I am a syndicated columnist in case you didn’t know that already. My column appears in about 105 newspapers and it’s called “Dear Pharmacist.” People write to me, or email me and I answer their questions. The original short version of this article below appears in newspapers nationwide August 2015, and was the answer to a letter I received from one of my papers.
My father and brother both died of prostate cancer. I am still fine, but at age 45, I want to do everything I can now to avoid prostate cancer. Truthfully, I am terrified. I’m a faithful reader, and I value your opinion. Can you give me more information?”
–M.M. Phoenix, Arizona
Answer: Prostate cancer is the third most common cause of death from cancer in men of all ages, and most common cause of death from cancer in men over 75.
One thing I have to clear up is the myth that having frequent sex causes prostate problems. Even though a few studies pointed to that conclusion, I believe with all my heart that it is absolutely false. The research that I read said that study participants were asked in a questionnaire about their sexual activity during the year before they developed prostate cancer. Since all the men were having some sex in the year prior, the researchers decided that “sex causes prostate cancer.” How stupid is that?! Almost as ridiculous as the 2017 study that suggested frontal baldness was associated with higher risk of prostate cancer. Again, not true!
But leave it to mainstream media to get hold of a sensational headline like that and scare all the guys away from their wives and lovers. Like, prostate cancer (or urinary incontinence) isn’t challenging enough!
Here’s a better headline I’ve settled upon: “Frequent Sex May Lower Your Risk for Prostate Cancer”
And in fact, there is some supporting research for this idea printed in the best journals, including JAMA, Harvard and British Medical Journal. My conclusion is that the frequency of your sexual activities has nothing to do with the development of prostate cancer and if anything, it may lower your risk.
Now, one other matter that I need to clear up. Some men think that Benign Prostatic Hypertrophy has nothing to do with cancer. That is not entirely true.
BPH is a good screening method to see if you are headed towards prostate dysplasia or cancer.
True it is NOT cancer, don’t freak out, but it is not ideal to have BPH in a perfect world. You want to take it seriously, don’t just brush it off. Some men don’t even realize that they have many symptoms of BPH so here they are:
* Pushing or straining to begin urination
* A weak urinary stream
* Dribbling after urination
* A frequent need to urinate, sometimes every 2 hours or less
* A recurrent, sudden, or uncontrollable urge to urinate
* Feeling the bladder has not completely emptied after urination
* Pain during urination
* Waking at night to urinate
If you have a lot of these symptoms, get further testing.
Having enlarged prostate symptoms, or established BPH is your wake up call to do something, to change diet, take supplements, exercise and lose weight, and control your insulin levels (which are probably high and you can verify this with a blood test). Yes, I said “insulin” not blood sugar levels. You want the levels to be less than 5. Since prostate cancer is usually slow-growing, you have time to take care of yourself and relieve symptoms and even make it retreat. It is absolutely possible!
Here are some treatments that I can think of off the top of my head. Please know that there are MANY other treatments, and ask your qualified Medical Doctor about them. I’m just trying to open your eyes right now, and I couldn’t possibly know what’s right for you, so again, talk with your practitioner about your personal treatment options/protocol. In no particular order:
Testosterone or “T” as I may refer to it is a hormone that both men and women make from the basic molecule called cholesterol which can form many hormones in the body. Yes, cholesterol, the same molecule that you might be trying to get rid of with your statin drugs (now you see why I don’t like statins, they interfere with the production of sex hormones in people but that’s another article).
Anyway, testosterone is one of THE most helpful hormones that you can have (even if you are a woman). It keeps you happy, healthy, fertile, energetic and it revs up sex drive ( in both men and women) It also helps you to build muscles. T helps you think clearly and gives you vitality. T is not the bad guy like many doctors make it out to be. The hormone specialists would all agree with me, you don’t want to chronically suppress natural hormones in the body.
