While drug companies search for a ‘magic bullet’, a consistent picture is emerging that suggests that prostate cancer is caused by a combination of factors, the most significant being:
- Exposure to carcinogens
- Lack of antioxidants
- Excess hormonal growth signals
These factors are remarkably similar to the emerging story for breast cancer, which is not surprising since the cells that make up prostate tissue are also under hormonal control. During adolescence, hormones trigger the prostate to grow from the size of a pea to the size of a walnut, in a similar way that they trigger female breast growth.
Problems with Your Prostate?
If the prostate swells (inflammation) or enlarges (overgrowth of cells) it can act like a clamp, making it harder to urinate. This is very common in men later in life. Sometimes overgrowth of cells can be benign. This is called benign prostatic hyperplasia (BPH) and affects one in three men over the age of 60. Although there is no clear link between BPH and prostate cancer, other than difficulty peeing, too many men avoid going to their doctor. In both cases, the earlier you know what’s happening the better.
Traces of prostate cancer are commonly found in older men who have died from other causes. According to Professor Jonathan Waxman of Imperial College, London, little spots of cancer occur in 70% of 70 year olds, 60% of 60 year olds and 50% of 50 year olds, but their relationship with the development of aggressive cancer is unknown. A non-aggressive type of prostate cancer is known as prostatic intra-epithelial neoplasia or PIN. Some doctors regard PIN as being a precursor of cancer, however not all agree.
The most commonly used screening test for prostate health is a blood test measuring PSA (prostate-specific antigen). This is produced by the prostate gland. High levels of PSA may be an early indicator of prostate cancer – but it is also raised in BPH, so a high level doesn’t always mean you are going to develop cancer. Generally, having a PSA below 2.5 if you’re under 60, or 4 if you are over 60, is consistent with good health. Doctors can also carry out a digital rectal examination (DRE), however this is also prone to false positives. I recommend having more than one PSA test over a period of months if the initial test is high. If your level is above 10, combined with a positive DRE, you will probably be recommended to have a needle biopsy. This identifies if there are any cancerous cells present, and the degree of abnormality.
If you are diagnosed with prostate cancer, one of the most interesting and non-invasive treatments is HIFU (high intensity focused ultrasound). This is targeted at the cancer cells only. Another is PDT (photodynamic therapy) which uses a laser light to activate chemotherapy drugs. If done well this means that the drugs designed to kill cancer cells don’t end up damaging other healthy cells, which is the fundamental problem with chemotherapy, and part of the reason why the side-effects are so bad. But none of these address the underlying cause, and what you can do to make sure you never get this far.
What Causes Prostate Cancer?
To search for answers to these questions I went to meet Professor Jane Plant, who became an expert on certain hormonal cancers after reversing her own breast cancer, at the stage when treatment was considered a waste of time, and who has written the highly-informative book Prostate Cancer: Understand, Prevent and Overcome Prostate Cancer. I also contacted Dr Emily Ho from the Linus Pauling Institute, and studied the work of Colin Campbell in his book The China Diet. This is especially relevant since prostate cancer is virtually unknown in rural China (the incidence is one in 25,000).
The general view is that there are three contributory sets of conditions. Firstly, there is initiation, whereby prostate cells get damaged in some way so that they become cancerous. Secondly, there is generalised inflammation, which itself increases oxidants which, in turn, damage cells. And lastly, there is growth, encouraged by certain hormones and growth factors.
Professor Plant is convinced that exposure to herbicides, pesticides, hormone-disrupting chemicals and toxic elements such as cadmium may initiate these ‘cancer seeds’. Dr Ho believes that a pro-inflammatory diet of fried food, meat, refined foods and lack of antioxidants helps generate more oxidants and less antioxidants, potentially leading to cell damage. “Chronic inflammation may be the cause for as much as one third of all cancers,” she says. “Tissues may be chronically inflamed and large quantities of [oxidants] produced locally can cause tissue damage and even alterations in DNA resulting in mutations”.1 All agree that a diet high in organic fresh fruit, vegetables and whole foods, low in meat, but including anti-inflammatory omega-3-rich oily fish, would minimise this risk. Incidentally, cadmium is found in orange-coloured cooking dishes. This can degrade and enter food, so do make sure you cook in stainless steel.
