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Men |
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Lipid abnormalities |
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Men often have larger bodies (more cells) and higher metabolic needs than women. Men therefore must eat more calories than women and thus can obtain more vitamins and minerals. However, they are often deficient in essential fats.
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Bladder and/or prostate infections
Bladder infection is a common condition in men and women. Touching the tip of the penis to a surface with bacteria can infect the bladder and/or the prostate. Infections often produce inflammation (to fight the infection). An infected prostate (prostatitis) or a prostate irritated by an infected bladder or intestine may release more PSA into the blood, causing a high PSA (rarely > 10 ng/dl). Patients with intestinal disease may have elevated PSA without having cancer. However, chronic (constant) prostate infection or inflammation likely predisposes to cancer.
Prostatitis or bladder infections can be acute (sudden onset) or chronic (continuous infection that is difficult to cure). Symptoms include fever, chills, pain on urination, lower back pain, and sometimes pain in the legs (caused by the enlarged organ pressing against nerves). A simple urine test using a special dipstick may find evidence of infection; a doctor can look at the urine in the microscope and see signs of the infection. You can have an infection without fever if the infection is not strong enough to get all of your body's attention.
Usual treatment is plenty of liquids and antibiotics. A soft membrane protects each cell and each organ. Deficiencies of essential fats can make it easier to get infection because the membranes are rough and hard and provide hidden places for bacteria. Excessive antioxidants could make it difficult for your body to attack and destroy (oxidize) your bacteria.
Benign prostate hyperplasia
Benign prostate hyperplasia (BPH) is the slow increase in prostate size with age. The enlarged prostate presses against the urethra, making it difficult for urine to flow. Urine may trickle in a thin stream, and sometimes dribble after you think you are finished. To compensate, the bladder walls increase in size, and the bladder may become distended and less elastic. You may feel a constant need to urinate.
The cause of BPH is not known. There are many theories, but none with sufficient data. No substantive evidence supports the effects of specific nutrients, supplements, herbs, etc. There appear to be great differences between men of difference races and men living in different parts of the world. We suspect that obesity and eating too many calories contributes to the problem, but some overweight men do not have BPH. Dr. Siguel hypothesizes that low levels of essential fats for many years causes the prostate cells to reproduce and enlarge and eventually develop a mutation that makes them abnormal.
Treatment. If there are not substantial problems, BPH should be left alone. It may get worse, it may get better by itself. If it causes substantial symptoms, you may treat it with medications. Severe cases can be treated with surgery. There is no need to remove the whole prostate. Surgeons may be able to remove parts of it enough to remove symptoms without causing complications (urinary incontinence, impotence). Vitamins, mineral and herb supplements have not been shown to be effective, except for saw palmetto and perhaps garlic.
PUFA-rich foods may improve BPH. People have reported that their prostate symptoms improved after eating foods rich in PUFAs. It is worthwhile to try, because the risks are practically zero. Practically all men with BPH are at risk for heart disease. The best mixture of PUFAs for CAD is also the best for BPH.
Prostate Cancer
Prostate cancer is very common. Nobody knows why this cancer develops. Most likely, there is a genetic predisposition enhanced by nutrition, substances in foods (chemicals, etc.), and the environment (temperature, humidity, chemicals in the air, water, etc) or chronic irritation of the prostate.
Diagnosis. You may not have any symptoms. A small cancer may not cause an increase in prostate size. Once the cancer increases in size, you may have the symptoms of BPH. If the cancer spreads to other organs such as bone, you can experience pain elsewhere. At present, the blood test PSA is the only practical way to monitor for the onset of prostate cancer. Start with your first PSA and physical exam of the prostate by the time you are 40 years old.
A new test involves the use of free and total PSA. It distinguishes enlarged prostate, prostatitis (prostate inflammation), and cancer. It can reduce the need for diagnostic biopsies (painful and costly). PSA values should be adjusted for prostate mass.
Treatment. Debate continues on when prostate cancer should be treated and how to treat it. Treatment options include drugs, hormones, radiation, and surgery. Each mode of treatment has side effects and different types of cancers for which it works best. Unfortunately, people can die from the consequences of treatment. Others would die from other existing diseases before they died of cancer. If you are old and have CVD which reduces your life expectancy to less than 10 years, a small # of prostate cancer cells can be left alone. Watch (with blood tests, ultrasound) in case the cancer begins growing rapidly. If the cancer increases slowly, the risks may outweigh the benefits of treating it.
There are different treatments with different benefits and risks. Radiation or drug treatments may pose a less dramatic risk than surgical treatment, but surgery can remove many cells and can be very effective for localized cancer. Even when the cancer is not localized, removing lots of cancer cells prevents those cells from moving (metastasizing) to other parts of the body and makes it more likely for other drugs to work.
External radiation is highly effective when the cancer is localized to the prostate. Internal radiation appears even more effective when the cancer is in one area of the prostate. Radiation often has very few undesirable side effects. Unless you need to preserve your sperm, everybody with prostate cancer should consider radiation therapy. At worst, it slows down the progression of the cancer.
Surgery is likely to "cure" cancer localized to the prostate. New "nerve sparing" techniques minimize the risk of urinary incontinence (~ 5%) and impotence (< 25%). However, once the prostate is removed, the man cannot make sperm and is infertile. You can freeze sperm in case you want to have a child in the future.
An orchiectomy (surgery to remove the testicles) is effective because it removes one source of testosterone that helps the cancer grow. It has relatively few side effects and you should consider it if you have an aggressive cancer.
Try to get a pathological determination of the type of cancer. Does it look aggressive, or is it the type that increases very slowly? You may choose to do nothing and wait. If your PSA remains fairly stable or increases very slowly, the chances are you will die of old age instead of cancer. However, it is better to always treat prostate cancer. If the cancer is not aggressive, one can use the least invasive therapy, such as small doses of radiation, hormones and drugs.
