How you can help yourself

taken from Small Gland, Big Problem 4th Edition
by Professor Roger Kirby, Health Press 2011

Men’s attitude towards their health has traditionally been ‘if it ain’t broke, don’t fix it’. These days, the thinking should be more along the lines of ‘if you look after your body (and particularly your heart and your prostate), it’s less likely to go wrong’.

Lifestyle

Adopting a healthier lifestyle, in terms of both diet and exercise, is obviously desirable. By staying slim and fit, you are more likely to remain healthy and, in particular, you will reduce your chances of developing cardiovascular disease and diabetes. This may also benefit your prostate, as there is increasing evidence that overweight men and men with higher cholesterol levels are more susceptible to prostate cancer. BPH is also more common in obese men, and surgery in obese individuals is more risky. In addition, prostatitis will often resolve as general health improves. In prostate disease, as in so many other areas, prevention is better than cure. I often advise my patients to use the mnemonic shown below to get to a better ‘place’.

A helpful mnemonic for healthy lifestyle
Portion control
Lose the booze
Axe the snacks
Cut the carbs
Exercise every day

Diet. A healthy diet is essential for good health, and the best way to achieve this is to eat moderate quantities of a wide variety of the right foods. Try to have:

  • less fat, particularly saturated fats, which are found in fatty meats and dairy products, and ‘trans fats’, which are found mostly in margarine and processed baked goods
  • more fish and chicken (but not the skin), and less red meat
  • plenty of fresh fruit and vegetables – try and eat at least five portions and aim for nine portions a day (see page 102)
  • foods high in fibre, such as wholewheat bread and grains
  • less sugar and salt
  • moderate amounts of tea, coffee and alcohol
  • antioxidant-rich foods, such as blueberries, strawberries and broccoli.

Selenium. Until recently, selenium was thought to reduce the incidence of all cancers and prostate cancer in particular, based on study results. However, a large study designed to specifically look at the effects of selenium and vitamin E, taken singly or in combination, has now disproved any protective effect.

Zinc. Zinc deficiency is unusual, but may be responsible for some prostate problems, as well as impotence. It is therefore important to include good sources of zinc in your diet: for example, meat, fish, wholegrains and legumes, such as peas and beans.

Vitamin D. Prostate cancer is more common in northerly latitudes. Sunlight increases the body’s vitamin D level, which is believed to be protective against prostate cancer. A vitamin D supplement can be taken but as yet there is no definite proof that taking a supplement reduces the risk of prostate cancer.

Antioxidants. Antioxidants are thought to protect the body’s cells against cancer-causing substances. The main antioxidants, which are found in fruit and vegetables, are vitamins A, C and E, and lycopene, which is found in tomatoes. The two most effective antioxidants are vitamin E (see selenium)and lycopene. Research has shown that those people who eat a lot of tomatoes and tomato products have a lower risk of certain cancers, particularly prostate cancer. Tomatoes are more effective when they have been processed or cooked, because heating with a little oil helps to release the lycopene from the tomato skin and makes it easier to absorb.

Cranberry juice. Urinary tract infections are more common in men with an enlarged prostate gland. While such infections are not life-threatening or significant, they can have a considerable financial and social toll on those affected. Although more research is needed, drinking one or two glasses of cranberry juice a day does seem to ward off urinary tract infections in some individuals. A word of caution: if you are taking warfarin, you should avoid cranberry juice as it can interfere with the effects of the drug.

Blueberry juice is thought to have similar properties and also contains antioxidants. Highly coloured fruits such as strawberries and raspberries are also recommended.

Saw palmetto. The herb saw palmetto (Serenoa repens) is a plant native to the south-east of the USA. It has been shown to inhibit the action of 5-alpha-reductase (see page 80), growth factors and inflammatory substances responsible for the common symptoms of BPH (see page 76). A study reported in the New England Journal of Medicine called into doubt its efficacy; however, some patients swear by it, so more research is needed.

Exercise. Regular exercise is essential for good health and plays an important role in reducing the risk of developing many diseases. A recent study in America found that men who undertook 3 hours of vigorous exercise per week were 70% less likely to develop or die from prostate cancer. Exercise also helps us to maintain a healthy body weight, particularly when combined with a healthy diet. The prominent ‘beer belly’ that is so characteristic of overweight men is strongly linked to an increased risk of heart attack and stroke. It therefore makes sense to try to do some moderate physical exercise for at least 30 minutes five times or more a week. Remember that vigorous exercise not only burns off calories as you do it, but also increases the metabolic rate for up to 12 hours after the exertion. Consequently, twice-daily exercise is especially good if you are actively trying to lose weight.

Smoking. Those readers who smoke are strongly exhorted to give it up! Although smoking does not cause prostate disease directly, it may result in bladder and kidney cancer and, because it damages blood vessels, it may also result in reduced erections and sexual dysfunction.

Other ‘therapies’. A host of other complementary therapies are claimed to protect against prostate cancer, but sound evidence for their safety and efficacy is sparse. This includes soya products, green tea, apricot kernels, pomegranates and St John’s wort. Cancer patients, in particular, are very vulnerable to hype about so-called ‘alternative’ therapies, many of which have no clinical or scientific basis. In some cases they may even be harmful, as they can contain toxic substances or may interact with medicines prescribed by your doctor. It is therefore important that you seek advice from your doctor before embarking on any alternative therapy. Much more research is needed to provide better evidence that various foods, plant extracts and supplements are truly as safe and effective as the manufacturers would have us believe.