Prostate Health Supplements – Prostate Cancer and BPH

Nearly 80% of men over 70 have benign prostate hyperplasia (BPH). This condition can lead to a number of troubling urinary symptoms. Prostatitis and prostate cancer are also common. OTC, vitamins, herbs and supplements may be self-administered by prostate cancer patients. One study found that 27% of prostate cancer patients used alternative medicines. 3 Most men who use these alternative therapies don’t know the risks and are not aware of them. Patients can ask the pharmacist about OTC and prostate health treatments. This article will cover some of the most common non-prescription treatments for prostate health.

Prostate Cancer

Men are more likely to develop prostate cancer. Prostate cancer is common in men. 4 The growth of hormone-dependent prostate cancer cells can be stimulated by testosterone, the male hormone.

Vitamin E, selenium and saw palmetto are all commonly used to treat prostate cancer. Selenium, a trace element, plays an important role in the body’s antioxidant defense mechanism. Vitamin E, a fat-soluble vitamin, is also an antioxidant. Supplementation with vitamin E or selenium may help to prevent prostate cancer. 3,4

Low levels of selenium have been shown to be associated with prostate cancer. Supplementation with it can prevent the growth of prostate cancer cells in vitro. 5 Selenium is an important component of the antioxidant enzyme glutathione oxidase. This helps cells from oxidative stress. One proposed mechanism of action for selenium in improving prostate health is its effect on the endocrine system; it influences testosterone production, thereby evidencing a possible link to the pituitary-adrenal-gonadal axis.6

Clark et. al. published a large-scale, randomized and double-blind placebo-controlled study in 1996 that examined the role of selenium on cancer recurrence. Secondary endpoints included all-cause mortality. Patients were randomly assigned to receive 200 mcg or placebo of selenium daily for an average period of 4.5 years. Although selenium treatment didn’t prevent the development of basal- and squamous cell carcinomas, the study was ended early due to statistically significant improvements in overall cancer mortality, as well as secondary endpoints like lung, colon and prostate cancer. Patients with low baseline levels of selenium had the highest rates of prostate cancer prevention. The primary purpose of this study was to assess selenium’s protective effects on skin cancer. However, the results have been questioned. Despite the fact that trial enrollment started in 1983, the secondary endpoints, such as prostate cancer development, were not added until 1990. The findings were fascinating, but the authors recommended that the effects of selenium be confirmed in an additional, well-designed trial before making any new recommendations about supplementation.

Yoshizawa and colleagues (N=51,000) published another study that found a strong correlation between prostate cancer risk and selenium levels. The difference was significant after controlling for factors like family history, diet, geographic region, and other influences. Hardell et. al. conducted a similar, but smaller, study and found that serum selenium levels were significantly lower among men with prostate cancer than those who did not. 8

Peters and colleagues performed a nested case-control analysis within the screening arms of the Prostate, Lung, Colorectal, Ovarian Cancer screening Trial. The serum selenium concentrations were prospectively compared among 724 prostate cancer patients and 879 healthy subjects. Subjects were followed up to eight years. There was no significant reduction in the risk of prostate cancer. However, had significantly lower risk in subjects who consumed high amounts of vitamin E and multivitamin users. This suggests that combination therapy could reduce the chance of developing prostate cancer.

The Selenium and Vitamin E Cancer Prevention Trial is a large, randomized, double blinded study that currently has been completed. It examines whether selenium or vitamin E can reduce the risk of developing prostate cancer. 10 32,400 healthy people will be randomly assigned to one of four groups: vitamin E (200 mcg), selenium (20 mcg), selenium (200 mcg), and placebo. The treatment will last seven to twelve years. The final results are expected to be available in 2013.

