Prostate enlargement and screening

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prostateProstate enlargement, Benign prostatic hypertrophy (BPH)
For prostate cancer, look under Cancer tab

Description: the prostate gland surrounds the urethra, which in males is the tube taking urine out from the bladder. With increasing age, the prostate gland can swell, restricting and then finally blocking the flow of urine.

What Doctors can do

  • Measure the PSA (prostate specific antigen). This antigen measured in the blood comes from both normal and cancerous prostate tissue. As we age the prostate enlarges and so the normal range for PSA also increases. The level is also higher in black men, and some drugs also affect PSA levels (Propecia |for baldness, statin drugs, NSAIDs for arthritis, and thiazide diuretics). Infection, trauma and even sexual activity can raise PSA.
    Because of all of these, routine use of PSA as a screening tool is debated as the cut off from normal to cancer is blurred. However a very high level could definitely start the hunt for prostate cancer. II discuss the use of this ffor prostate screening below).
  • Usually doctors recommend surgery; either removal of the prostate gland by prostatectomy or they shave a larger track through the prostate for the urine to go (TURP). These operations can affect sexual function.
  • There are a number of drugs which can relax the bladder neck muscles and improve the flow (Hytrin, doxazosin) and others, such as finasteride (Proscar) which can block the hormone dihydro testosterone (DTH) which is what causes the gland to swell. (Like all drugs these can have side effects - Hytrin can make the blood pressure fall on standing, and finasteride can affect sexual performance.

What you can do

Lifestyle

  • Don’t allow the bladder to overfill as this can sometimes result in a complete blockage. Make sure that the bladder empties completely (it is a good idea to use the 'double-pee technique.  When you have finished, stand or sit for about 30 seconds and then see if there is any more urine to pass).  Physical activity such as walking 2-3 hours per week can reduce the symptoms by 25%. Being overweight can make the symptoms and outcome worse.

Nutritional supplements

  • Saw Palmetto is a Chinese herb which suppresses swelling of the prostate improving symptoms in an unexplained yet effective way.  I recommend everyone with any prostate symptoms, perhaps every man after 50 years to be taking this very safe herb.
  • Lycopene is found in pink fruits, especially cooked tomatoes. When concentrated in the prostate gland it can reduce BHP. Most men over the age of 50 should consider taking both these supplements (lycopene and saw plametto)
  • A good multivitamin/multimineral makes sure the prostate tissue has all the nutrients necessary to function normally - especially minerals like selenium which has been shown to reduce the risk of developing prostate cancer

The Nutritional supplements I use and recommend to my patients

For my prostate patients I recommend -

USANA - Cellsentials *, Palmetto plus -

Other therapies

There are a number of other therapies which you might like to look at.  They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help.    They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner.    My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.

Nutritional supplements

I believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.  

 

Screening for prostate cancer 

Prostate cancer is the most commonly diagnosed malignancy in males, but has one of the lowest percentage mortality compared to other cancers.   this is because there is a 'benign' type of prostate cancer which grows very slowly and rarely spreads, as well as the aggressive form.  Prostate cancer is identified by a blood test (PSA - prostate specific antigen) and digital rectal examination.  Then there follow a number of tests, biopsies to confirm the diagnosis and then hormone therapy and surgery.   The problem is that in the 'benign' form of prostate cancer, these tests have a morbidity and mortality with o benefit, and overall the dangers of screening are greater than the deaths from prostate cancer - hence many authorities are not recommending prostate cancer screening.   But this means that the serious forms of prostate cancer will not be detected.  A more logical approach would be to check the PSA level.  If it is less than 1.5ng/ml then severe prostate cancer is unlikely, and repeat this test in 2-5 years.  If above 1.5 then refer for further investigations. This approach is further discussed here.
However I would still recommend that most males over 50 take regularly saw palmetto and lycopene as a supplement ( USANA Palmetto plus) as above.