December 06, 2007

Prostate Cancer - Preventive Tips, Coping Skills


Prostate cancer can't be prevented, but you can take measures to reduce your risk or possibly slow the disease's progression. The most important steps you can take to maintain prostate health — and health in general — are to eat well, keep physically active and see your doctor regularly.

Eating well
High-fat diets have been linked to prostate cancer. Therefore, limiting your intake of high-fat foods and emphasizing fruits, vegetables and whole fibers may help you reduce your risk. Foods rich in lycopenes, an antioxidant, also may help lower your prostate cancer risk. These foods include raw or cooked tomatoes, tomato products, grapefruit and watermelon. Garlic and cruciferous vegetables such as arugula, bok choy, broccoli, brussels sprouts, cabbage and cauliflower also may help fight cancer.

Soy products contain isoflavones that seem to keep testosterone in check. Because prostate cancer feeds off testosterone, isoflavones may reduce the risk and progression of the disease.

Vitamin E has shown promise in reducing the risk of prostate cancer among smokers. More research is needed, however, to fully determine the extent of these benefits of vitamin E.

Getting regular exercise
Regular exercise can help prevent a heart attack and conditions such as high blood pressure and high cholesterol. When it comes to cancer, the data aren't as clear-cut, but studies do indicate that regular exercise may reduce your cancer risk, including prostate cancer.

Exercise has been shown to strengthen your immune system, improve circulation and speed digestion — all of which may play a role in cancer prevention. Exercise also helps to prevent obesity, another potential risk factor for some cancers.

Regular exercise may also minimize your symptoms and reduce your risk of prostate gland enlargement, or benign prostatic hyperplasia (BPH). Men who are physically active usually have less severe symptoms than men who get little exercise do.

Drug protection
Research on prostate cancer prevention has shown that the drug finasteride (Proscar, Propecia) can prevent or delay the onset of prostate cancer in men 55 years and older. This drug is currently used to control prostate gland enlargement and hair loss in men. However, finasteride also has been shown to contribute to increasing sexual side effects and to slightly raise the risk of developing higher grade prostate cancer. At the time, this drug isn't routinely recommended to prevent prostate cancer. However, if you're at higher risk for developing prostate cancer, discuss the use of finasteride with your doctor.

Finally, nonsteroidal anti-inflammatory drugs (NSAIDS) might prevent prostate cancer. These drugs include ibuprofen (Advil, Motrin, others) and naproxen (Aleve). NSAIDS inhibit an enzyme called COX-2, which is found in prostate cancer cells. More studies are needed to confirm whether NSAID use actually results in lower rates of prostate cancer or reduced deaths from the disease.

Coping skills

Once you receive a diagnosis of prostate cancer or treatment for this disease, you may experience a range of feelings — including disbelief, fear, anger, anxiety, emptiness and depression. You may not be able to get rid of these distressing feelings. But you can find positive ways to deal with them so they don't dominate your life. The following strategies can help you cope with some of the difficulties of prostate cancer:

Be prepared. Ask your doctor questions and read about prostate cancer and its potential side effects. The fewer the surprises, the more quickly you'll adapt.

Maintain as normal a routine as you can. Don't let the cancer or side effects from treatment dominate your day. Try to follow the routine and lifestyle you had before learning of your cancer. Go back to work, take a trip, join your children or grandchildren on an outing. You need activities that give you a sense of purpose, fulfillment and meaning. But realize that initially you may have some limitations. Start slowly and gradually build your level of endurance.

Try not to wallow in sad feelings. Seek diversions and plan at least one enjoyable experience every day. This might include pursuing a hobby, playing golf or going to a movie. Make it something you enjoy and look forward to.

Get plenty of exercise. Exercise helps fight depression and is a good way to relieve tension and aggression.

Look for ways to compensate. If you have problems with incontinence, sit in the back of the theater or meeting room instead of the front. That way you're less conspicuous if you need to leave for the bathroom. Sit in an aisle seat on an airplane or train. Wear absorbent undergarments if you're not sure whether you'll be near a bathroom. Avoid caffeinated products, which tend to increase your need to urinate.

Open up to a friend, a family member or a counselor. Cancer is too heavy a load to carry all by yourself. Sometimes it helps to talk with someone about your deepest feelings and fears. Your mind and body aren't separate. The better you feel emotionally, the better you'll be able to physically cope with your illness. You may find joining a support group helpful, because it can provide you with a sense of belonging, give you an opportunity to talk with people who understand your situation and provide you with advice. Your doctor or someone you know who has experienced prostate cancer may be able to help you locate a support group.

Seek sexual contact. Your natural reaction to impotence may be to avoid all sexual contact. Don't fall for this feeling. Touching, holding, hugging and caressing can become far more important to you and your partner. In fact, the closeness you develop in these actions can produce greater sexual intimacy than you've ever had before. There are many ways to express your sexuality.