There are many effective drugs that lower the levels of hormones that prostate cancer cells need to grow. The optimal drug mixture depends on the individual circumstances.
Hormones exist that fight the hormones that cause cancer cells to grow. Estrogens are highly effective, have many side effects, but may be safer than other drugs. The optimal drug combination depends on the stage of your cancer, the therapy you are receiving, and other factors.
Future therapies involve the use of targeted drugs and perhaps even parts of viruses (like HSVII) to enhance the immune system or attack cancerous cells. For example, genetic analysis of the cancer cells may detect a cell defect or a change in cell structure that makes the cancer cell different from a healthy cell and opens the door for an attack that destroys the cancer cells but barely hurts normal cells.
If you have $1,000,000, it is possible to develop a highly effective new treatment for prostate or breast cancer. A less expensive therapy involves large doses of special mixtures of fatty acids combined with a vegetarian diet. Mixtures of w3 fatty acid derivatives (i.e., EPA, DHA) may inhibit cancer growth. ALA may also be effective. GLA’s role is confusing. Visit www.essentialfats.com. (Siguel E. Cancerostatic Effect of Vegetable Diets. Nutrition and Cancer, 4:285-289, 1983.)
Have your blood tests done before a physical exam of the prostate; otherwise you need to wait at least one week before blood testing. Sex (through prostate manipulation) and exercise can elevate PSA values, sometimes as much as 2 or 3 times. Although the role of sex in elevating the PSA is still debated you want to avoid exercise and sex for at least 72 hours before having your PSA measured. Of course, if you are one of those types that can have sex without barely moving a muscle, your PSA may not be affected. Your physician can measure the PSA before and after exercise, to better determine whether you have an enlarged prostate or cancer. This is a new sophisticated test that may or may not turn out to be valuable.
When you have an ultrasound to evaluate your prostate for cancer, the physician may order biopsies to confirm a suspected cancer, or multiple biopsies to determine whether the tissue is normal. This procedure is expensive and mildly painful for up to two weeks (with occasional blood in the urine) and is rarely prescribed unless cancer is suspected.
Nutrition to prevent Prostate Cancer
A key mistaken concept is that antioxidants treat cancer.
Antioxidants may protect cells from oxidation and may protect the cells from
harmful effects of radiation and sun. If you have to have diagnostic X-rays,
taking extra antioxidants may be desirable. However, antioxidants may protect
cancer cells from destruction. If you are treated for cancer it seems best to
avoid antioxidants. The picture we get is that a balance of all nutrients is
the key to prevent or treat any cancer.
ä Essential fats. Deficiencies of the essential fats appear to stimulate the prostate to increase in size and thereby increase the chances of developing cancer. Maintaining optimal levels of the essential fats may prevent prostate cancer and reduce prostate size. Older research suggested that low fat diets prevented against cancer. This research is mostly discredited now. It is total calories that matter, not total fat. A diet low in total calories is the best defense.
ä Selenium. Highly preliminary research suggests that low levels of selenium may be associated with prostate cancer, but most Americans eat enough selenium (and too much is highly toxic). You could have your blood tested for selenium and eat more if you are deficient. People who have enough selenium may not benefit from extra selenium and could protect cancer cells from destruction.
ä Lycopene. The chemical lycopene, a type of carotenoid found in tomatoes (including cooked and processed tomatoes) may help. We suggest eating tomatoes every day or as frequently as possible. Soy foods contain a large number of chemicals that may prevent prostate cancer. Eat tofu and natural foods made with soy instead of soy supplements. Eat soy products that contain natural soy fats; avoid “fat free” products which have eliminated the EFAs found in soy.
ä Vitamin E may be effective in preventing cancer, but is probably not effective in treating or stopping advanced cancer. Take ~ 100 IU per day if you do not have cancer. However, do not take vitamin E while you are undergoing radiation or chemotherapy (you do not want to make the cancer cells resistant to treatment).
ä Green tea may help prevent prostate cancer and heart disease. One cup of tea per day seems desirable and probably not harmful.
ä Vitamin D and calcium are also important. Be sure to have enough every day. However, excessive calcium intake appears to increase the risk of prostate cancer. It may be safer to avoid eating too much dairy products and milk.
Fertility
About 5-10% of men aged 20-50 appear to be infertile, mostly due to lower sperm production or defective sperm production. The proportion of infertile men over 50 is even greater. Many have circulation problems that restrict the blood flow to the penis and make erection difficult (erection is caused by increased blood flow to the penis).
Male infertility appears to be increasing every year, but the cause is not known. Some of the conventional ways to increase fertility include wearing loose clothing (tight clothes interfere with sperm production), keeping the scrotum cool (hot showers decrease sperm production), avoiding foods with synthetic estrogens (sometimes used in poultry and other animals), and selecting peanuts and grains low in aflatoxin (a toxin).
Sperm is high in Vitamin C, so if you do not eat plenty of fruits and vegetables, a supplement of about 200 mg/day of vitamin C can be beneficial. If you are deficient in zinc, you can take zinc supplements which will help improve sperm function. Sperm is a highly motile and high in essential fats. Bringing your fatty acid profile closer to that of healthy men is practically harmless and can improve your sexual function and sperm production. It also improves overall blood circulation.
Treatment. Testosterone is inversely related to % body fat. (A Mazur, Science, 1998; 279: (Letters). Reducing body fat to reasonable levels with diet may increase testosterone. Weight loss + PUFAs could correct impotence!
Read Dr. Siguel’s books for more extensive discussion of these issues. Visit | EFA Books.
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© 1998 Edward N. Siguel.
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modified 1/15/00 |