It is the ratio of testosterone to estrogen that makes the difference in men and women. Obviously, men have more of the manly T and women have more estrogen floating around. As we age, levels of our individual hormones tend to go down (as a general rule). So in women, lowered estrogen levels around the age of 50 mean she goes through menopause. And in men, a similar situation occurs and as testosterone levels go down, he goes through andropause. Stay with me.
Now, the human body has two major choices that it can do with testosterone. It can convert to either ESTROGEN or DHT (dihydrotestosterone).
Testosterone converts to DHT with the help of an enzyme called 5-alpha Reductase.
Testosterone could also convert to ESTROGEN with the help of an enzyme called aromatase.
Now stay with me here, it’s critical If you block either of those enzymes (either 5-alpha reductase, or aromatase) you are going to stop some of the production to those other molecules, and keep the testosterone levels higher. This is not necessarily a good thing. The reason is (and let me be specific for guys right now) is that you WANT some of that DHT. If you block conversion of testosterone to DHT, you get less DHT and less DHT means you get less of the next substance in line which is called “Androstanediol.”
That last molecule protects a man from fast-growing (aggressive) and hard-to-treat forms of prostate cancer. This is the reason that some studies are showing that DHT blockers (like finasteride sold as “Proscar”) can actually increase the risk for aggressive tumors. Perhaps the tumor shrinks at first, but the chronic hormone deprivation causes a more aggressive cancer to come back years later.
More about that in a moment.
I’ve researched and prepared this list to help you and other proactive men:
Consider vitamin D.
This antioxidant may help reduce overall cancer risk and lower PSA values by 25 to 50 percent in men with prostate cancer. People think of vitamin D as the “sunshine vitamin” because our skin converts it to an active healthy form called D3. Vitamin D is anti-cancer. What you might not know is that the enzyme that converts it to an anti-cancer compound is in the prostate too! There are numerous studies that are easily accessible by any physician which show how helpful vitamin D is to the prostate.
If you are a man, do NOT let yourself become vitamin D deficient. You can have your levels checked at any laboratory, your doctor just has to order the simple blood test. If you are low, take a supplement “cholecalciferol” or “vitamin D3” and not the other forms that go by different names. Another reason that vitamin D helps a man with prostate cancer is because D improves the way your cells use insulin, a hormone secreted by your pancreas to control blood sugar. What does insulin have to do with the prostate? Good question, insulin that is high (or insulin that is rejected by the cell, a condition termed “insulin resistance”) can increase the risk of cancer, even prostate cancer according to some emerging scientific data. There are many, many articles and in a 2003 article in Anticancer Research, scientists concluded that “Vitamin D metabolism in human prostate cells: implications for prostate cancer chemoprevention by vitamin D.”
Healthy amounts of vitamin D3 (cholecalciferol) are also found in cold water seafood and in supplemental cod-liver oil. There are also supplements for this galore! Just make sure you get a good brand.
Reduce free radical damage.
I’ll be blunt: Stop smoking and eating greasy burgers, french fries, beer, foods with MSG and other artificial chemicals, all of which assault your cells. Stop drinking alcohol, even i fyou think it’s good for your heart… I disagree with all of that! I personally feel like the fastest way to speed up growth of prostate cancer cells (again in my opinion) is is to eat garbage, drink alcohol, smoke and be sedentary. This lifestyle speeds up all kinds of diseases!
You see, your cells take millions of hits a day in terms of free-radicals. You can look at the effects of free-radical damage in any smoker (or sun-worshipper) and look at their skin. Compare it to yours. Two people that are the same age could look 20 years apart, and if the skin is showing this accelerated aging, you bet your prostate, heart, brain and pancreas are showing the damage too. Free radicals come at a high cost, your life! The best away to protect yourself from free-radical assault is to AVOID the problems in the first place. If it’s too late to avoid them (ie years of bad habits) then start taking strong antioxidants today, such as resveratrol, pycnogenol, blueberry extract, vitamin C, vitamin D and beta carotene.
