The prostate is a walnut-size gland that encircles the urethra just below the bladder. Glandular tissue contributes fluid to the semen; muscles within the prostate help expel semen during ejaculation. Disorders of the prostate are relatively common.
More than 30 million men suffer from prostate conditions, such as prostatitis, benign prostatic hyperplasia, and prostate cancer. The first is more common in younger men; the last two become more common with age.
Prostatitis (prostate inflammation) affects about half of men sometime during their lifetime. Bacteria can infect the prostate gland. The prostate is also susceptible to acute and chronic noninfectious inflammation, though the underlying cause is poorly understood.
The symptoms of acute bacterial prostatitis include frequent and painful urination, pain in the low back or behind the testicles, painful ejaculation, aching muscles, fever, chills, and fatigue. Chronic bacterial infection can cause mild symptoms or none at all. Noninfectious prostatitis mainly causes pelvic pain, as well as pain with ejaculation and urination.
Bacterial prostatitis is treated with antibiotics. Treatment of noninfectious prostatitis is more challenging. Pain relievers, a class of medication called beta-blockers, and physical therapy may help. Benign prostatic hyperplasia, also called benign prostatic hypertrophy (BPH), affects mostly older men. About half of fifty- to sixtyyear- old men develop BPH. Between ages eighty and ninety that proportion rises to nearly 90 percent. This noncancerous enlargement of the prostate encroaches on the urethra, decreasing the ability of urine to easily flow from the bladder. Symptoms include increased frequency and urgency of urination, nighttime urination, a weak urine stream, an inability to fully empty the bladder, and difficulty stopping and starting urination.
The underlying cause is an age-related rise in prostate levels of dihydrotestosterone (DHT) as well as estrogen, which stimulate cells to multiply. Prescription medications can reduce prostate size and improve urine flow. Severe cases may require surgery.
Some herbs may be helpful in cases of mild BPH. These include extracts of the African plant pygeum (Pygeum africanum), saw palmetto (Serenoa repens), and nettle root (Urtica dioica). Several studies show that supplemental betasitosterol (a plant chemical structurally similar to cholesterol) reduces BPH symptoms. These botanical treatments mainly reduce symptoms, but without shrinking the size of the prostate. Reported side effects for these supplements are minor and rare.
Excluding skin cancer, prostate cancer is the most commonly diagnosed cancer in men. Each year, some 230,000 men learn they have it. For most men, the prognosis is good with adequate treatment. Risks include family history, older age, black race, obesity, and higher consumption of meat and high-fat dairy products.
Until it spreads to other tissues, prostate cancer causes no symptoms unless it narrows the urethra (making urination more difficult) or releases blood into the urine. That’s why annual physical exams are important. Specifically, a doctor or nurse performs a digital rectal exam, which allows the examiner to estimate the size and texture of the prostate gland.
Controversy exists about screening tests using prostate specific antigen (PSA), a protein unique to the prostate. The problem is that, in addition to prostate cancer, other prostate conditions (prostatitis and benign prostatic hyperplasia) increase levels of this protein. That means that many men with benign causes of elevated PSA levels are subjected to prostate biopsies and needless anxiety. Furthermore, most cases of prostate cancer progress relatively slowly.
When the U.S. Preventive Services Task Force reviewed studies on PSA testing in 2012, it concluded that the harms related to testing outweighed the potential benefits. Nevertheless, PSA testing is the best screening tool currently available. The American Urologic Association (AUA) does not recommend PSA screening for men younger than age forty. For men ages forty to fifty-four, PSA testing is only recommended for those at higher risk for prostate cancer—African Americans and those with a family history of prostate cancer. For men between ages fifty- five and sixty-nine, the AUA recommends shared decision-making between the man and his doctor. In other words, discuss this test with your doctor.
Treatments vary from watchful waiting (for mild cases), to chemotherapy, radiation therapy, hormonal treatments, and removal of the prostate gland.
Recipes to support prostate health
Salubrious Stir-Fried Veggies and Tofu
1 cup (248 g) firm tofu, cubed 1½ teaspoons (8 ml) soy sauce 3 tablespoons (45 ml) olive oil, divided 3 cups (400 g) combination of any of the following: chopped red bell pepper, asparagus, onion, broccoli, and mushrooms 3 garlic cloves, minced 1½ teaspoons (4 g) grated fresh ginger Freshly ground black pepper
Preparation and use:
In a bowl, toss together tofu, soy sauce, and 1 tablespoon (15 ml) of the olive oil. Heat a skillet over medium-high and sauté the coated tofu about 3 minutes until it begins to brown. Transfer the tofu to a bowl and set aside. Into the hot skillet place the remaining olive oil, veggies, garlic, and ginger. Sauté the mix for about 6 minutes. Add the tofu and combine it with the vegetables. Add black pepper to taste. Enjoy the veggies in a bowl or over brown rice.
