1. Q: Once a prostate gland has been removed because of cancer, can diet help prevent the cancer from recurring?
A: Nobody knows for certain. Obviously, if all the cancer cells and prostate cells have been removed by surgery, then dietary supplements would not be needed to prevent recurrence. If any cancer cells were left behind, perhaps, they could help prevent these cancer cells from accumulating more mutations and becoming more aggressive.
2. Q: What exercises do you recommend both before and after retropubic prostate surgery?
A: In addition to Kegel exercises, I recommend overall physical fitness exercises. Good physical conditioning is helpful in recovery from prostate cancer surgery.
3. Q: How much does family history of prostate cancer increase the risk for it?
A: In the general population, about one in six men is diagnosed with prostate cancer, and I recommend screening for prostate cancer at age 40 for the general population.
But for men with a primary relative with prostate cancer (a brother or father), the risk is two-fold higher. Accordingly, in my opinion, it is especially important for men with a primary relative who had prostate cancer to have regular checkups. Men with familial prostate cancer might develop the disease at an earlier age, so screening should be considered earlier, at age 35.
4. Q: Can the sport of bicycle riding increase the likelihood of BPH, prostate cancer or other prostate problems?
A: Prolonged cycling on a hard seat is thought to affect potency by injuring the pudendal arteries that supply blood to the penis. Cycling can also traumatize the prostate, causing an elevation in the PSA level. No evidence, to my knowledge, shows that cycling can increase the risk for benign prostate enlargement or prostate cancer.
5. Q: Is ejaculation good for prostate health?
A: The short answer is yes. The prostate has innumerable tiny glands located in its periphery. Their function is to drain prostatic secretions through the tiny prostatic ducts into the urethra. Approximately 90% of the fluid that comes out with ejaculation is prostatic fluid. With long periods of abstinence from ejaculation, the prostate may become filled with secretions. This condition is called congestion of the prostate.
Symptoms associated with prostatic congestion can include voiding difficulties and discomfort in the region of the prostate. In some instances, accumulation and stagnation of prostatic fluid can contribute to the development of infection in the prostate (prostatitis). Regular ejaculation has the effect of keeping the prostate flushed out and healthy.
6.Q: Do you recommend Proscar or Avodart, the 5-alpha reductase
inhibitors, for prostate cancer prevention or for an enlarged prostate?
A: I do not.
There is a constituency claiming that they prevent prostate cancer, help with
symptoms from an enlarged prostate, and make PSA testing more accurate.
My take on the data is that these drugs can suppress BPH (enlarged prostate)
and low-grade prostate cancer but they can't affect high-grade cancer.
Accordingly, with prostate cancer, the PSA can go down for a while and the prostate
gland shrinks until the high-grade cancer that is more aggressive and resistant
to hormonal therapy becomes the dominant player.
Patients may not be doing themselves a favor by using Avodart or Proscar to prevent
And I seldom recommend them for BPH (only when all else has failed and the patient
appears to be in danger of developing urinary retention or requiring surgery)
because they can lower the PSA and disguise prostate cancer detection until the
more aggressive cancer takes over, and then treatment is often too late
7. Q: What are your thoughts on the recent study linking multi-vitamin use to increased
prostate cancer risk? I was under the impression that vitamin
D and vitamin E were beneficial to those of us who have had RP
surgery. Now I wonder if I should continue taking these supplements
based on the results of this recent study.
A: The place of diet, vitamins and supplements for prostate health is in limbo.
New studies are showing that even foods we thought were helpful,
such as those with lycopene, seem to have no benefit. And some of
them, such as heavy doses of beta-carotene are proving harmful. (See
Nutrition News Updates: Winter Quest, 2007on www.drcatalona.com)
Recently, the National Cancer Institute reported on a study tracking
the diet and health of 300,000 men. A third of those men took daily
multivitamins and 5 percent of them were heavy users.
In the men from that study who were diagnosed with prostate cancer,
heavy multivitamin users were about twice as likely to get a more
aggressive prostate cancer.
The study found no connection between multivitamin use and early
stage prostate cancer. Researchers proposed that possibly high-dose
vitamins had little effect until a tumor appeared and then they might
somehow encourage or stimulate the cancer growth.
Clearly, more research is needed in this area. But there is a possibility
that increased use of supplements could cause harm rather than help
in prostate health. The key word appears to be moderation.
I currently recommend that you can eat anything in moderation, but
if you eat meat, white meat is better than red meat. A diet high in
fruits and vegetables is preferable. Fats that are liquid at room
temperature (olive oil or corn oil) are healthier than those that
are solids, such as cheese or butter.
I recommend an inexpensive multivitamin capsule with extra calcium.
8. Q: Do you still think taking soy protein could be effective in the prevention of prostate cancer?
A: Not necessarily in the prevention, but there is evidence discovered
by some of my colleagues at Northwestern that soy protein contains a substance
that might reduce the tendency for prostate cancer cells to spread and metastasize.
We currently have a clinical trial to test this in my surgery patients with high-risk
prostate cancer – stay tuned.
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