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J. Patrick Adair

Navigating Prostate Health: Essential Guide for Men over 50

Updated: Apr 1


The term "complementary and alternative medicine" (CAM) refers to a type of care that is administered either in place of or in addition to conventional therapies.


Approximately 1 in 8 males in the US will receive a prostate cancer diagnosis. In the US, it is the second most frequent cancer among men. Men with prostate cancer frequently use complementary and alternative medicine. Research examining the factors that influence men with prostate cancer to choose complementary and alternative medicine (CAM) include medical history, perceptions of the benefits and drawbacks of CAM in

comparison to conventional treatments, and a desire to have control over their care.


alternative medicine for prostate health

Alternative treatments have been researched to see if their use alters the risks of prostate cancer, kills prostate cancer cells, or lowers the risk that cancer will come back after treatment. Most of these studies used prostate-specific antigen (PSA) levels to find out whether the treatment worked. This measurement is used more of an estimate and doesn’t compare to direct measures, such as fewer new cases of prostate cancer, or smaller tumor size or lower rate of recurrence after treatment for prostate cancer.


Risks


Prostate cancer is influenced by various risk factors that contribute to its development. Here are key points outlining the risks associated with prostate cancer:


Age: The risk of prostate cancer increases with age, particularly after the age of 50.

Genetics: A family history of prostate cancer can elevate the risk, indicating a potential genetic predisposition.


Ethnicity: Certain ethnicities, such as African American men, face a higher risk compared to others.


Inherited Genetic Mutations: Presence of inherited faulty genes may contribute to an increased susceptibility to prostate cancer.


Obesity: Being overweight or obese is linked to a higher risk of developing aggressive forms of prostate cancer.


Hormone Levels: Imbalances in hormone levels, especially higher levels of testosterone, may contribute to an elevated risk.


Tall Stature: Some studies suggest a correlation between height and an increased risk of prostate cancer.


Dietary Factors: While the evidence is not conclusive, diets high in animal fat are considered a potential risk factor.


Understanding these risk factors is crucial for early detection and proactive management of prostate cancer. Regular screenings and adopting a healthy lifestyle can mitigate some of these risks and contribute to overall well-being.


Top 10 supplements reviewed:


• Calcium

• Green Tea

• Lycopene

• Modified Citrus Pectin

• Pomegranate

• Selenium

• Soy

• Vitamin D

• Vitamin E

• Combination Therapies

• Other Prostate Health Supplements


Calcium


Calcium is a vital mineral in the human body, playing a crucial role in facilitating the functioning of blood vessels, muscles, and nerves. Additionally, it is essential for cellular communication and hormone release, with the majority of calcium stored in bones and teeth.


Calcium can be obtained through various sources, primarily from foods and dietary supplements. About one-third of dietary calcium is derived from milk and milk products like cheese and yogurt, while vegetable sources include Chinese cabbage, kale, and broccoli. Foods may also be fortified with calcium, such as fruit juices, drinks, tofu, and cereals. It's noteworthy that most research on calcium and prostate cancer risk has focused on dietary calcium rather than calcium supplements.


Numerous studies globally have explored the relationship between dairy products, calcium, and the risk of prostate cancer, yielding mixed results. Some suggest a potential link between high calcium intake and an increased risk of advanced and metastatic prostate cancer, while others show no clear association.


Combined reviews and population studies have further contributed to the complexity of understanding this relationship, with factors like age, body mass index (BMI), and other nutrients in dairy products influencing study outcomes. Clinical trials, A 2015 review of 32 studies found that high amounts of milk, low-fat milk, cheese, total dietary calcium, and dairy calcium in the diet may increase the risk of prostate cancer. Calcium supplements and non-dairy calcium were not linked with an increased risk of prostate cancer.


Food and Drug Administration (FDA) has not approved calcium for use as a cancer treatment in the United States.


Green Tea


green tea supplement

Green tea, derived from the Camellia sinensis plant, undergoes specific processing methods to produce different types of tea, such as green tea, black tea, or oolong tea. Green tea is crafted through steaming and drying the leaves. The health benefits attributed to green tea are primarily linked to polyphenols, including catechins, which act as antioxidants protecting cells from damage. The variation in catechin composition due to tea leaf sources and processing methods complicates the identification of specific chemical factors responsible for the health benefits.