Current evidence suggests OTC selenium supplementation (200 mg daily) may be beneficial for certain men to lower their risk of developing prostate cancer. Men who have a lower baseline selenium level (122 ng/mL) and a lower prostate-specific antigen levels (PSA), may see the greatest benefits from OTC selenium supplementation (200 mcg daily). However, the results of the SELECT study will be necessary to confirm that 200 mcg of supplementation is safe and effective in reducing prostate cancer risk among healthy men. The majority of research on selenium supplements has been focused on prevention. It is not clear whether OTC selenium supplementation should be used to treat prostate cancer. The latest evidence doesn’t support vitamin E as a preventative for prostate cancer. 12

BPH

BPH is when the prostate gland becomes larger and pushes against the urethra. This can cause various urinary symptoms. However, not all men who have an enlarged prostate experience these symptoms. BPH is more common in men over 50, possibly because of an increase in estrogen and testosterone levels. BPH does not increase the risk of developing cancer. However, they can occur in tandem. BPH symptoms include inability to urinate, difficulty starting urination or weakening of the urinary stream, frequent urination and urinary urgency. Asymptomatic men do not need treatment. However, if there is pain or difficulty urinating, treatment may be required.

Saw palmetto (Serenoa Repens) is the most commonly used non-prescription drug to treat symptoms of BPH. 13 This substance, which is extracted from the berry of the see palmetto shrub is believed to inhibit 5-alpha reductase (5-5-AR), which blocks the conversion of testosterone into dihydrotestosterone. This is responsible for stimulating the growth of the prostate. Side effects of saw palmetto are rare, but can include headaches and stomach upset. This herb is not known to interact with any drugs.

Some studies have shown that saw palmetto can increase urine flow in men with BPH compared with placebo. 13,14 Also, men with prostate cancer and urinary bladder problems were exempted from the study. 15 Participants could be eligible if they had not taken alpha-blockers or 5-AR inhibitors for a certain time before the study. In standard objective urinary symptoms scores, such as maximal urinary flow rate, prostate size, residual volume following voiding, quality-of-life, and serum PSA levels, there was no difference between saw palmetto groups and placebo. Side effects were similar in both groups. This study cast doubt on the efficacy of saw palmetto in the treatment of BPH.

Similar results were obtained in a study by Marks et al. 16 BPH patients (n=44), who were treated for six-months with either saw palmetto, placebo or both. Marks et al. (16) conducted a similar study on 44 patients with BPH. They used saw palmetto or placebo for six months.

Complementary and alternative medicine for urological symptoms (CAMUS) is a new study that could be useful in recommending alternative therapies. 18 This trial aims to determine if the phytotherapies repens or Pygeum Africanum can delay or stop the progression of BPH. The randomized, double-blind and actively controlled efficacy trial, which began in 2005, has already enrolled 2,860 participants. It will end in 2012. Randomly, participants are assigned to one of the following four treatments: extract S. repens or extract of P africanum. Tamsulosin is also available. For four years, patients will be seen at the clinic once a month. At clinic visits, the following assessments will be done: physical examination, digital rectal exam; medical follow up (new diagnoses and treatments, hospitalizations); vital signs; PSA and uroflow measurement; as well as questionnaires regarding prostate health, adverse events and medications. The CAMUS trial will provide a solid comparison between some phytotherapies, placebo, and the currently recommended prescription-treatment drug class.

P africanumis tall evergreen found in South and Central Africa. The powdered bark has been traditionally used to treat a range of urinary problems. Concentrated extracts from P Africanum were studied for their efficacy in treating BPH. 19 However, clinical trials revealed that there are methodological problems, such as short follow-up and incomplete outcome assessments, and lack product standardization.

Although the risks of saw-palmetto are unknown, it is thought that the herb may interact with 5-AR inhibitors. This could lead to unexpected or abnormal results. 20 Pharmacists should be able to engage patients in a discussion about the risk and benefits of saw-palmetto. Self-medicating using saw palmetto should not be done by men with new-onset obstructions of the urinary system. These patients should be monitored as symptoms of BPH may mimic other conditions such as prostatitis and prostate cancer.