The key antioxidants
Two key antioxidants are What it does: Component of over 200 enzymes in the body, essential for growth, important for healing, controls hormones, aids ability to cope with stress… and What it does: Antioxidant properties help to protect against free radicals and carcinogens, reduces inflammation, stimulates immune system to fight infections, promotes a healthy heart,…. Zinc is found to be deficient in prostate cancer patients, and low levels are a good predictor of risk. Zinc is both Antioxidants are substances that protect cells within the body from damage caused by free radicals. They help to strengthen the body’s ability to fight infection… and anti-inflammatory, as well as helping to repair damaged DNA. Most of us don’t get anything like enough. I recommend supplementing 10-20mg a day and eating zinc-rich foods (seeds, nuts and seed and nut butters such as tahini).
Low selenium is also a good predictor of prostate cancer. Professor Plant recommends people supplement about 100mcg of selenium. Lycopene in tomatoes, quercitin in red onions, What it does: Strengthens immune system – fights infections. Makes collagen, keeping bones, skin and joints firm and strong. Antioxidant, detoxifying pollutants and protecting against… and E are all important antioxidants with good evidence suggesting an anti-prostate cancer effect both from foods and isolated nutrients.
A recent study found that a glass of pomegranate juice helps lower PSA levels2 while a high vegetable diet lowers risk for BPH.3 Spices are amazing antioxidants, especially turmeric, cinnamon, chilli and ginger. I recommend you maximise your use of all these foods in your diet.
Milk Makes Prostate (and Breast) Cancer Cells Grow Rapidly
Cancer only develops if cancer cells grow. Their growth is under the influence of hormones and growth factors. Professor Plant and Colin Campbell are convinced that the single major cancer growth promoter is dairy products. Milk is naturally high in Oestrogen is one of the main female sex hormones…., as well as growth factors such as insulin-like growth factor (IGF). This is hardly surprising since milk’s job is to make cells grow. Milk consumption is the second most predictive risk factor, with age being the first. According to the National Cancer Institute (NCI), 19 out of 23 studies have shown a positive association between dairy intake and prostate cancer. “This is one of the most consistent dietary predictors for prostate cancer in the published literature,” reports NCI.
“In these studies, men with the highest dairy intakes had approximately double the risk of total prostate cancer, and up to fourfold increase in risk of metastatic or fatal prostate cancer relative to low consumers.”4
How to reduce your risk of cancer
1. Don’t drink milk: The strongest dietary risk factor for prostate cancer is dairy consumption. Switzerland, for example, has the highest dairy intake and the highest numbers of deaths from prostate cancer. This is almost certainly due to a hormone in milk called Insulin-like Growth Factor (IGF). Prostate tissue has receptors for IGF-I and IGF-II. Research shows clearly that men with high levels of circulating IGF-I are at greater risk of suffering from prostate cancer than those with lower levels. Research also shows that circulating levels of IGF-I in the blood correlate with high dairy consumption. A pint of milk a day, or the equivalent in other dairy products, quadruples risk.
2. Reduce animal fats and increase fish and fish oils: Industrialised meat is also high in hormones. The only meat I’d recommend is wild game or organic lamb. I’ve not eaten any meat for 30 years. Fish and fish oils, on the other hand, may be protective against prostate cancer. A study published in the Lancet followed more than 6,000 Swedish men age 55 for up to 30 years.5 Its conclusion: eating fatty fish such as salmon, sardines, herring and mackerel could reduce the risk of prostate cancer by a third. The men who ate no fish had a two-fold to three-fold higher risk of prostate cancer than those who ate moderate or high amounts. Supplementing purified omega-3 fish oils (EPA is short for Eicosapentaenoic Acid. It is an essential omega-3 fatty acid found in fish such as salmon, mackerel and herring, and is often… and DHA is short for Docosahexaenoic Acid. It is an essential omega-3 fatty acid found in fish such as salmon, mackerel and herring, and is often…) provides a guaranteed PCB-free source of these powerful anti-inflammatory agents. If you’re suffering from BPH or prostatitis, supplement the equivalent of 1,000mg of EPA a day.