Green tea can be consumed by drinking it or taken as a dietary supplement. Numerous studies, including laboratory and animal research, have explored the potential of green tea in preventing or treating prostate cancer. Population studies suggest that green tea may offer protection against prostate cancer, particularly in Asian populations with lower prostate cancer death rates. Clinical trials, though limited in sample size, indicate that green tea catechins may lower PSA levels and potentially reduce the risk of prostate cancer in individuals at high risk.


While green tea is generally considered safe, certain side effects have been reported, including headache, chest pain, nausea, and diarrhea. Long-term use, especially in clinical trials, may lead to more side effects. Notably, the U.S. FDA has not approved green tea as a cancer treatment. The FDA recommends cautious use of green tea extract, advising participants to take it with food and undergo frequent liver function tests, emphasizing that dietary supplements are not regulated for safety and effectiveness.


Lycopene


Lycopene is a natural red carotenoid found in various fruits and vegetables such as tomatoes, apricots, guavas, and watermelons. As a carotenoid, it dissolves in fats and plays a protective role in plants, shielding them from light-related stress and aiding in utilizing sunlight for nutrient synthesis.


In the United States, tomato-based products, particularly processed forms like tomato paste and tomato puree, are the primary sources of lycopene, which the body finds easier to absorb compared to raw tomatoes.


Studies have explored lycopene's potential in preventing heart and blood vessel diseases. Lycopene can be incorporated into the diet through food consumption or taken as a dietary supplement. Laboratory and animal studies, detailed in the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements, investigate lycopene's effects. Clinical trials and population studies on lycopene's role in preventing or treating prostate cancer present mixed results. Some studies suggest a lower risk of prostate cancer or a reduction in prostate-specific antigen (PSA) levels, while others do not provide conclusive evidence.


Side effects of lycopene reported in clinical trials are minimal, including symptoms like diarrhea, nausea, and bloating. Notably, the U.S. FDA has not approved lycopene as a treatment for cancer or any medical condition, but it is Generally Recognized as Safe (GRAS). Lycopene is available in the U.S. through food products and dietary supplements; however, the FDA does not regulate the manufacturing of supplements, emphasizing the responsibility of companies to ensure safety and accuracy in labeling.


Modified Citrus Pectin


Modified citrus pectin (MCP) is derived from citrus fruits, particularly the peel and pulp of oranges, grapefruits, lemons, and limes. Pectin, a natural substance comprised of small linked sugar molecules, is commonly found in the cell walls of plants, exhibiting gel-like properties useful in various food and medicinal applications. During manufacturing, citrus pectin undergoes modification to enhance its solubility in water, allowing for better absorption by the body, resulting in what is known as modified citrus pectin.


MCP is typically administered orally, available in powder or capsule form. While laboratory and animal studies investigating MCP are detailed in the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements, there is limited evidence from human studies, particularly in men with prostate cancer. The available data is insufficient to conclusively determine MCP's impact on prostate cancer.


Reported side effects of MCP include itching, stomach upset, abdominal cramps, increased gas, and diarrhea. Notably, the U.S. Food and Drug Administration (FDA) has not approved MCP as a treatment for cancer or any other medical condition. In the United States, MCP is accessible in food products and dietary supplements. However, it's crucial to note that the FDA does not endorse the safety or efficacy of dietary supplements, placing the responsibility on manufacturers to ensure safety and accurate labeling, with variations among batches and brands due to the lack of FDA regulation in supplement production.


Pomegranate



The pomegranate is a fruit cultivated in Asia, the Mediterranean, East Indies, Africa, and the United States, and it has a rich history of medicinal use spanning centuries. Its components include the peel, constituting half the fruit and containing polyphenols and minerals; the seeds; and the aril, the layer between the peel and seeds, containing phenolics and flavonoids, including anthocyanins, imparting the characteristic red color to both the fruit and its juice.


Pomegranate can be consumed as food, drink, or in dietary supplement form, offering versatility in its intake. While laboratory and animal studies regarding pomegranate can be found in the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements, human studies, like a 2015 trial involving 183 men with recurrent prostate cancer, have shown inconclusive results. In this trial, individuals received pomegranate juice, pomegranate extract, or a placebo, with no significant difference observed in the rate of prostate-specific antigen (PSA) level increase among the groups.