Prostatitis

Prostatitis–inflammation of the prostate gland–can be acute (bacterial) or chronic (bacterial or nonbacterial). Prostatitis can be characterized by pain, fever, and problems with urination. Kaplan et al recently published the results of a single-blind, randomized trial comparing saw-palmetto and finasteride for the treatment of chronic prostatitis. All patients had received antibiotics for a period of nine to 93 weeks, 52 had been on alpha blockers. The mean National Institutes of Health Chronic Prostatitis Symptom Index score at 12 months was significantly lower in patients who were given finasteride (23.9 to 18.1) than those who were on saw palmetto. At 12 months, the quality of life and pain in the finasteride group were significantly better. The authors concluded that patients who received saw palmetto did not experience any long-term improvements, while patients who received finasteride showed significant improvement over the long-term in all other parameters except urination.

The Truth about Herbal Supplements and Your Prostate health

It doesn’t matter if you have been diagnosed with prostatic cancer, or if you are trying to prevent it from happening, it is tempting to look into alternative or complementary medicine. We are here to clarify how vitamins and herbal supplements can affect prostate health.

Let’s not forget to mention that any type of cancer can be difficult to manage. Sometimes, traditional treatments don’t work as well as you expect. Over-the-counter herbs and supplements are a great alternative. Before you take any new medication, it is a good idea to consult your Pittston urologist. Let’s look at some common alternatives, side effects, and issues.

Common herbs and supplements for prostate health

Harvard Health has estimated that approximately one-third (33%) of American men suffering from prostate cancer have tried at least one alternative treatment, including herbal and supplement remedies. The most popular supplements are:

Saw Palmetto This one is near the top as it can be used for many urological conditions, such as patients with an enlarged prostate (also known by benign prostatic hyperplasia, or BPH). People take approximately 320 mg of saw palmetto daily. While some studies claim it may help with incontinence, others suggest that saw palmetto does not really work. Men often take the herb with melatonin to slow down the spread of prostate cancer. You run the risk that you will get bleeding if you take this herb with pain relievers such as naproxen, aspirin, and ibuprofen.

– Selenium and Vitamin E – Have you heard about the SELECT Study? The findings of the Selenium and Vitamin E Cancer Prevention Trial were widely publicized. They examined the use Vitamin E and selenium in prostate cancer patients. Preliminary research suggested that this combination may actually lower the risk of developing prostate cancer. In SELECT, which was published in the Journal of the American Medicine Associationin 2011 found that Vitamin E supplement users had a 17% higher chance of developing prostate cancer than those who received placebo. Researchers used SELECT survey data in 2014 to determine that men at high risk for developing prostate cancer had no benefit from taking Vitamin E or selenium. The researchers also found that high levels of selenium in patients who entered the study raised their risk of developing high-grade prostate cancer by 91 per cent when they received additional selenium supplements.

Lycopene This naturally occurring antioxidant can be found in high levels in your prostate cells. It is commonly found in cooked tomatoes . Once upon a time, research suggested that lycopene could be used twice daily to reduce prostate cancer growth and prevent it from developing. These findings were disproved many years later.

Does your diet promote a healthy prostate

The Mediterranean Diet is associated with lowering your risk of developing heart disease and helping you to prevent it. This can be attributed to the Mediterranean Diet’s emphasis on whole foods, including fruits, vegetables, beans, and healthy unsaturated oils from plants. This style of eating emphasizes the consumption of whole foods and less processed food. It allows alcohol, but only in moderation. The emphasis on whole foods encourages adequate fiber intake. It allows for a broad range of food, making it more lifestyle than a diet.

This type of eating can have a positive effect on cancer prevention. It is possible to prevent future problems by adopting healthy eating habits. Your prostate health can be affected by certain nutrients and vitamins. A balanced diet and the right nutrients can have a significant impact on the health of your prostate.

