UNDERSTANDING PROSTATE HEALTH
November is here and with it comes the 'ever growing' ritual of the newly-growing moustache. Although some do it for fun, most do it to raise money for prostate cancer research. The event began in Australia, as a way to bring people's awareness to the incidence and risks of prostate cancer, the third most common cause of cancer death in men. In the spirit of MO-vember, I thought I would shed some light on the topic...

Q. What does your Mo mean?

A. What is a Praw-stay-te?
The prostate is a ductal (or secreting) gland of the male reproductive system. It secretes a slightly alkaline, milky or white, fluid that accounts for 20-30% of semen volume. Androgens, mainly testosterone, support the proper functioning of the prostate gland, and can, in part, be responsible for hyperplasia or abnormal cell growth in the prostate. The alkaline fluid produced from the prostate helps to neutralize the acidity of the vaginal tract, ultimately prolonging life span of sperm. The prostate also contains smooth muscle that helps to expel semen during ejaculation. It wraps around the urethra, which explains why prostate related symptoms often include those dealing with urination.

Prostate Cancer – Risk factors
Prostate cancer is the most common cause of cancer death in men over 75 years old. Age and family history are the primary risk factors. Prostate cancer rarely occurs in men under the age of 45-50 years old. It is also much more likely (double the risk) if you have a first degree relative with prostate cancer, particularly a brother. Other risk factors include being of African American descent, having high blood pressure, men frequently exposed to environmental toxins, such as farmers, tire plant workers, painters, as well as those exposed to cadmium or agent orange, and men who eat diets high in fat (particularly animal fat). There is also some weak evidence to suggest that men who undergo vasectomy have an increased risk of developing prostate cancer.

How bad is it, doc?
Most prostate cancers are very slow growing, with many men never experiencing symptoms, undergoing no therapy and eventually dying of other causes. That being said, about 1/3 of all prostate cancers can be aggressive. Determining prognosis or outcome is usually done based on staging. Stages T1 and T2 are found only in the prostate. T3 and T4 have spread somewhere else (metastasized), with the most common areas of spread being the bone, ureter and liver. The Gleason score is another ranking system (a scale from 2-10) also ranking prostate cancers from low (2-4) to high grade (8-10). Again, the higher the score the more likely the cancer has spread beyond the prostate and potentially the more difficult it will be to treat.

How do I know I have it? - Symptoms and Tests
Prostate cancer is usually detected when a patient goes to his or her Naturopath or MD with complaints such as difficult urination, increased frequency or hesitancy with urination or painful urination in more severe cases, also problems with sexual intercourse or erectile dysfunction. As I mentioned, many men do not experience any of these symptoms, and as such, hypertrophy or enlargement of the prostate may be discovered on routine physical exam, during rectal examination. If you are at risk or are observing prostate related symptoms, your doctor may also choose to check your PSA (prostate specific antigen), which is elevated in prostate cancer. PSA levels are also commonly elevated with prostatitis, of various forms, and benign prostatic hyperplasia (BPH). So this is not a specific test and by no means is diagnostic of cancer. A prostate biopsy is the only diagnostic test for prostate cancer. There is some controversy in regards to when or if testing should be done in all males. It is important to talk to your Naturopath or MD about the pros and cons of testing after the age of 50.

How do I protect myself against Prostate Cancer?
Notice I said, protect, instead of treat. I love the fact that initiatives such as the MO-vember fundraiser are raising awareness of prostate cancer and raising funds towards the treatment and early detection of prostate cancers, but what about PREVENTION. A diet low in animal fat is one way to protect yourself against prostate cancer. Limit your intake of red meat to one serving a week. Include lean animal proteins, such as fish (and fish oil!) and chicken more often, as well as focus on plant based proteins, such as quinoa, beans and lentils. Consider a vegan protein supplement, that includes pea and rice protein. Add nuts and seeds to your daily routine. They are a source of protein, essential fats, as well zinc. Try pumpkin seeds, sesame seeds, walnuts and flax seeds. Add them to your morning (slow cooked) oatmeal, as oats are a great source of fibre. Curcumin (from the Indian spice tumeric) is a potent anti-inflammatory and anti-oxidant. Therapeutic dosages are difficult to get through diet, alone, so consider a supplement. Research has shown curcumin to have chemopreventive and growth inhibiting activity, across a number of tumour cell lines, including that of the prostate.

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