Prostate cancer diet, food, prevention and treatment, home remedy, natural cures
Supplements, herbs and vitamins
July 16 2018 by
Ray Sahelian, M.D.

Prostate cancer is a group of abnormal cells in the prostate that grow out control. It can be aggressive, which means it grows quickly and spreads to other parts of the body. When it spreads doctors say it has "metastasized." Or it may be slow growing and stay in the prostate gland alone, causing few, if any, problems. Three out of four cases are of the slow-growing type that is relatively harmless. Prostate cancer is the most common type found in American men, other than skin cancer. The American Cancer Society estimates that there are about 200,000 new cases in the United States each year, and about 30,000 men die of this disease.
   Screening is controversial. Perhaps some doctors are too aggressive in testing and screening men, especially in men over the age of 70. Studies do not prove that aggressive screening makes much of a difference in overall quality of life and mortality. PSA blood tests are often used to screen men, but there is still no good evidence that they cut death rates from the disease.

Treatment of early disease, diagnosis
Men with early stage prostate cancer who have surgery to remove their tumor do not live longer than those who receive no treatment at all. Furthermore nearly one in three men who have the surgery wind up with long-term complications, such as urinary incontinence and erectile dysfunction. "After nearly 20 years of follow-up among men with localized prostate cancer, surgery was not associated with significantly lower all-cause or prostate-cancer mortality than observation. " July 13, 2017 New England Journal of Medicine.
   During the period of observation and surveillance, it may be a good idea to focus on dietary and nutritional methods of preventing or reducing the spread of the tumor.

Exercise and weight management, weight loss
Patients who routinely engage in modest amounts of vigorous physical exercise lower their risk of dying from this disease, American Association for Cancer Research, news release, 2014. Obesity increases the risk, so does a high fat diet.

I recommend eating less and losing weight in order to reduce the risk for prostate cancer.

Eur Urol. 2013. Obesity and prostate cancer: weighing the evidence.

Smoking cigarettes
Smoking significantly increases the risk that prostate cancer will return after surgery for the disease.

Natural remedy, prevention and treatment
Maintaining normal body weight, eating fish, legumes, flaxseed, foods with high fiber content, yellow-orange vegetables and cruciferous vegetables lower prostate cancer risk. Increasing the ratio of omega-3 to omega-6 fatty acids in the diet appears to slow the progression. The so-called Western diet commonly consumed in the US contains mostly omega-6 fatty acids, derived from corn oil and other sources. Omega-3 fatty acids, by contrast, are abundant in cold-water fish, a food source missing in the diets of many Americans.
   Certain supplements have been found to have an influence on prostate cancer, particularly in laboratory tests. Long term, double blind human studies are not available to confirm these early laboratory findings, but it may be worthwhile to consider the following supplements with medical supervision:

I have no doubt that cancer is influenced by diet, perhaps more so than most doctors recognize. Several trials over the past few years have shown that supplementation with selenium or vitamin E is associated with a reduction of prostate cancer risk. Researchers wanted to find out whether supplementation with low doses of several antioxidant vitamins and minerals could reduce the occurrence of prostate cancer. The trial comprised 5,141 men randomized to take either a placebo or a supplementation with nutritional doses of vitamin C, vitamin E, beta-carotene, selenium and zinc daily for 8 years. Biochemical markers of prostate cancer risk such as prostate-specific antigen (PSA) and insulin-like growth factors (IGFs) were measured. During the follow-up, 103 cases of prostate cancer were diagnosed. Overall, there was a moderate reduction in prostate cancer rate associated with the supplementation. However, the effect differed significantly between men with normal baseline PSA and those with elevated PSA. Among those with normal PSA, there was a significant reduction in the rate of prostate cancer for men receiving the supplements. The researchers say, "Our findings support the hypothesis that chemoprevention of prostate cancer can be achieved with nutritional doses of antioxidant vitamins and minerals."
   There are a number of other supplements that have been studied in relation to prostate cancer prevention or treatment, at least in the laboratory or in mice. These include curcumin (from turmeric), lycopene (found in tomatoes), silymarin (in milk thistle), genistein (in soy), and many others.

may help fight cancer, including prostate cancer. Researchers have found in the lab that curcumin can enhance the cancer-fighting power of treatment with TRAIL, a naturally occurring molecule that helps kill cancer cells. TRAIL stands for tumor necrosis factor-related apoptosis-inducing ligand. In an experiment with human prostate cancer cells in a laboratory dish, the combination treatment killed off two to three times more cells than either treatment alone.
Fish oils appear to be beneficial. Eating lots of fish could reduce the risk of dying from the disease, American Journal of Clinical Nutrition, published online September 15, 2010.
A NEJM study in May 2013 found that men with a higher level of omega-3 fatty acids in their blood had a higher rate of advanced prostate cancer. This conflicts with results of prior studies. Do not to base your understanding of cause and effect results based only on one study since the results of others could show a different outcome.
Flax seed oil may also be helpful. I know some websites caution against it, but I see no reason for this, in fact it could be of benefit, Cancer Epidemiol Biomarkers Prev. 2008 Dec. Flaxseed supplementation (not dietary fat restriction) reduces prostate cancer proliferation rates in men presurgery.
Krill oil is another option to fish oil.