Middle-aged men naturally have lower levels of Testosterone is a male sex hormone important for sexual and reproductive development…., oestrogens and IGF. But the average intake of milk and meat changes this. It basically creates a hormonal environment similar to puberty, so it’s no surprise this would cause cell growth. Many of the drugs used to treat prostate cancer attempt to block the growth signals of hormones. Yet some of these are less effective after a couple of years as the cancer is said to become ‘drug resistant’. This is hardly surprising if you don’t change your intake of growth factors.
3. What it does: Helps maintain strong and healthy bones by retaining calcium. Deficiency Signs: Joint pain or stiffness, backache, tooth decay, muscle cramps, hair loss….: One of the most potent anti-cancer vitamins is vitamin D, which is made in the skin in the presence of sunlight. Having enough can halve your risk of prostate and other cancers. If you live in the Northern hemisphere, especially in winter, you just won’t make enough. Nor will diet alone give you enough – oily fish being the best source. Interestingly, a high-meat-protein diet and high-calcium diet, which is what you get from dairy products, blocks the ability to create active vitamin D. Most experts agree we should all be supplementing somewhere between 15 and 50mcg a day. The pharmaceutical industry have cottoned on to this and are trialling a vitamin D derived drug for prostate cancer.
4. Soya is a Superfood: The dietary antidote to an overload of growth promoting hormones is soya, the staple source of Proteins are large molecules consisting of chains of amino acids. Proteins are essential nutrients for the human body – they are a building block of… for the Chinese.
The evidence consistently shows that a regular intake of soya and other phytoestrogen-rich foods greatly reduces risk of both breast and prostate cancer, as well as menopausal problems. “Soya is a superfood,” says Professor Plant. “I have non-GM organic soya every day. The idea that it promotes cancer is absolute rubbish. If we just ate soya, instead of feeding it to cows and eating them, it would save masses of energy, water and greenhouse gases.” She believes that much of the anti-soya propaganda is ill informed and has little or no scientific basis. “If it were so bad,” she says, “why does the dairy industry feed it to their cows? I recommend you have a glass of soya milk, or a serving of tofu a day, and make peas, beans and lentils a regular part of your diet.”
Phytoestrogens, from plant foods are about 1000 times less oestrogenic than other oestrogens, but bind more effectively to hormone receptors on cells, hence they lower the oestrogen load by protecting your cells from too many growth signals.
Phytoestrogens are high in many fruits and vegetables – from strawberries to oats. A plant-based diet, deriving protein from these foods, is consistent with a much lower cancer risk and may even help to reverse the condition.
You need 15mg of phytoestreogens a day from soya foods for maximum protection. This is easily achieved by having a small portion of tofu (100g serving provides 78mg), or a 100mg glass of soya milk or soya yoghurt (11mg) and a portion of chickpeas, perhaps as hummous (2mg). Eating rye bread, beansprouts, beans, lentils, nuts and seeds also helps boost your levels. Alternatively, you can supplement these.
5. Beneficial broccoli: Another superfood is broccoli, high in DIM, a phytochemical that mops up excess growth hormones. Growth hormones stop cancer cells committing suicide, a process called ‘apoptosis’. DIM switches back on this suicide signal.6,7 One study involving 12 men (two with PIN) taking 100mg of DIM as a supplement, found that PSA levels dropped in 11 of them and PIN had disappeared in both cases. I recommend eating lots of broccoli and possibly supplementing a concentrate containing DIM. Dr Dean Ornish put this kind of diet to the test on a group of people with early prostate cancer. There was clear evidence of a reversal of all the indicators of prostate cancer. “Intensive lifestyle changes”, he concludes, “may affect the progression of early, low grade prostate cancer in men.”8
Professor Jane Plant agrees. “If you cut your growth factors right back, I think you can reverse the cancer process. I always tell people to continue their conventional medicine but radically change their diet. A man came to see me four years ago with a terrible prognosis, and was considered not worth treating. He changed his diet and is now alive and well. His PSA dropped from above 100 to about 0.1.” You can see other success stories on her website www.cancersupportinternational.com
Other particularly beneficial vegetables include tomatoes, rich in lycopene, and kale, cabbage, tenderstem and cauliflower.
