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Supplement Savvy for Cancer: Prostate Health

By Jill Place, MA, RD

Prostate Cancer is the most common cancer among men. One out of every six men is at risk for Prostate Cancer. Risk factors include:

Age— The risk of Prostate Cancer increases with age.

Race—African-Americans have the highest rate of Prostate Cancer. Asians have the lowest rate.

Family History—There's twice the risk with one first-degree relative. There's NINE TIMES the risk with both first- and second-degree relatives.

Sexual History— Men who have had vasectomies, high sexual activity, and sexually transmitted diseases are at greater risk.

Dietary Factors—There's a strong connection between a high-fat diet, red meat, and Prostate Cancer. There are many other dietary factors that may prevent Prostate Cancer. These dietary factors will be discussed below.

Androgens, male sex hormones, are required for growth, maintenance, and proper functioning of the prostate. But when production of these androgens gets out of whack it may cause Benign Prostatic Hypertrophy (BPH), a precancercous prostate condition. Eventually, hormone imbalance may cause androgen-dependent Prostate Cancer.

The primary male sex hormone, testosterone, can be converted either to a form of estrogen called estradiol by the enzyme, aromatase, or to dihydrotestosterone (DHT) in your body. As you age, you become less active, lose muscle mass, and gain body fat. An increase in body fat may lead to an increase in circulating DHT in your body. Also, as you age, your body becomes less sensitive to DHT and more sensitive to estradiol. This leads to an imbalance between estadiol and DHT that may be the primary cause of prostate problems in aging men.

Benign Prostatic Hypertrophy (BPH) may occur with increased estradiol, decreased testosterone/DHT, and increased sex hormone binding globulin (SHBG). In males, SHBG binds testosterone and increases the estrogen to testosterone ratio. The activity of SHBG may increase with age. SHBG also contributes to androgen imbalance. In one study, families with the lowest level of circulating androgens had the highest risk for prostate cancer.

You can change this hormone imbalance with diet and lifestyle changes.

LIFESTYLE CHANGES

It has been estimated that 75% of prostate cancer might be prevented by diet and lifestyle changes. Exercising and cutting fat intake can reduce body fat and balance hormone levels. Dietary fiber clears hormones and fats from your body. Fruits and vegetables provide fiber, antioxidants, and other nutrients that may prevent prostate cancer. Soy foods have also shown to be preventive.

In order to decrease your risk of Prostate Cancer, it might be a good idea if you:

Eat a very low-fat diet with about 15% of your calories from fat.

Increase fiber-containing foods like whole grains, beans, fruits, and vegetables to 20 to 35 grams a day.

Eat nine-plus servings of fruits and vegetables a day.

Eat more cruciferous and carotenoid vegetables and fruits like carrots and broccoli.

Cut red meat out of your diet and stick to small amounts of organic poultry and fish.

Commercially-grown chickens and fish are treated with hormones to plump them up. Buy hormone-free fish and poultry at the Health Food Store.

Increase intake of soy foods to 40 to 60 grams a day.

Exercise regularly.

Practice some form of stress reduction.

Here are some supplements that may also help:

SOY

Soy isoflavones, especially genistein and diadzen, appear to have antioxidant activity. They also have been associated with the reduced risk of breast, lung, and prostate cancers and leukemia. Soy is widely used in countries like Japan and China that have the lowest incidence of Prostate Cancer in the world. The average daily intake of isoflavones appears to be 50 mg and as high as 100 mg in these cultures.

Genistein is the most studied of the isoflavones and might prevent Prostate Cancer. Genistein may help kill cancer cells and stop the growth of blood vessels that feed tumors. Genistein may also inhibit aromatase activity and may lower circulating estrogen levels, which might help balance the estrogen to testosterone ratio. Genistein has been shown to slow prostate tumor growth.

It would be ideal if you ate three or more servings of whole soy foods like tofu, tempeh, edamame (fresh soybeans), soy milk, and miso a day. Soy milk has about 30 mg in one glass alone. But if you can't stomach soy, a supplement might be a good thing. There are many soy supplements and soy protein powders on the market. Ask your dietitian or Supplement Savvy Specialist to recommend one for you.

