Cancer-proof your prostate
from men's health magazine
It's one of those weird anatomical-arboreal coincidences: the human prostate
is about the size and shape of a walnut. But what if it really were a
walnut? For one thing, you'd never get prostate cancer. Which sounds great,
until you realise that you could get “walnut curculio” or “walnut-husk
maggot” instead. Better to deal with the devil you know. And what a devil
it is. The latest research shows it to be the leading cancer in males
worldwide, ahead of lung, colon and brain. The lifetime risk of developing
prostate cancer is one in 24 (count Nelson Mandela, Arch-bishop Desmond
Tutu and Robert De Niro among those ranks). And South Africa ranks right
near the top in terms of incidence, especially whites and coloureds who
have the highest rates in the world bar the USA. Black males compare with
those reported in other developing countries, while rates in South African
Asian males are almost five times those reported in Bombay, India. These
are grim statistics, but there's reason to be optimistic. Make that eight
reasons. What follows is the latest, hot-out-of-the-lab research on how
you can prevent, detect and treat the disease. Putting this science into
action (read: more sex, more wine) won't confer absolute immunity, but
it will make your prostate one tough nut to crack.
PREVENTION
Love thyself As if masturbation didn't already provide enough of a pay-off,
a recent Australian study found that DIY sex may also help prevent prostate
cancer. The study of 2 338 men showed that the guys who masturbated five
or more times a week were 34 percent less likely to develop prostate cancer
by age 70 than those who handled matters less often. “Seminal fluid contains
substances that are carcinogenic,” says Dr Graham Giles, the lead study
author. “Regular ejaculation may help flush them out.”
And in case you're wondering, no, masturbating more than once a day won't
offer more protection, and yes, straight-up sex works, too. But before
you have unprotected nookie with your partner, be sure she's been tested
for cytomegalo-virus, a type of herpes recently found in cancerous prostate
tissue.
Be happy you're going bald Turns out the hair-loss drug Propecia has one
impressive side effect. In a US National Cancer Institute (NCI) study
of 18 882 men, researchers found that the men who took five milligrams
(mg) of Propecia, aka finasteride, daily for seven years had a 25 percent
lower risk of prostate cancer than those taking a placebo. Finasteride
blocks production of dihydrotestosterone, a hormone that triggers hair
loss and prostate growth.
“It's the first study to prove that prostate cancer is preventable,” says
Dr Peter Green-wald, the NCI's director of cancer prevention – and one
of those 18 882 men. “My prostate's normal,” he adds. One caution: men
on finasteride had a slightly greater chance of being diagnosed with a
more aggressive form of the disease than did the placebo takers. More
research on the drug is needed, but if you're concerned about prostate
cancer, discuss these findings with your doctor.
Wine and dine There's a good reason Western European men have lower prostate-cancer
rates than we do. And it has nothing to do with Speedo thongs. New research
suggests that certain staples of the Mediterranean diet have prostate-cancer-fighting
properties. For starters, a recent study published in the Journal of the
National Cancer Institute shows that men who eat more than 10 grams (g)
of garlic or spring onions (that's about three cloves of garlic or two
tablespoons of spring onions) daily have a 50 percent lower risk of prostate
cancer than those who eat less than two grams. (Give credit to the organosulfur
compounds, which are common to both vegetables.) Then there's red wine;
red grapes are flush with resveratrol, an antioxidant found in some plants
that may help inhibit the growth of prostate cancer, according to a report
from the University of Texas.
A glass or two of red wine daily should suffice. “If you drink too much,”
says the lead study author, Dr Catherine O'Brian, “you can neutralise
the beneficial effects.”