Despite its historical medicinal use, there is currently insufficient evidence to determine whether pomegranate can effectively prevent or treat prostate cancer. Notably, no serious side effects have been reported from the use of pomegranate, and it has not received approval from the U.S. Food and Drug Administration (FDA) for the prevention or treatment of cancer or any other medical condition.


Selenium


Selenium is an essential mineral vital for various bodily functions, including reproduction and immunity. It is naturally present in foods like meat, vegetables, and nuts, its concentration influenced by soil selenium levels. Stored in organs like the thyroid gland, liver, pancreas, pituitary gland, and kidneys, selenium is critical for overall health.


In the context of disease, selenium has been investigated, particularly in relation to cancer. The National Cancer Institute's Selenium and Vitamin E Cancer Prevention Trial (SELECT) studied selenium's impact on prostate cancer. Results suggested that men with prostate cancer should avoid selenium supplements. Selenium can be obtained through dietary sources or supplements.


Numerous studies, including population studies and clinical trials, have explored selenium's role in preventing or treating prostate cancer. Mixed results have emerged, with a large randomized clinical trial, like SELECT, indicating that selenium had no preventive effect on prostate cancer.


SELECT's findings were nuanced. While early results showed no difference in prostate cancer rates, a slight increase in diabetes mellitus risk was noted in the selenium alone group. Subsequent results demonstrated no overall impact on prostate cancer risk, but selenium supplements posed risks for specific subgroups, such as those with high initial selenium levels, increasing the risk of aggressive prostate cancer.


Selenium supplements were generally well-tolerated, but in SELECT, they were associated with a slight increase in diabetes mellitus rates. Studies indicated that men with high selenium levels might face a higher risk of aggressive prostate cancer or prostate cancer-related mortality.


Despite its potential benefits, the U.S. Food and Drug Administration (FDA) has not approved selenium supplements for cancer treatment or prevention.


Soy


The soybean plant, cultivated in Asia for centuries, yields various products like soy milk, miso, tofu, soy flour, and oil. Rich in phytochemicals, soy contains extensively studied compounds known as isoflavones, including genistein, daidzein, and glycitein. These phytoestrogens, resembling plant-derived estrogens, interact with estrogen receptors in prostate cancer cells, potentially influencing processes related to cancer growth and spread.


Soy can be consumed through dietary sources or supplements. Laboratory and animal studies on soy are available in the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements. Numerous population studies and clinical trials have explored soy's role in preventing or treating prostate cancer, yielding mixed results. Some studies indicate a lower prostate cancer risk or changes in prostate-specific antigen (PSA) levels, while others show no significant impact. Factors contributing to varied outcomes include study participant numbers, diverse soy product types, and different doses administered.


A 2018 review suggested that high consumption of nonfermented soy foods, like tofu and soybean milk, may lower the risk of prostate cancer, while fermented foods, such as miso, did not show a significant effect. Clinical trials, specifically small randomized ones, focused on isoflavones or soy and their impact on prostate cancer, resulting in mixed findings.


Prostate cancer patients taking soy products and isoflavones in clinical trials reported minimal side effects, predominantly gastrointestinal symptoms like diarrhea. Notably, the U.S. Food and Drug Administration (FDA) has not approved soy as a cancer treatment. Soy is available in the U.S. through food products and dietary supplements, but the FDA does not regulate the manufacturing process of supplements, emphasizing the responsibility of companies to ensure safety and truthful labeling.


Vitamin D


Vitamin D, a fat-soluble vitamin present in fatty fish, fish liver oil, and eggs, is crucial for various bodily functions. It aids in calcium absorption in the small intestine, enhances muscle strength and immune system function, lowers inflammation, maintains blood calcium and phosphate levels, and supports bone growth, protecting against osteoporosis in adults. Vitamin D levels are assessed through 25-hydroxyvitamin D measurements in the blood.


The vitamin is obtained through sunlight exposure or dietary sources, including supplements. Laboratory and animal studies on vitamin D are available in the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements. Population studies and clinical trials exploring the relationship between vitamin D and prostate cancer show mixed results. While some studies suggest a link between vitamin D levels and prostate cancer, others do not provide enough evidence to confirm preventive effects.