What To Watch Out For . . .

Please discuss the use of soy supplements with your doctor before you decide to use them. Soy has been associated with low thyroid in some individuals. Soy contains phytic acid, which may bind with certain minerals and reduce their absorption.

DIETARY FIBER

Dietary fiber clears hormones and fats from your body. Testosterone and estradiol levels in middle-aged men were found to be lower in those who ate large amounts of cereals, grains, beans, fruits and vegetables. But the average American eats about 11 grams of fiber a day. Possibly the only fiber they may see is the lettuce and tomato on their Big Mac.

One of the easiest ways to get more fiber in your diet is by eating a high-fiber cereal in the morning. A high-fiber cereal contains about 15 grams of fiber per serving. Beans are among the highest-fiber foods. A two-cup serving of vegetarian chili, for example, may contain more than 20 grams of fiber. Fiber is also found in fruits and vegetables, which also have a lot of cancer-preventing phytonutrients.

Modified Citrus Pectin, a soluble fiber found in citrus fruits, has been shown in one animal study to inhibit the spread of prostate cancer. Other fiber supplements are also available on the market. But your best bet is to eat more fiber in food.

Watch To Watch Out For . . .

The use of Modified Citrus Pectin for the treatment of prostate or any type of cancer is experimental and you should ask your doctor if you decide to try it as a supplement.

SAW PALMETTO

The research regarding the treatment of BPH and prostate enlargement with Saw Palmetto is quite encouraging. In one study, the herb significantly improved urinary flow rate and most other measures of prostate disease. In studies using both Saw Palmetto and drugs used to treat BPH, Saw Palmetto proved to be almost as effective as the drug.

Saw Palmetto alone has not been studied much as a preventive for Prostate Cancer. But an herbal preparation called PC-SPES, which has Saw Palmetto as a main ingredient, has. PC-SPES is a formulation of eight herbs: seven are plants and one is a fungus. Most of these herbs have been used for thousands of years in Traditional Chinese Medicine. Preliminary PC-SPES research shows that it might slow the progress of Prostate Cancer. Several human studies have found that PC-SPES decreases cancer cell growth, hastens tumor cell death, and reduces prostate-specific-antigen (PSA) levels in both hormone-sensitive and hormone-insensitive Prostate Cancers. PSA is the main tumor marker for Prostate Cancer. The reason that PC-SPES seems to work appears to be its estrogenic actions. Estrogen has long been one of the therapies for Prostate Cancer.

Unfortunately, PC-SPES is not being made at this time because of accidental contamination of some of the raw herbs with dangerous drugs. Perhaps this promising herbal blend will be available in a safer form sometime in the near future.

What To Watch Out For . . .

The safety of this product has not been established. It's not advisable to self-medicate with PC-SPES or any other herbal blend. Please talk to your doctor before considering taking this product. This product is for adult men only and shouldn't be taken by women or children. Herbs may not be safe for those with liver or kidney ailments. Side effects of PC-SPES are many and may be similar to those of estrogen when taken by men for the Prostate Cancer treatment. PC-SPES may cause breast or nipple tenderness or swelling, hair loss, hot flashes, and loss of sexual desire. Leg cramps, nausea and vomiting, and blood clots in the lower extremities among other symptoms. Side effects of PC-SPES may increase with dosage. Because of the estrogen-like effects of PC-SPES, you may have to adjust the dosage if you're taking hormonal drugs. PC-SPES also has licorice root in it, which as several side effects. There are many people who shouldn't use licorice, including those with kidney and liver problems, diabetes, arrhythmias, high blood pressure, and low potassium levels, edema, high sodium levels, and heart problems. You also shouldn't use licorice if you're taking furosemide/thiazide diuretics, digitalis glycosides, or anti-arrhythmic agents such as procainamide and quinidine, or corticosteroids.

GREEN TEA EXTRACTS

Green tea has been a popular beverage in China and Japan for centuries. And green tea may be one of the reasons why these countries have the least amount of certain cancers, such as breast and prostate cancers, in the world. The most active ingredient in green tea appears to be Epigallocatechin-3-gallate (EGCG), which might have an anti-cancer effect against breast, prostate, ovarian, colon, pancreatic skin, lung, and liver cancer, and others. In China, esophageal cancer risk was reduced 60% with the consumption of two to three cups of green tea a day.