The prostate-specific antigen (PSA) blood test is America’s gold standard test but unfortunately it could be normal in the presence of prostate cancer, giving a man a false sense of security. If you told me that you were never going to get another PSA I wouldn’t care. Because a more accurate diagnostic lab test may be to measure the percentage of “free PSA” rather than absolute, total PSA.
Also, evaluating levels of estrogen, androstanediol, testosterone and dihydrotestosterone or “DHT” are important. Why? Because a few experts think that too much estrogen (more specifically too much xenoestrogens, a.k.a. xenobiotics (the poisonous sort of hormone found in pesticides, household items, plastic bottles, etc) can increase risk for cancer. Also, levels of “androstanediol” matter. If you lower this too much, trouble could follow so don’t overmedicate.
Prescribed medications suppress serum DHT but lowering it too much could backfire. It’s shocking, but very low DHT hormone will also suppress an anti-cancer hormone called androstanediol causing more aggressive tumors. Progressive physicians know this, so they routinely measure the ratio between DHT and androstanediol, which is more important than the level of either hormone alone. A good doctor knows it is about balance. Lowering DHT is helpful, but lowering DHT too much is harmful.
Again, lowering DHT is helpful, it reduces levels of DHT, which also by the way, seem to slow down baldness, many baldness drugs work by this principle. But lowering DHT can be harmful in some cases and I stand by that. It’s the same with anything really.
Life is about balance and moderation, too much of anything is dangerous. And not to be flippant, but these clinical trials just crack me up sometimes because the researchers can skew the data any way they want them to, in order to draw a conclusion that they want. I read them because I am that type of a nerd-like individual.
And I’ve drawn my own conclusion: If you a give a rat too much of anything, it gets cancer 😉
So not all the studies will agree with me on this, especially the studies propagated by the drug companies that want to sell you the drugs. Their answer is to lower DHT and lower it good! I disagree with high doses of medication that deprive you of hormones for many years. If DHT was really the sole problem for cancer, wouldn’t all the 18 year old men be sick with prostate cancer?
They have testosterone levels that are much higher than middle-aged and elderly men. Their testosterone levels and DHT is usually sky high (in comparison to older men) that’s why they are young ‘studs’ (if that’s the right word and it’s probably not) but my point is this, young men have lots of T, and they have lots of DHT, and they have lots of androstanedione.
Their ratios are not abnormally skewed like in a man who is ill. And… if testosterone and DHT was SO bad for a man, then why isn’t this population the one dying of prostate cancer? Because driving down levels of DHT for a long time, can’t be a good thing– just look at the common sense here. But one study published back in the year 2003 in New England Journal of Medicine studied 18,000 men to see if lowering DHT with the drug finasteride could reduce the risk of cancer, including aggressive cancers.
What they found stunned a lot of medical experts, and is worth discussing with your doctor! In the study, the male participants that took the drug finasteride, the recurrence of cancer was 18% percent, and of these, the rate of the more aggressive tumor was 37%. In the guys who took a dud pill (placebo which is inactive) the overall rate of cancer was higher at 24%, but the development of that nasty aggressive form was significantly lower, 22 % as compared to 37% for the drug takers. Wow wow wow! This is just one study, but it’s crazy to think that years after taking a medication intended to protect you, your risk for the virtually untreatable form of prostate cancer is significantly worse than if you didn’t take the drug.
Please discuss this with your doctor because I don’t know what’s right for you, I just know that lowering DHT too much, suppresses production of a protective hormone and this may be one contributing reason to the results found in the New England Journal of Medicine.
Remember, prostate cancer is usually slow growing.
I want you to do is find a very good doctor (of any sort, with any initial behind his name) that TRULY HONESTLY knows about how to measure all these pathways using the right tests, and how to prescribe bio-identical hormones. Yes, BIO-IDENTICAL. No ifs ands or butts. Your life is at stake. Do you really want more synthetic chemicals in you? There are many Functional Medicine practitioners who use specialized labs to draw your hormones, or they use saliva tests, urine tests, blood or combinations. Some are spot tests, others require a 24 hour urine catch.
Consider insulin levels.