Various reviews and studies on population and clinical levels reveal diverse findings. Some studies indicate no correlation between vitamin D intake and prostate cancer risk, while others propose associations with vitamin D levels and the disease. Clinical trials investigating vitamin D supplements for cancer prevention or treatment show varying outcomes, including no significant reduction in cancer rates.


Concerning safety, vitamin D can pose risks at high doses over extended periods, leading to hypercalcemia. Reviews of 26 studies indicate a low risk of side effects and interactions with other drugs used for cancer treatment.


In summary, while vitamin D plays essential roles in the body, its link to prostate cancer prevention remains inconclusive, and the FDA has not approved it as a cancer treatment.


Vitamin E


Vitamin E is a crucial antioxidant nutrient that supports various aspects of health, including vision, reproduction, and the well-being of blood, brain, and skin. It also possesses antioxidant properties, which help protect cells from damage caused by free radicals. These free radicals are produced during food breakdown or exposure to tobacco smoke and radiation. While vitamin E supplements offer antioxidant benefits, it’s essential to recognize that naturally occurring antioxidants in food may provide additional advantages.


Foods rich in vitamin E include canola oil, olive oil, margarine, almonds, peanuts, meats, dairy, leafy greens, and fortified cereals. Nuts, seeds, and vegetable oils are excellent sources.


There are eight forms of vitamin E, including four tocopherols (alpha, beta, gamma, and sigma) and four tocotrienols (alpha, beta, gamma, and sigma). Alpha-tocopherol, the most active form, is commonly used in dietary supplements.


Health Benefits:

  • Heart and Blood Vessel Health: Vitamin E may protect against chronic diseases related to heart and blood vessels.

  • Alzheimer’s Disease: Some research suggests that high-dose vitamin E might delay the progression of Alzheimer’s disease in individuals with mild to moderate Alzheimer’s.

  • Liver Health: Studies indicate that vitamin E may improve symptoms of nonalcoholic fatty liver disease.

  • Prostate Cancer: While vitamin E and selenium supplements don’t prevent prostate cancer, higher blood levels of alpha-tocopherol are associated with a lower risk of prostate cancer. Additionally, gamma-tocopherol may reduce the risk of advanced prostate cancer.

When taken at appropriate doses, oral vitamin E is generally safe. Rare side effects may include nausea, diarrhea, intestinal cramps, fatigue, weakness, headache, blurred vision, rash, and increased creatine concentration in urine. High doses should be approached with caution.


Remember that a balanced diet usually provides sufficient vitamin E. If you have specific health concerns, consult your healthcare provider before taking vitamin E supplements


Combined supplementation


Pomi-T (Pomegranate, Green Tea, Broccoli, and Turmeric): Polyphenols, with antioxidant properties, are abundant in plants. A study examined a polyphenol-rich supplement in men with non-metastatic prostate cancer, consisting of pomegranate, green tea, broccoli, and turmeric. Although well-tolerated, the supplement group experienced more gastrointestinal symptoms.


Lycopene, Selenium, and Green Tea: A supplement containing lycopene, selenium, and green tea catechins was investigated in 60 men at high prostate cancer risk. After 6 months, those taking the supplement had higher prostate cancer rates upon repeat biopsy. The outcome suggests potential cancer misses at the study's onset.


Lycopene and Other Therapies: In a study with 79 men scheduled for prostatectomy, different interventions were assigned for three weeks before surgery:

  1. Tomato products with lycopene.

  2. Tomato products with added nutrients (selenium, omega-3 fatty acids, soy isoflavones, grape/pomegranate juice, green/black tea).

  3. A diet without added nutrients.

While PSA levels were similar between nutrient and non-nutrient groups, men with intermediate-risk prostate cancer showed lower PSA levels in those consuming tomato products or experiencing significant lycopene level increases.


References


PDQ® Integrative, Alternative, and Complementary Therapies Editorial Board. PDQ Prostate Cancer, Nutrition, and Dietary Supplements. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/about-cancer/treatment/cam/patient/prostate-supplements-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389501]


Disclaimer:


No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.







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