Chryisn flavonoid

Garlic may be helpful for prostate cancer. Diallylsulfide, a powerful garlic component, inhibits oxidative stress caused by testosterone and accelerates testosterone metabolism. In the early stages of prostate cancer, when sensitivity to testosterone is retained, the predominant effect of allium derivatives is to stimulate testosterone degradation and, in the later stages, to interfere with signal transduction. The proliferation of human prostate cancer cell lines, both androgen sensitive (LNCaP) and androgen insensitive (PC-3), is inhibited by allium derivatives from garlic in a dose-dependent fashion.
Genistein levels are lower in patients with enlarged prostates or prostate cancer. Soy isoflavonoid supplements may help.

Graviola plant could be of benefit
     Sci Rep. 2016. Graviola inhibits hypoxia-induced NADPH oxidase activity in prostate cancer cells reducing their proliferation and clonogenicity.

Green tea extract has shown some promise in early studies as a treatment of prostate cancer.
Compounds found in green tea may prevent the development of prostate cancer in men with a pre-cancerous condition called high-grade intraepithelial neoplasia (PIN). A trial was performed involving men with high-grade PIN, who were given an inactive placebo preparation or one containing 600 milligrams of green tea catechins daily, "equivalent to 12-15 cups of green tea infusion, that is about two times the average intake in Asian countries. After a year, only 1 man among 32 in the green tea catechins group developed prostate cancer. In contrast, 9 out of 30 men treated with placebo developed it.
Indole 3 carbinol may be helpful as an anti prostate cancer supplement.
Melatonin sleep hormone - Men who have higher levels have a lower risk,
Jan 19, 2014, presentation, American Association for Cancer Research meeting, San Diego.
Resveratrol has been found helpful in mouse studies.
IP6 - inositol hexaphosphate
Lycopene Adding lycopene to orchidectomy produces a more reliable and consistent decrease in serum PSA level; it not only shrinks the primary tumor but also diminishes the secondary tumors, providing better relief from bone pain and lower urinary tract symptoms, and improving survival compared with orchidectomy alone. However, lycopene supplements, alone, may not be enough.

Magnolin inhibits prostate cancer cell growth in vitro and in vivo. Magnolin is the most active ingredient in the herb Magnolia fargesii, which has been traditionally used in oriental medicine to treat headaches and nasal congestion. Recent researches demonstrate that Magnolin inhibits cancer cell migration and invasion. Biomed Pharmacother. 2017.

Milk thistle -- many compounds in mile thistle, including silymarin and silibinin, have shown potent anti-prostate cancer activity.
Modified citrus pectin acts as a potent inhibitor of spontaneous prostate carcinoma metastasis. Inhibition of spontaneous metastasis in a rat prostate cancer model by oral administration of modified citrus pectin. J Natl Cancer Inst. 1995.
Quercetin is a flavonoid found widely in plants.

Saw palmetto -- one test tube study indicates saw palmetto slows the growth of prostate cancer cells. See Prostate Power Rx formulated by Ray Sahelian, M.D.
Stinging Nettle -- see study below
Reishi has anti-cancer activity in prostate cancer cells.
Vitamin D supplements may slow or prevent low-grade prostate cancer from progressing, March 22, 2015, presentation, American Chemical Society meeting, Denver.
Vitamin E natural complex. It is preferable to keep total vitamin E dosage a day to between 20 and 100 units.
High blood levels of alpha- and gamma-tocopherol, seem to cut the risk. Journal of the National Cancer Institute, 2005.
Selenium, the mineral, may be of benefit if the dose is low. Use of supplements containing selenium may reduce the risk of advanced prostate cancer in those who have low levels. It may work by slowing progression rather than by preventing it all together. However, on the flip side, those who take large amounts may increase their risk. If you eat many foods that have a high amount of this mineral, there is not need for you to take additional amounts, 2014, Journal of the National Cancer Institute.

Q. Is it alright for men to take vitamin E and selenium if there is a history of prostate cancer in the family? Does it increase or decrease the risk? I am greatly concerned about this.
   A. It is difficult to give blanket statements that apply to everyone. Much depends on one's diet. Some may have adequate amounts of vitamin E and selenium in their diet and additional amounts may not help or be counterproductive whereas for others it may be of some benefit. If a person decides to take some, low amounts are preferable with occasional breaks from use. I do not think high doses are helpful. We still need more research to know whether high doses increase the risk for prostate cancer or have no effect.

Prostate Power Rx to maintain a healthy gland, formulated by Ray Sahelian, M.D.
Supplement Facts
Saw Palmetto extract
Stinging Nettle extract
Beta Sitosterol isoflavone
Pygeum extract
Daidzein and Genistein (standardized to contain 40% isoflavones)
(treatment with the isoflavones daidzein and genistein, the estrogen-like compounds found in soy, block prostate growth in rats)
Lycopene -
Epidemiological evidence strongly suggests that lycopene consumption contributes to prostate health cancer risk reduction. Lycopene acts via different mechanisms, which have the potential to cooperate in reducing the proliferation of normal and cancerous prostate epithelial cells, in reducing DNA damage, and in improving oxidative stress defense.

