|Today's SuppVersity article revolves around the question what YOU can do to make sure that the procedure this guy is about to endure is the only thing to be afraid of, when you are going to your check ups ;-)|
Apropos useful, if you asked me about the one thing you can do to ward off prostate cancer my answer would be "turn to physical culture". Whether you are at risk of developing a form of prostate cancer (PCa) that will have you die or at least suffer from the disease, everybody has in mind, when he thinks about PCa, will not depend on doing A and not doing B. It's, just as so often, a matter of checks and balances. And the things you got to balance are
- 25% of cancer cases globally are due to excess weight and a sedentary lifestyle. (McTiernan. 2008)diet,
- sleep, and
- sun exposure
- Don't ignore this post if you are a woman. Most, if not all of the things that help men ward off prostate cancer will also help women to reduce their risk of developing breast and other forms of cancer. A whole foods diet, a reasonable amount of exercise, a lifestlye that tailors to your natural circadian rhythm (learn more) and allows for adequate amounts of quality sleep (7h+ every night) are a MUST for both, women and men who are concerned about developing any form of cancer.a 40% risk reduction in advanced PCa for white men consuming a high amount of fruits,
In fact, the way these parameter changed in the course of the last century, is probably the most likely explanation why you may get the impression that developing some sort of cancer is about to become the new normal.
- much to my own surprise no conclusive evidence that veggies are only half as protective as most of us probably thought they would be (think about the heavily advertised effect of DIM in cruciferus vegetables, for example.
- the thing about dairy in whites and meats in black increasing the overall prostate cancer risk by 70% and 80-90% (all meats vs. red meats), respectively
- the "problem" with only whole tomatoes being associated with significant risk reductions and the failure of tomato sauce (likewise pimped as a savior of the average American's prostate in the media) to elicit any effect on the health of your prostate
- an undebatable increase in cancer risk with increasing food consumption (+100% in the third tertile, Rohan. 1995)
- a non-significant association with the risk of developing prostate cancer with high intakes of vegetable oils (+24%; Rohan. 1995)
- a protective effect of saturated fats (-52%; Rohan. 1995) that appears to depend on the population you are analyzing (and I suppose the bias with which you approach the data)
- the protective power of real vitamin A (retinol; -34% for high(er) intakes. Rohan. 1995) and the absence of the latter for carotenes
What's the role of supplements here?
Despite the fact that the word "supplement" already implies that these agents are nothing that's intended to treat, cure and replace, the shiny adds of the multi-billion dollar industry does suggest just that: Don't be fooled. There is probably use in supplements such as
- the usual suspects: lycopene, ginger, pomegrenate, garlic, green tea, curcumin, resveratrol, grape seed extract, milk thistle, DIM,
- methyldonors (choline, betaine, SAM, etc.) and molecules that are important for the optimal function of the methylation cycle (B6, B12, etc.)
- mitochondrially targeted anti-oxidants like CoQ10 --33% reduction in PSA with 100mg in Safarinejedat et al. (2013),
- "fish oil" and here mostly EPA -- 30% reduction in PSA with 1.2g per day; Safarinejedat. 2013)
- melatonin (Srinivasan. 2011)
- coffee and coffee polyphenols -- 47% total risk reduction in a recent study by Li et al. (2003); effect was particularly evident in overweight and obese subjects, etc.
|Follow the "Three Simple Rules of Sensible supplementation" (read more)|
Exercise: Obligatory not facultative!
Contrary supplements, exercise is an obligatory part of the "anti-cancer" lifestyle, of which you should by now realize that it is above all a lifestyle in the most sense. It's not an intervention, a regimen, medication or pill and exercise, in the broadest sense of the word, has to be an integral part and not a doctor prescribed addition to your daily routine. It's not a short term intervention or a quick fix solution and you cannot expect "immediate results". If you start out working out regularly (I suggest to go for at least three and no more than 5 workouts per week), you will be able to reap the fruits of your labor in 10-15 years, when the doctor will stick his finger in your anus and say: "Everything all right Mr Physical Culturist! Absolutely no reason to be worried" (a high fitness level translates to a -64% risk reduction; cf. Olivera. 1996).
|You don't want to forget that both exercise and intermittent or alternate day fasting (Varaday. 2008) can help balance the mTOR/AMPK seesaw (read more), and reduce the potential overexpression and overabundance of total and free IGF 1.|
Don't be scared of your own hormones!