6. Helpful Herbs: The most consistently helpful herbs are saw palmetto and pygeum. Saw palmetto has been proven to help inhibit cancer growth and to reduce inflammation. This makes it the perfect supplement for both BPH and prostatitis as well as prostate cancer. Studies have shown reduction in enlargement of the prostate with daily supplementation. In addition, saw palmetto inhibits an enzyme, called 5-alpha reductase, which turns testosterone into DHT, which is the form of testosterone that promotes prostate cancer.9 Recent research has also shown that saw palmetto inhibits the growth-promoting effects of IGF-1 in milk, so that’s an additional benefit.10 Personally, I think there’s enough evidence now to recommend any man over 50 to supplement saw palmetto. Since it’s the fatty acids in saw palmetto that seem to be most biologically active, choose a supplement that is standardised to 45% fatty acids. This means it’s high quality. I recommend 120mg a day for prevention and 360mg a day if you have BHP or prostate cancer.
The African bark Pygeum also lessens the harmful effect of too much IGF-I and, in animal studies, is profoundly anti-cancer.11 This is because Pygeum is an excellent source of B-sitosterol, a plant sterol. When supplementing Pygeum it’s worth getting high quality standardised extract with up to 5% B-sitosterol. I recommend 40mg a day for prevention and 120mg a day if you have BPH or prostate cancer.
7. Take an antioxidant supplement: While individual antioxidants haven’t always come up trumps, a recent trial giving over 5,000 men a combined antioxidant supplement containing vitamin C, What it does: Acts as an antioxidant, protecting cells from damage, including against cancer. Helps body use oxygen, preventing blood clots, thrombosis, atherosclerosis. Improves wound…, beta-carotene, selenium and zinc daily for eight years proved protective.12 However, the protective effect was far higher in those men with a normal PSA level (below 3mcg/l). The antioxidants did not, however, appear to either lower PSA or IGF levels.
For more on prostate health – and how to prevent or even reverse prostate cancer – read my more detailed article here.
Jane Plant’s excellent book Prostate Cancer: Understand, Prevent and Overcome Prostate Cancer is available from Amazon
- E Ho, ‘Dietary influences on endocrine-inflammatory interactions in prostate cancer development’, Archives of Biochemistry and Biophysics (2004), vol 428, pp 109-17.
- J Allan et al, ’Phase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancer’, Clinical Cancer Research (2006), vol 12(13), pp 4018-4026.
- S Rohrmann et al, ‘Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men’, American Journal of Clinical Nutrition (2007), vol 85, pp 523-529.
- J Stanford et al, ‘Prostate cancer trends 1973-1995’, Bethesda, MD:SEER Program, National Cancer Institute, 1998.
- P Terry et al, ‘Fatty fish consumption and risk of prostate cancer’, The Lancet (2001), vol 357(9270), pp 1764-1766.
- Y Li et al, ‘Regulation of FOXO3a/-Catenin/GSK-3 Signaling by 3,3′-Diindolylmethane contributes to inhibition of cell proliferation and induction of apoptosis in prostate cancer cells’, The Journal of Biological Chemistry (2007), vol 282, pp 21542-21550.
- D Kong et al, ‘Inhibition of angiogenesis and invasion by 3,3′-Diindolylmethane is mediated by the nuclear reactor– B downstream target genes MMP-9 and uPA that regulated bioavailability of vascular endothelial growth factor in prostate cancer’, Cancer Research (2007), vol 67, pp 3310-3319.
- D Ornish et al, ‘Intensive lifestyle changes may affect the progression of prostate cancer’, The Journal of Urology (2005), vol 174(3), pp 1065-9.
- W H Goldmann et al, ‘Saw palmetto berry extract inhibits cell growth and Cox-2 expression in prostatic cancer cells’, Cell Biology International (2001), vol 25(11), pp 1117-24.
- T L Wadsworth et al, ‘Saw palmetto extract suppresses insulin-like growth factor-I signaling and induces stress-activated protein kinase/c-Jun N-terminal kinase phosphorylation in human prostate epithelial cells’, Endocrinology (2004), vol 145(7), pp 3205-14.
- F Yablonsky et al, ‘Antiproliferative effect of Pygeum africanum extract on rat prostatic fibroblasts’, The Journal of Urology (1997), vol 157(6), pp 2381-7.
- F Meyer et al, Antioxidant vitamin and mineral supplementation and prostate cancer prevention in the SU.VI.MAX trial, International Journal of Cancer (2005), vol 116 (2), pp 182186.