Chronically elevated blood insulin levels are associated with prostate cancer, especially in men who are overweight. For real. There is a link between high insulin (the hormone that you use to reduce blood sugar) and prostate cancer. Straight out of U.S. News and World Report, here’s the headline: Obesity, “Insulin Levels Impact Prostate Cancer Survival.
Hopefully by now I have convinced you to lose weight and eat better (which then reduces insulin levels) and that helps you to avoid medication of various sorts. If you are overweight especially, then you have higher insulin levels (in most cases, not all) and higher insulin levels reduce survival. You can have your insulin levels measured with a blood test. Optimally speaking, serum insulin should be less than 5. A two-hour post prandial insulin level should be less than 25. Your physician will understand all this and if you have your labs, you can compare your results to my suggestions here.
When you are overweight, your fat cells hold on to estrogen. Excessive estrogen in a man may cause erectile dysfunction, not to mention a higher risk of cancer. Overweight men/women have more estrogen inside their cells, and estrogen (especially estradiol) is known to cause a higher risk for cancer.
In women under age 45, excessive estrogen can produce the following symptoms: Heavy periods, bad PMS, depression, anxiety, stubborn weight loss or sudden weight gain, fibroids, breast tenderness, and insomnia. Of course, these symptoms could mean other things too.
Now, in men, excessive estrogen could look a lot different, and necessitate the need for Viagra. Erectile dysfunction is just one possible symptom of estrogen dominance. Remember earlier, I told you that the ratio of hormones was important? It’s the same here too. As a man ages, his levels of testosterone decline. It is a natural part of aging. It gets accelerated with the use of statins which by the way cause hypothyroidism, which then also lead to erectile dysfunction. But if that same gentleman is exposed to estrogen-containing substances, or he is a heavy meat eater (commercial meat sometimes contains traces of estrogen hormone in it) then his estradiol levels could rise, and as estrogen rises, it’s all relative to his declining testosterone. Got it? The more estradiol (a form of estrogen, the lower the testosterone, relatively speaking).
Let’s talk more about food.
Diet is VERY important.
Men who are heavy meat eaters (5 times or more per week) are 2 and half times more likely to develop prostate cancer than men who eat it once a week. The reason may be linked to many factors, one of which is the hormonal content of commercial-raised beef. Consider natural supplements that support prostate health, I don’t necessarily think you should take them all, but you can if your doctor approves of the following regimen.
Ask your doctor if these are right for you, and more than that, have him measure your hormones (estrogen, testosterone, insulin, androstanediol, etc.) to see what YOU need as an individual. Don’t let him shoot darts in the dark, he might miss the bullseye. Here are the best nutritional supplements I can find for men who have rising PSA, or prostate troubles. Eat more foilage to get more folate and B6, so that you can spin your methylation cycle and break down homocysteine. Homocysteine is linked to higher risk for cancer. If you’re interested in my article on that, CLICK HERE to read, Homocysteine is Linked to Mood and Mental Health.
It’s a natural 5-alpha reductase inhibitor, meaning it suppresses DHT to some extent. Your prostate needs and craves zinc the way a woman does chocolate! You must have zinc in order to function, and it’s found in sunflower seeds, pumpkin seeds… eat ‘em up! Zinc is also found in many supplements sold over-the-counter and in pharmacies. Suggested dose: 10 – 50mg zinc per day, ask your doctor because too much zinc will cause a relative deficiency of other minerals. You might take a break from zinc every few weeks because again, it can tilt your copper and magnesium out of balance if you take high doses for too long.
Found in apples and other fruits, this is a bioflavonoid with powerful antioxidant qualities. It may help relieve prostate pain, especially in prostatitis and it too is a 5-alpha reductase inhibitor so it can lower DHT to some degree as well. Suggested dose is 500 -1,000 mg once or twice daily.
Discussed above. Suggested dose: 5,000 – 15,000 IU daily in the morning, measure your blood levels.
Curcumin or Turmeric.