DETECTION
Lower the bar Here's a PSA (Public-Service Announcement) regarding your
PSA (Prostate-Specific Antigen): using a score of 4.1 or greater as the
alarm for prostate cancer could prove fatal. A recent study of 6 691 men,
published in the New England Journal of Medicine (NEJM), showed that this
traditional threshold for ordering a follow-up biopsy may be missing 82
percent of prostate-cancer diagnoses in men under 60. “The threshold of
4.1 that's being used has never been rigorously studied,” says one of
the study's authors Dr Karen Kuntz. And while critics say a lower threshold
will lead to unnecessary biopsies, Dr Rinaa Punglia, another of the study
authors, believes that the broader standard could be worth it. “It's a
trade-off,” she admits. “But it could save lives.” So how low should you
go? Punglia recommends that when you have your PSA level checked (annually
beginning at age 50 – or 45 if you have a family history), you observe
a threshold of 2.6, especially if you're under age 60. According to the
NEJM study, following this guideline doubled the cancer-detection rate,
from 18 percent to 36 percent.
Calculate your risk Let's say your PSA is 2.6. You still may not need
a biopsy. Instead, ask your doctor to use a nomogram. This needle-free
analysis turns a patient's age, PSA density (PSA divided by the volume
of the prostate), digital-rectal-exam result and transrectal-ultrasound
result into a score that helps determine whether a biopsy is really warranted.
“We can say whether or not, for your prostate, that's a high PSA,” says
Dr Mark Garzotto, director of urologic oncology at the Port-land VA Medical
Centre. In a study of 1 200 men, Garzotto found that if a nomogram had
been used in every case, it would have spared 24 percent of the men from
unnecessary biopsies. If your doctor can't crunch the numbers, ask for
copies of your test results; you can find the same nomogram below in this
article, and do the maths yourself.
TREATMENT
Head for tomatoes Researchers at the Centre for Holistic Urology at Columbia-Presbyterian
Medical Centre in New York City recently found that a blend of herbs including
ginger, oregano, rosemary and green tea reduced prostate-cancer cell growth
by 78 percent in the lab. But if the spice rack's not your game, you can
safely head for tomatoes.
A study at Harvard University, over six years and on 47 894 men, found
a reduction in advanced prostate cancer risk by 53 percent in those taking
tomatoes or tomato products. The key ingredient here is lycopene, a red
chemical found mainly in tomatoes and tomato-based products. High levels
of lycopene have consistently been found to correlate negatively with
the risk for prostate cancer – the higher the intake, the lower the risk.
One of the best-known products out there is the herbal remedy Gardian.
Scientist and lead researcher for the Cancer Association of South Africa,
Dr Carl Albrecht, says all tomato products are good for treating prostate
cancer, except for “tomato juice, which does not have the same beneficial
effects since the tomato product needs to be cooked for the lycopene to
be absorbed by the body.”
Use CAD (Computer-Assisted Doctor) The radical prostatectomy recently
became a lot less radical, thanks to a new robotic version of the procedure.
With the da Vinci system, doctors use three-dimensional imaging to direct
two nimble robotic hands through a few small slits in the patient's abdomen
to remove the cancerous prostate. According to data from the Vattikuti
Urology Institute at the Henry Ford Health System in the US, 90 percent
fewer men became incontinent and 50 percent fewer became impotent with
the da Vinci system than with manual gland removal. “It's like playing
golf with a titanium driver versus a wooden driver,” says chief of urology
Dr Mani Menon. Another plus: patients spent an average of 1.5 days in
the hospital, compared with 2.3 days for open surgery.
Rehab your erections Unless you're David Beckham, this one's a no-brainer:
take a nerve graft from your ankle and save your sex life. The cavernous
nerves, aka the boner bugle corps, are often a casualty of prostate removal
if cancer has spread outside the gland. But by replacing the cavernous
nerves with the sural nerve that runs along the ankle, as many as 9 000
men a year could recover erectile function, says one of the developers
of the procedure and chairman of urology at Memorial Sloan-Kettering Cancer
Centre in New York City, Dr Peter Scardino. “If you've got only one [cavernous]
nerve left, you're firing on four cylinders, but if I do a graft, it's
like you're firing on seven out of eight.” And don't worry; a slight numbness
in your foot is the only side effect. Talk to your urologist about where
to find a surgeon experienced in sural-nerve grafting.
By Matt Bean
Click here
to return to the healing zone; click here to go home
Click here to go home