Four nutrients that are important for prostate health

  • Fiber
    Healthy weight is essential for your overall health and your prostate’s health. Fiber may help you lose weight because it gives you a feeling of fullness, slows fat absorption and prevents constipation. A diet high in fiber from whole grains, fruits, vegetables, legumes and legumes may help reduce your cancer risk and slow the progression of prostate cancer.
  • Omega-3 Fatty Acids
    Omega-3 fatty acids can help reduce the risk of prostate cancer and slow down the progression of cancer. One study showed Men who ate cold-water fish three or four times per week had a lower risk of developing prostate cancer. Omega-3 fatty acids have been shown to reduce blood pressure, lower triglycerides and improve cardiovascular health. They also provide anticancer properties that are beneficial for prostate health. Omega-3 fatty acids can be found in cold-water fish, such as salmon, trout and herring–flaxseeds and walnuts–and soybeans–and canola oil.
  • Lycopene
    Lycopene, a powerful antioxidant, has been linked to cancer prevention. Although more research is required to determine if lycopene has any effect on prostate cancer, the general consensus is that it is beneficial. Watermelon, tomatoes, pink grapefruits, apricots and papaya are all good sources of lycopene. The cooking process in tomatoes releases lycopene, which increases your ability to absorb it.
  • Vitamin C
    High levels of vitamin C in cruciferous vegetables like broccoli, cauliflower, kale and brussels sprouts may help reduce the risk of an enlarged prostate. Although more research is needed to determine whether vitamin C supplements can be used to prevent or combat prostate cancer, the National Cancer Institute says that people who consume cruciferous vegetables rich in vitamin C have a lower chance of developing it.

Sometimes, Less Is More

Some foods and dietary supplements can have positive effects on prostate health. However, it is important to limit intake of some items or avoid them altogether. These are just a few examples where nutrients are more important than others.

  • Alcohol
    Resveratrol, an antioxidant found in red wines, is also available as a supplement. It is used to prevent and combat cancer. Some people believe that drinking more alcohol is better, but in reality, it could increase the risk of many types of cancer. Low alcohol intake is best for prostate health. A limit of 1 glass of wine per day or 1 drink per day is recommended.
  • Multivitamin
    While a single low-dose multivitamin may provide some protection against prostate cancer, high-dose multivitamins can be dangerous and even worsen the disease. Also, don’t take too many vitamins.
  • Vitamin E and Selenium
    The National Cancer Institute (NCI), in 2001, launched a large-scale study called “SELECT” (Selenium & Vitamin E Cancer Prevention Trial). This was to verify evidence suggesting that vitamin E and selenium might lower the risk of developing prostate cancer. The trial found that adding selenium does not reduce the risk of developing prostate cancer. It could also increase your risk of developing type 2 diabetes. The same study showed that healthy men who took 400 international units of vitamin E (the standard dose in U.S. capsules) had a higher risk of developing prostate cancer. You might consider switching to a women’s supplement, as most men’s vitamins include both vitamin E and selenium.
  • Zinc
    Zinc has been suggested as a way to boost the immune system and improve prostate health. Low levels of zinc in the prostate or seminal liquid are common among chronic prostatitis patients. Supplementation with zinc through diet doesn’t increase the prostate’s zinc levels. High doses of supplemental Zinc have been shown to cause abnormal immune system changes. This can lead to increased prostate enlargement and infection, as well as increased risk for aggressive prostate cancer. A multivitamin containing 20 mg of zinc per day is sufficient.

Conclusion

Alternative medicines are not subject to clinical trials and don’t need to be approved by the Food and Drug Administration. This is one of the greatest concerns. There is very little information available on what these supplements do to our bodies. Remember that herbal remedies as well as supplements can interact with each other and with any medications you may be on. Supplements can affect the effectiveness of some medications or cause side effects.

These alternative therapies don’t work miracles. Some men may experience side effects or benefits that are positive for treating prostate disease. You shouldn’t be surprised if there are no changes. Talk to your Pittston Urologist before you try anything discussed here for treatment or prevention of prostate cancer. You can count on him to provide the support and guidance you need in managing, treating, and preventing prostate problems.

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