More and more guys are getting the message about getting checked out for prostate cancer. That’s a good thing, since prostate cancer is the leading cancer killer of men, with about 27,000 guys dying every year from this disease. But what most guys don’t know is that recent medical research has clearly demonstrated that you can reduce your risk for getting prostate cancer – maybe even prevent it altogether. The evidence is still coming in, but it’s exciting and I want to devote this blog to summarizing it. There are 3 leading contenders for preventing prostate cancer; 2 are prescription medications and 1 is a natural product. I’ll describe each in turn.
In 1992, the Food and Drug Administration (FDA) approved the use of a 5 mg pill of finasteride, for treating a noncancerous enlargement of the prostate that can block the flow of urine. Finasteride is marketed as Proscar for this use. At a much lower dosage (1 mg), finasteride is used to prevent hair loss and promote hair growth and is marketed as Propecia.
This medicine works by blocking the conversion of testosterone to dihydrotestosterone (DHT). Most people don’t know this, but it’s DHT, not testosterone itself, that promotes the growth of prostate tissue, hair loss, and now, it appears, prostate cancer. By blocking the enzyme that converts testosterone to DHT, finasteride lowers DHT levels in the blood and prostate tissue.
Here’s the exciting thing: a 10-year study of more than 18,000 men was recently completed by the National Cancer Institute. The goal was to see whether low-dose finasteride cut the rate of prostate cancer in subjects. About half the guys in the study got finasteride (5 mg daily dose), the other half got a placebo (sugar pill). At the end of the study, the results were clear: 18% of men in the finasteride group developed prostate cancer vs. 24% of men in the placebo group. That means the guys taking finasteride had an overall rate of prostate cancer 25% less than the guys on placebo.
Like any medicine, finasteride can cause side effects, the most common being decreased sexual desire and difficulties getting or maintaining erections. But not only are there ways to overcome these issues (if they happen), but the men in the NCI study who took finasteride were less likely to experience urinary symptoms, such as having to get up in the middle of the night to urinate.
More studies of finasteride are underway. For example, it may be that the prostate-protective effects of this medicine can be achieved with only 1 mg per day. We’ll just have to see. But in the meantime, I suggest that guys talk to their doctor about this potential option for reducing their risk of prostate cancer.
Statins are a class of medicines that have been used for many years to lower cholesterol levels. New research shows that these drugs may have other beneficial effects, such as preventing prostate cancer and erectile difficulties. A number of large-scale studies have found significant reductions in the risk of prostate cancer among men taking statins. A US study of almost 35,000 men found a 49% decrease in risk of advanced prostate cancer among statin users. Another US study of 69,000 men showed that the risk of prostate cancer was 28% lower among statin users.
How do statins work to protect against cancer? It could be the anti-inflammatory effects of statins, or it could be that the statins directly block the growth of cancer cells, which has been seen in some in vitro studies (studies of tissue outside of the body.)
If future research confirms the anti-cancer effects of statins, it would be great news, because these medicines have already been shown to be safe and well tolerated by millions of men.
Cancer-fighting chemicals, such as anti-oxidants, are found in many foods. One food rich in these kinds of chemicals is pomegranate juice. A recent study by UCLA researcher Allan Pantuck, MD, and colleagues found that drinking only 8 ounces of pomegranate juice a day had a significant effect on levels of prostate-specific antigen (PSA), which is widely used as a gauge of prostate health. High PSA levels are a red flag for prostate cancer.
Pantuck's team enrolled 46 men in a study funded by the owners of POM Wonderful Co., the maker of the pomegranate juice used in the study. The men's overall PSA doubling time was nearly 4 times slower after they began drinking pomegranate juice. Sixteen of the 46 patients had a decrease in PSA levels – and in 4, PSA levels dropped by half. Pantuck says that some men in the study have been drinking pomegranate juice – and keeping their PSA levels stable – for more than 3 years.
Now, this isn’t a cure for prostate cancer…but it certainly suggests that pomegranate juice may help lower your risk. Larger and more long-term studies will have to be conducted…but this is one case in which you don’t need to wait to take action. Pomegranate juice is a great source of vitamins, minerals, and antioxidants. Plus it’s delicious…I drink it often, myself.