Look for the positive. Cancer doesn't have to be an all-negative experience for you. Good can come out of it. Confrontation with cancer may lead you to grow emotionally and spiritually, to identify what really matters to you, to settle long-standing disputes and to spend more time with people important to you.

Complementary and alternative medicine

As people take a more active role in their health care, many are exploring options of care that fall outside the realm of traditional medicine. In fact, a range of dietary supplements and herbal medicines offers new ways to prevent or treat prostate disease, and cancer in general. The question is, do these therapies work? Some do show promise and are slowly gaining acceptance in mainstream medicine. But the benefits and risks of many products and practices remain unproven. Unfortunately, the production of these products isn't well regulated, and the amount of active ingredient may vary from bottle to bottle or even pill to pill.

Herbal products marketed to relieve common prostate problems, such as frequent urination or a weak urine flow, include:

African plum tree (Prunus africana)
African wild potato (Hypoxis rooperi)
Pumpkin (Cucurbita pepo)
Rye grass (Secale cereale)
Stinging nettle (Urtica dioica, Urtica urens)

Taken in small to moderate amounts, these products appear to be safe. But they haven't been studied in large, long-term trials to confirm their safety or to prove they work.

Saw palmetto
An exception is the herb saw palmetto (Serenoa repens). Unlike other herbal supplements, it has been widely tested, and the results show promise. However, it is important to know that saw palmetto is recommended to treat the symptoms associated with benign prostate gland enlargement, not prostate cancer.

Saw palmetto is thought to work by preventing testosterone from breaking down into another form of the hormone associated with prostate tissue growth. In 1998, researchers with the Department of Veterans Affairs reviewed more than a dozen studies involving saw palmetto and concluded that the herb appears to be as effective as the medication finasteride (Proscar) in reducing the size of an enlarged prostate. It also appears to produce fewer side effects. The researchers recommended additional studies to determine the appropriate daily dosage of the supplement and its long-term effectiveness.

Saw palmetto works slowly. Most men begin to see an improvement in their urinary symptoms within one to three months. If after three months you haven't noticed any benefit from the product, it may not work for you. It appears safe to take saw palmetto indefinitely, but possible effects from long-term use are unknown.

One drawback of this herb, and many other such herbal products, is that it may suppress PSA levels in your blood. This action can interfere with the effectiveness of the PSA test. That's why if you take saw palmetto or other herbal medicines, it's important to tell your doctor before having a PSA test.

Lacking scientific evidence
A few herbal and dietary products claim to help cure or prevent cancer. There's no scientific evidence that these products work, and some may be dangerous. Three popular "cancer-fighting" supplements include:

Chaparral. Also known as creosote bush or greasewood, chaparral (Larrea tridentata) comes from a desert shrub found in the southwestern United States and Mexico. Research hasn't shown that the herb effectively treats cancer, and it can lead to irreversible liver failure.

PC-SPES. This is an herbal mixture that has been marketed for treatment of prostate cancer. It contains eight herbs: da qing ye (Isatis indigotica), licorice (Glycyrrhiza glabra, Glycyrrhiza uralensis), san qi (Panax pseudoginseng), reishi mushroom (Ganoderma lucidum), Baikal skullcap (Scutellaria baicalensis), chrysanthemum (Dendranthema morifolium), dong ling cao (Rabdosia rubescens) and saw palmetto (Serenoa repens). A study of PC-SPES in the New England Journal of Medicine found that the product works like estrogen supplements. It reduces concentrations of testosterone that help fuel prostate cancer growth, and in some instances may suppress the cancer, at least temporarily. However, the product commonly produces impotence and breast tenderness. It can also cause blood clots in deep leg veins and, if taken in large amounts, can be toxic. Another concern with this product is that it can mask progression of your cancer. It reduces PSA levels, even when the cancer is advancing.

If your doctor is unaware you're taking PC-SPES, PSA test results may lead him or her to think that your cancer is under control, when it really is not. The product's manufacturer, BotanicLab, recalled the supplement temporarily beginning in February 2002 after questions were raised by the California Department of Health Services. The California agency said its testing had revealed the presence of undeclared prescription drug ingredients in samples of PC-SPES. BotanicLab then took steps it said would ensure the product's purity. This product hasn't been reintroduced because of concerns regarding its safety and its contamination with estrogenic compounds.

Shark cartilage. Shark cartilage contains a protein that has some ability to inhibit the formation of new blood vessels within tumors in sharks. Shark cartilage therapy is based on the theory that capsules containing shark cartilage will do the same in humans — stop and shrink cancerous tumors. However, these benefits haven't been shown in humans.

Because it's not always easy to tell which products may be unsafe, interact negatively with other medications or affect your overall cancer treatment, it's best to talk with your doctor before taking any dietary or herbal product.

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Adapted from: Mayo Foundation for Medical Education and Research