EGCG has been shown to be a more potent antioxidant than Vitamin C. EGCG also kills tumor cells without killing normal cells. Green tea helps the liver to get rid of cancer-causing substances more rapidly. Green tea also enhances the actions of cancer drugs such as doxorubicin and may increase concentrations in cancer cells and not in normal cells. It would be great if you drank a lot of green tea. And don't worry about the caffeine! The caffeine in green tea doesn't act like a stimulant like the caffeine in coffee. The caffeine in green tea might also have a favorable effect upon breast health. If you don't drink green tea, a supplement appears to be a good bet.

What to Watch Out for . . .

There's no long-term safety data on this supplement. Green tea may also decrease blood clotting, so it's not a good idea for hemophiliacs and those taking wayfarin or aspirin. It's also not a good idea to take green tea before and after surgery.

MULTIVITAMINS

Taking a multivitamin may be important in Prostate Health. There are many nutrients such as the antioxidants Vitamin E, Vitamin C, Selenium, and the carotenoid Lycopene and Vitamin D that may be preventive against Prostate Cancer. A quality multivitamin with minerals also has adequate amounts of Folic Acid, B-Complex Vitamins, and minerals needed for overall health. It also has just a small amount of Calcium. Excessive amounts of Calcium from dairy products might increase Prostate Cancer. Multis have very little Calcium because an excess may bind other minerals.

Also make sure that your multi has at least 400 to 800 mg of Vitamin E, 500 to 1,000 mg of Vitamin C, 200 mcg of Selenium, and 200 to 400 IU of Vitamin D3 as cholecalciferol. If not, take additional supplements. But remember that even a quality multi isn't a substitute for a healthy diet. A quality multi can, however, be the base upon which to build a good supplement regime.

If you're interested in a quality multi, ask your dietitian or Supplement Savvy Specialist for information on how to choose one. Or ask him or her for a recommendation.

Americans eat a lot of foods with fats like corn oil, soybean oil, and other polyunsaturated fats. These fats have a lot of linoleic acid, which is a fatty acid. In some studies, linoleic acid encouraged the growth of Prostate Cancer. Linoleic acid and other unsaturated fatty acids have also been shown to increase the activity of the enzyme, which converts testosterone into dihydrotestosterone (DHT). If you remember, too much DHT encourages Prostate Cancer cell growth.

While it's important to reduce the total amount of fat in your diet to a very low 15%, it also may be a good idea to stop eating those polyunsaturated fats and eat some fish. Research has shown that the Omega-3 fatty acids found in fish, especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may slow the spread of cancer and stop formation of blood vessels that feed tumors. Omega-3s might also regulate prostaglandins, very important substances that help in many body processes. One way Omega-3s may stop tumors from happening is by making less of one type of prostaglandin and making more of another. Because of their effect on prostaglandins, EPA and DHA might also reduce inflammation and protect your heart. In cancer treatment, EPA and DHA may increase the potency of some chemotherapies, including doxorubicin, mitomycin, cisplatin, and vincristine. EPA and DHA might also keep you from losing weight, losing muscle, and being malnourished.

Having more Omega 3's in your diet is important for cancer prevention. But you may not like fish. Or you may not be able to get enough fish if you're eating a very low fat diet. Or you may have decided to become a vegetarian. Vegetarian forms of Omega-3's are not easily converted to EPA. So it might be a good idea to take a supplement.

What To Watch Out For . . .

Fish oils make cell membranes more fluid and cause less blood clotting. So they're not appropriate for hemophiliacs, those taking wayfarin (coumadin), or pre- and post-surgery patients. Rare interactions may happen between fish oils, ALA, and aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) and herbs such as Garlic and Gingko Biloba. Side effects may include mild nausea and diarrhea, bad breath, a general fishy smell, possible nosebleeds, and easy bruising. You also want to take fish oil supplements with a small amount of vitamin E to keep them from oxidizing and lessen their possible unpredictable effect upon the immune system.

© Copyright 2002 Jill Place, MA, RD