Found in curry spice (turmeric) which is found in Indian food. I would supplement with this anti-cancer compound. There are hundreds of scientific papers supporting it’s use as an anti-inflammatory, anti-cancer compound. It’s also a natural TNF alpha blocker which means it could help people with arthritic pain and much more. Suggested dose is 500 – 1,000 mg twice daily. You can also buy turmeric shots and drink them, these are sold on Amazon and in almost every health food store nationwide.
It’s not bullet proof as studies conflict, but it appears that this carotenoid (along with other antioxidants like vitamin E, and those listed in this article) can definitely help reduce risk for prostate cancer. Suggested dose: 30 mg once daily.
Your sleep hormone, secreted when the sun goes down and it gets dark. Numerous studies show that melatonin can amp up your body’s ability to fight cancer. You need melatonin for proper rest and it naturally declines as you age. Suggested dose: 1 to 3 mg at bedtime. When you are dealing with cancer, higher dosages may be advised by your physician. Only take this much melatonin if your doctor tells you too, no matter what I’ve outlined here because too much melatonin is harmful.
Like grapefruit seed extract (GSE) or aged garlic, also probiotic supplementation. Your immune system is in your GUT, so if you eradicate Candida and other opportunistic yeast, your immune cells begin to thrive again. Your body has a better chance of beating any disorder (including cancer) if your immune cells are able to live in a healthy environment that is not overrun by germs and yeast.
This herb was not on my list in the original article which printed in newspapers even though it has a wonderful effect on the prostate. But I didn’t have enough space to say WHY it wasn’t on the list even though it can help. I can tell you here, the reason is that Saw palmetto can turn off DHT so well (and that’s what medications seek to do… to turn off DHT) that it can suppress that cancer-protective hormone called “androstanediol” that I discussed earlier in this article.
So if you are going to take this non-drug alternative (which is a strong 5-alpha reductase inhibitor) then I want you to do so under supervision, so that you can have your levels measured routinely. Again, it is the ratio of DHT to androstanediol that seems to matter the most, not either one of those alone.
Believed to be one of the major ingredients from saw palmetto that work to reduce DHT. Everything I said about saw palmetto above, applies here too!
How Do You Control Estrogen Formation?
Answer: Aromatase Inhibitors! These are Aromatase medications that prevent the formation of estradiol, a female hormone, by interfering with an enzyme called “aromatase.” Aromatase inhibitors are sometimes prescribed by doctors sometimes for post-menopausal women who have hormone-dependent breast cancer. The reason it may help prosate cancer is because some men have imbalanced hormones, and sometimes their estrogen levels are high, relatively speaking. The two most common aromatase inhibitor drugs are Evista and Aromasin. Natural aromatase inhibitors include broccoli extracts (think of I3C or DIM) as well as Chrysin.
References if you want to keep researching…
There are dozens of references, in fact, hundreds collectively-speaking, here are just a few:
Shoskes D. Use of bioflavonoid quercetin in patients with long-standing chronic prostatitis J Am Neutraceut Assoc 1999;2:18-21.
Shoskes D, et al. Quercetin in men with category III chronic prostatitis. A preliminary prospective double-blind placebo-controlled trial. Urology 1999;54:960-3.
Anticancer Agents Med Chem. 2009 Sep 1. [Epub ahead of print]Links
Novel Anti-Prostate Cancer Curcumin Analogues that Enhance Androgen Receptor Degradation Activity.
A combination of micronutrients is beneficial in reducing the incidence of prostate cancer and increasing survival in the Lady transgenic model.
Beta-sitosterol inhibits cell growth and induces apoptosis in SGC-7901 human stomach cancer cells.
Suzy Cohen, has been a licensed pharmacist for over 30 years and believes the best approach to chronic illness is a combination of natural medicine and conventional. She founded her own dietary supplement company specializing in custom-formulas, some of which have patents. With a special focus on functional medicine, thyroid health and drug nutrient depletion, Suzy is the author of several related books including Thyroid Healthy, Drug Muggers, Diabetes Without Drugs, and a nationally syndicated column.