PROSTATE DISEASE

What is a prostate?  The prostate organ produces most of a man’s semen or ejaculate fluid.  It pumps fluid out of the penis during arousal and protects him from getting urinary tract infections. 

How common are prostate problems? Each year more than 1,000,000 men are diagnosed with a prostate disease, and another 180,000 with prostate cancer.  Enlargement of the prostate is extremely common, effecting half of men over the age of 50. This condition, called benign prostatic hyperplasia (BPH), causes symptoms such as urinary urgency, frequency and inadequacy as well as difficult erections and/or painful ejaculation.  Prostate cancer is the leading cause of cancer death in men.  Luckily, in many cases, it is slow growing.  This means that more men are likely to die with it than of it.

Ambiguities in Diagnosis. Diagnosing someone with BPH or even prostate cancer is not as straight forward as you might have been lead to believe.  A good example of this is the prostate-specific antigen (PSA), the gold standard for screening for prostate cancer and judging the effectiveness of therapies.  PSA levels can be falsely elevated by sexual activity, riding a bicycle, prostate size and medications.  While it is an indicator for cancer, sometimes BPH too can cause elevations PSA while prostate cancer can exist without elevations of PSA.  Some physicians believe this early detection method can lead to unnecessary treatments and procedures.

What are the side effects of conventional treatments?  This question is difficult to answer because of the huge variety of prostate problems compounded with multiple possible treatments.  For BPH side effects of medications range from low blood pressure, dizziness and heart palpitations to impotence and decreased sex drive.  The gold standard surgery for BPH is called TURP (transurethral resection of the prostate).  It has a 25% failure rate and brings serious complication such as urinary incontinence (2-4% men), retrograde ejaculation (70-75% of men) and impotence (5-10% men).  Medical expert Dr. Glenn Bubley admits that when it comes to treating prostate cancer, not enough evidence exists to clearly establish which procedures might be most effective, whether it is a surgical removal (radical prostatectomy), radiation, chemotherapy or drugs.  Depending on the man, impotence may be one of the most common and disconcerting side effects of certain procedures. While this type of detail is beyond the scope of this article, be aware, says Dr. Bubley, that each specialist (for example, a radiologist) is likely to tell you their method is the best, while this is not necessarily the case.  Ask lots of questions, see several different specialists, and decide what is best for you.

How may prostate disease relate to lifestyle? A number of epidemiological factors, clinical observations and small studies indicate multiple lifestyle factors that contribute to both BPH and prostate cancer.  Most striking is that a man is 36 times more likely to develop prostate cancer in North America than in China.  When men from China migrate to America their incidence of prostate cancer rises.  Epidemiological evidence suggests that having red meat and dairy products as the main source of protein in North America, versus soy and fish sources in China, may explain this difference.  We also eat fewer whole grains, fruits and vegetables.  The main beverage in China, green tea, with its proven anti-cancer properties, is in stark contrast to the milk, coffee and pop drinking culture of North Americans. 

Obesity may contribute to prostate problems since fat cells convert testosterone into estrogen, and high estrogen levels have been shown, in dogs, to induce BPH.  Furthermore, the hormone testosterone also factors in.  Eunuchs, men who have no testes and therefore very low levels of testosterone, are said to never get prostate cancer.  Deficiencies in a number of nutrients such as Zinc can cause excessive amounts of dihydrotestosterone (DHT), a form of testosterone, to accumulate in the prostate of some aging men.  This can cause enlargement of the prostate and be a risk factor for prostate cancer.