Yield: 3 To 4 servings
How it works:
Traditional Asian diets are associated with a reduced likelihood of BPH and prostate cancer. These diets include regular consumption of vegetables, soy, and green tea, all of which contain substances that restrain prostate growth. On the other hand, diets high in fats, carbohydrates, and red meat seem to increase the risk.
Super Tomatillo-Pumpkin Seed Salad Dressing
1 can (13 ounces, or 368 g) tomatillos, drained ½ white onion, chopped ¼ cup (4 g) fresh cilantro leaves, chopped ½ cup (32 g) roasted pumpkin seeds 1 jalapeño pepper, seeded and chopped 1 garlic clove 1 tablespoon (15 ml) fresh lime juice Water Salt
Preparation and use:
Purée the tomatillos, onion, cilantro, pumpkin seeds, jalapeño, garlic, and lime juice in a blender until coarse. Pour in a bowl and add just enough water to give it a saucelike consistency. Add salt to taste. Drizzle over broiled chicken or fish.
YieLd: 4 ServingS
How it works:
Pumpkin seeds contain healthy oil, fiber, carotenes (which are antioxidant and promote immune function), vitamin E, and zinc. Pumpkin seed oil extracts, with or without saw palmetto, can reduce BPH symptoms. Zinc seems to inhibit proliferation of prostate cancer cells. Low zinc can occur in men with BPH and prostate cancer. Zinc is also needed for sperm production.
Green Tea for Guys
Drinking green tea with your meal aids digestion. 2 green tea bags Handful of fresh mint Fresh lime juice Honey, to taste
Preparation and use:
Bring the water to a boil in a saucepan and then turn off the heat. Add the tea and mint and steep, covered, for about 10 minutes. Pour into cups, straining out the mint. Stir in the lime juice and honey. Enjoy hot or cold.
Yield: 2 servings
How it works:
Habitual consumption of green tea correlates with reduced cancer risk. Lab studies show that green tea polyphenols impair the ability of prostate cancer cells to divide and trigger the death of these cells.
Powerful Pomegranate Smoothie
2 cups (400 g) plain nonfat Greek yogurt 8 ounces (235 ml) pure pomegranate juice 1 banana, peeled, cut into chunks, and frozen ½ cup (128 g) sliced strawberries, frozen
Preparation and use:
Pour the yogurt and juice into a blender. Add the fruit and blend until smooth. Enjoy!
Yield: 2 servings
How it works:
Pomegranate juice inhibits the development of prostate cancer and the progression of already existent prostate cancer. Compounds in pomegranate cause prostate cancer cells to die and decrease the migration of these cells. A study in men with prostate cancer resulted in none of the patients progressing to advanced stages while drinking 8 ounces (235 ml) of pomegranate juice a day. Pomegranate also slowed the rise in blood levels of PSA.
When Simple Doesn’t work
One study demonstrated improved success in antibiotic treatment of chronic bacterial prostatitis with the addition of a supplement containing the antioxidant quercetin and the herbs saw palmetto, nettles, and curcumin (the active ingredient in turmeric). Ask your doctor about the herbs noted in the introduction to this chapter, which have minor or rare side effects and may help reduce symptoms without actually shrinking the size of the prostate, as well as about the supplement beta-sitosterol. You may also discuss with your doctor prostatic massage, in which the doctor inserts a gloved, lubricated finger into the rectum and presses gently on the prostate. Frequent massage may help open ducts that are blocked in the prostate and help improve circulation. However, if you have acute bacterial prostatitis, massage could spread infection through the body. Warning: Do not try this at home without first discussing with your physician.
When to call the Doctor
• You have symptoms of prostatitis. Fever, chills, and nausea are associated with acute bacterial prostatitis. Chronic bacterial prostatitis can cause blood in semen or urine.
• You have symptoms of BPH: frequent and painful urination, pain in the low back, pelvis, or behind the testicles, painful ejaculation, aching muscles, fever, chills, and fatigue. Get a proper diagnosis, even if you want to try a dietary supplement such as saw palmetto. Symptoms of BPH can overlap with those of prostate cancer.
• You develop trouble urinating, blood in urine or semen, discomfort in the pelvic area, or bone pain.
• Discuss screening tests for prostate cancer with your doctor.
Sunday, 6 April 2014
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