in Ankara, Turkey, there may be significant changes in serum PSA over the course of just one day. So if your PSA levels are elevated after one screening, don’t panic – and don’t let your doctor sign you up for a biopsy. Biopsies for prostate cancer aren’t just painful, they can also result in bleeding and infection. Instead, tell your doctor that you want to repeat the test in a few weeks. And while you’re waiting for your second PSA screening, start taking action to boost your prostate health. ------------------------------ A natural approach ---------------------- There are two things you need to know about abnormal PSA levels. First, prostate cancer is usually slow growing. In fact, most prostate cancers remain dormant, and only a small number progress to cause illness or death. Second, an elevated PSA reading may simply be an indication of BPH. Don’t get me wrong – BPH can have a serious impact on your life, but it’s rarely fatal. So, needless to say, it’s important to get an accurate diagnosis. Regardless of whether you’re diagnosed with prostate cancer or BPH, conventional doctors take the same approach – drug therapy or surgery, both of which can cause side effects, including impotence. But there are better options. A few years ago, a study published in the Journal of the National Cancer Institute suggested that vitamin E may reduce the risk of advanced prostate cancer. The prospective, placebo-controlled, double-blind trial studied 29,133 men, ages 50 to 69. The subjects received either vitamin E (50 IU daily), beta-carotene (20 mg. daily), both supplements together or a placebo. The treatments were continued for five to eight years. Combined, the two groups receiving vitamin E developed 32 percent fewer prostate cancers than the two groups that did not receive it. They also had a 40 percent reduction in the risk of developing advanced cancer and their mortality from prostate cancer was 41 percent lower. Although vitamin E didn’t affect how long the subjects would survive advanced cancer once it had developed, these results suggest that it may help prevent prostate cancer from moving from the dormant to the progressive stage. Selenium may also help reduce the risk of prostate cancer. In one Harvard study of 51,529 male health professionals, researchers found that those with the highest selenium levels were the least likely to develop advanced prostate cancer. And here’s an added bonus – vitamin E enhances selenium’s anti-tumor and antioxidant properties. Herbs can also play a significant role in prostate health. One of the best is saw palmetto, mainly because it works on two fronts. First, the herb inhibits the formation of dihydrotestosterone (DHT), a hormone that stimulates prostate growth. But its impact on prostate health doesn’t stop there. According to a study in the journal Cell Biology International, saw palmetto also causes prostate cancer cells to commit suicide. Here’s even more good news – besides being effective and free of side effects, saw palmetto costs about one-third as much as prostate medications like Proscar. If your doctor suspects BPH, check out the bark of the large African evergreen tree, Pygeum africanum. Pygeum contains lipophilic compounds that decrease prostetic swelling, diminish prolactin (which in turn decreases prostatic uptake of testosterone), and lower cholesterol. DHT and testosterone bind more easily to prostate receptors when cholesterol levels are high. Besides helping to alleviate BPH, a preliminary study conducted in Spain found that pygeum also helps keep prostate cancer cells from spreading. One last thing . . . Peter also mentioned that his doctor had him on Flomax, a drug used to treat BPH. Flomax doesn’t shrink the prostate. Instead it relaxes the muscles around the gland, freeing the flow of urine – and symptoms should improve in a week or so. But if, as in Peter’s case, it isn’t working (or if you’d rather not risk the drug’s side effects, including abnormal ejaculation, chest pain and infection), beta-sitosterol might be what you’re looking for. Beta-sitosterol is a plant sterol found in rice bran, wheat germ and soybeans. It’s also available in supplement form. In one double-blind trial, 200 men with BPH received 20 mg. of beta-sitosterol three times a day or a placebo for six months. Men receiving the beta-sitosterol had a significant improvement in urinary flow and other symptoms, but no change was reported in the men receiving the placebo. Another double-blind study reported similarly positive results using 130 mg. of beta-sitosterol a day. But if BPH isn’t the reason for your frequent nighttime trips to the bathroom, get a second opinion to rule out other conditions. This just in . . . When it comes to turning back the hands of time, a lot of people rely on the hormone DHEA, a.k.a dehydroepinandrosterone. But, according to a study in the latest issue of the Journal of Clinical Endocrinology, DHEA may also help prevent age-related heart disease. In the study, Japanese researchers examined the effect of replenishing the hormone in 24 older men with high cholesterol levels. Half of the men were given 25 mg. of DHEA daily for 12 weeks, while the other half were given a placebo. DHEA treatment, but not the placebo, produced a significant improvement in artery flexibility after just four weeks. Treatment with DHEA also produced a significant drop in blood sugar levels without altering insulin levels. In other words, DHEA could improve diabetic symptoms by increasing insulin sensitivity. Earlier research has linked DHEA to a reduction in body mass and bone loss. It has also been found to increase stamina and sexual desire. Unfortunately, the body’s DHEA levels decrease with age. But supplementing with DHEA should be done in moderation, particularly if you’re a man since this hormone can stimulate DHT. If you are taking more than 25 mg. a day, it’s a good idea to be supervised by a doctor familiar with anti-aging hormones. Yours in health and happiness, References: “DHEA May Ward Off Heart Problems, Diabetes.” Reuters. 25 July 2003. Eastham JA, et al. “Variation of serum prostate-specific antigen levels: an evaluation of year-to-year fluctuations.” Journal of the American Medical Association. 2003; 289:2695-2700. Goldman WH, et al. “Saw palmetto berry extract inhibits cell growth an dCox-2 expression in prostatic cancer cells.” Cell Biology International. 2001; 25:1117-1124. “Prostate test misses tumors, study finds.” Reuters. 24 July 2003. Wilt T, et al. “Beta-sitosterols for benign prostatic hyperplasia.” Cochrane Database System Reviews. 2000; CD001043.
|