If you pair that with adequate sleep (at least 7h) and light exposure patterns that are both synchronized to your circadian rhythm, there is no reason to be worried about androgens as their effect on prostate cancer is facilitative, not causative (Gershman. 2013), so that even testosterone replacement therapy (TRT) should not pose a problem (Isbarn. 2009).
"Although no controlled studies have been performed to date to document the safety of testosterone therapy in men with prostate cancer, the limited available evidence suggests that such treatment may not pose an undue risk of prostate cancer recurrence or progression" (Morgentaler. 2013)In fact, case reports and small scale observational studies from Morgentaler et al. and Rhoden et al. clearly suggest that prescribing TRT is not just save even for patients who have just undergone treatment for PCa, it is even more or less warranted, to "reverting iatrogenic hypogonadism and its associated cardiac and metabolic complications" (Aversa. 2012) and can lead to decreases in PSA even in untreated PCa patients (Morgentaler. 2009)
|Does estrogen make women better endurance athletes because it increases mitochondrial biogenesis and gears your metabolism towards fatty acid not glucose oxidation? And if that is the case, would men benefit from some more estrogen, as well? Also, what about muscle building, is estrogen your friend or the foe people want it to be (read more)?|
Can your masturbate your way to a healthier prostate?
Apropos side effect. The total eradication of your libido is unfortunately one of the most common side effects of androgen deprivation therapy - I wonder if that happens to the same extent if it's done with estrogen, but I am digressing, ... so back to the libido thing and Carl's absolute favorite, the protective effects of regular ejaculations: 4-7, to be precise is what a 2004 study by Leitzmann et al. found to be associated with a -11% risk reduction in young and a whopping -51% risk reduction in older men (Leitzmann. 2004). We do yet have to be careful, because
- We all know (at least I hope so) that two parameters that correlate do not necessarily have a causal relationship, as well.
- The study participants were almost exclusively European Americans and in view of what we have learned from the Hayes study (1999) about the vast differences various dietary factors have on African vs. European Americans, it is not impossible that ejaculations are like grains: beneficial for fair skinned, but carcinogenic for people with dark skin (again no causation implied ;-)
- We could be dealing with another case of reverse causation, where early symptoms of prostate cancer (like prostate enlargement) cause pain and will have the subjects reduce their ejaculation frequency; luckily the scientists were smart enough to come up with this possible confounding factor as well:
A hefty dose of Tongkat Ali is probably not turning you into a bodybuilder, but maybe into a sex machine (read more).
In addition, our findings were essentially unaltered when we excluded cases diagnosed in the early years of follow-up. Hence, our results suggest that reverse causation may have accounted for very little, if any of the observed inverse association between high ejaculation frequency and total and organ-confined prostate cancer risk." (Leitzmann. 2004)
- False reporting could be an issue, but within the same cohort of health professionals other studies checked for the accuracy of the reports and found them to be "reasonably accurate" (Leitzmann. 2004). With the questionnaires being totally anonymous, it is thus unlikely that someone lied about his ejaculation frequency.
- The study did not measure ejaculation frequency during puberty, so that the results are "generalizable to white US men aged 46 years or older" (Leitzmann. 2004), only.
Moreover, we are still at a loss as far as the potential reasons for the touted beneficial effects. Often heard hypothesis usually revolve around
- HPV infections are unlikely the reason for the downsides observed in some of the studies. More recent studies could not find any evidence of previous HPV infections in "the average" prostate cancer patient (May. 2008; Groom. 2012)alterations of the composition of prostatic fluid, a decrease of the intraprostatic concentration of xenobiotic compounds and chemical carcinogens, which readily accumulate in prostatic fluid,
- a reduced development of intraluminal prostatic crystalloids, which have been associated with prostate cancer in some, but not all pathology studies and
- endogenous effects of the seminal plasma on the local immune responsiveness that may diminish intraprostatic immune surveillance against tumor cells.
Against that background I decided (probably much to Carl's dismay, to kick the "masturbate regularly" advice from the initial list of the four pillars of prostate cancer prevention, i.e. diet, exercise, sleep and a reasonable amount of sun exposure. As far as sex and masturbation goes, the jury is simply still out there.
So, do we either die from prostate cancer or die with prostate cancer? Those of you who have listened to the show know the answer already. Your chance to die from prostate cancer is 0.018% (CDC data from 2012). So unless you are one of the 188 unlucky guys among 1 million male US citizens, I gather that your chance of dying with "prostate cancer" (i.e. any form of abnormal tissue in your prostate) is probably 10,000x higher (estimated based on data from Zare-Mirzaie. 2012) ... and so is the chance neither you or anyone else will ever notice.
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