Q. I am a retired physician and am interested in Passion Rx. Most other agents such as Axiron are contraindicated if there are concerns about prostate Ca. Is this also true with Passion Rx?
   A. We have no reason to suspect that this natural sex enhancer has a major influence on this condition one way or the other.

Role of diet and food, what we eat has an influence
A review of studies done by Australian scientists finds the risk of developing prostate cancer, or slowing its progression, may be achieved by reducing intake of bad fats, processed or grilled meats, and dairy products. Men who regularly eat vegetables, including cruciferous vegetables like broccoli, cauliflower, cabbage and Brussels sprouts have a lower risk. The same appears true of men who consume greater amounts of vitamin E, soy, fish and omega-3 fatty acids -- "good" fats found in oily fish and certain other foods, such as flaxseeds. Improving dietary habits after prostate cancer diagnosis may improve survival from the disease. Dr. Robert Ma, of the University of New South Wales in Sydney, believes that eating grilled or processed meat more than five times per week is associated with a higher risk of prostate cancer. Similarly, men who eat dairy products more than five times per week may have a higher risk than those who consume such foods less frequently. Journal of Human Nutrition and Dietetics, June 2009.

Asian Pac J Cancer Prev. 2013. Allium vegetables and risk of prostate cancer: evidence from 132,192 subjects. Allium vegetables, especially garlic intake, are related to decreased risk of prostate cancer.

Men who put on a significant number of pounds after their 20s face a higher risk of prostate cancer than those who remain close to their youthful weight. Cancer Epidemiology, Biomarkers and Prevention, 2009.

Men who eat a lot of red meat and processed meats appear to have a higher risk.

Men treated for prostate cancer who smoke or put on excess pounds raise their odds of disease recurrence and of dying from the illness.

Eat a variety of fruits and vegetables, reduce the intake of white bread, high intake of meats and saturated fat, reduce or eliminate smoking, reduce stress, sleep well, exercise, avoid unnecessary hormone use, particularly androgens, eat more flax and fish oil.
   Greater consumption of dark green and cruciferous vegetables, especially broccoli and cauliflower, is associated with a decreased risk of aggressive prostate cancer.

Regular coffee use reduces the risk. Journal of the National Cancer Institute, published online May 17, 2011.

Pomegranate benefit - In men with recurrent prostate cancer, drinking a few ounces of pomegranate juice daily increases the time it takes for an increase in levels of prostate specific antigen (PSA).

Role of soy foods - Epidemiologic studies have shown that the consumption of soy foods may be associated with a reduction in prostate cancer risk in humans.

Risk from alcohol excess - Men who drink heavily raise their risk.

Prostate cancer cause
The cause is not fully known, but hormonal, genetic, environmental, and dietary factors are thought to play roles. The following risk factors have been linked with development of this condition:
   Age: There is a strong correlation between increasing age and developing prostate cancer. More than 80% of prostate cancers are diagnosed in men older than 65 years. Autopsy records indicate that 70% of men older than 90 years have at least one region of cancer in their prostate.
   Race: African American men are 2 times more likely than white men to develop prostate cancer.
   Genetic factors: Men who have a history of prostate cancer in their family are at an increased risk.
   Diet: A diet high in fat and low in vegetables has been associated with an increased risk. 
Adding arachidonic acid, a common omega-6 polyunsaturated fatty acid, to culture media causes prostate cancer cells to grow twice as fast. Prostate cancer patients who are obese seem to have more aggressive tumors. Charred meat from barbeques can increase the risk for prostate cancer.
   Hormone use:
Men who take testosterone or other androgen hormones may be at increased risk for prostate cancer. So does human growth hormone. HGH raises blood levels of another hormone, insulin-like growth factor, which preliminary evidence indicates may promote prostate cancer.
   Shift work - men who rotate shifts at work are more likely to get prostate cancer. This may be due to reduced release of melatonin and possibly additional factors.
   Sexually transmitted diseases are a cause of prostate cancer. Men with a history of the sexually transmitted disease gonorrhea may face a higher risk of prostate cancer. Chronic inflammation in the prostate gland, caused by infection, may over time promote tumor development.
   Smoking: Cigarette smoking increases a man's risk for developing and dying from this condition. American Journal of Public Health, April 2010.

Vasectomy raises risk of lethal prostate cancer, especially among men who had a vasectomy before age 38.

Excess folic acid
Excess intake of folic acid in the form of supplements may increase the risk in some men. Dr. Jane C. Figueiredo of the University of Southern California in Los Angeles found men taking 1 milligram of folic acid more than twice as likely to develop prostate cancer over a 10-year period than men given placebo. Folic acid is the synthetic form of folate, a B vitamin found in green, leafy vegetables and other foods. Folic acid plays an essential role in cell growth and division so an excess could accelerate tumor growth. It does not seem that intake of folate through food would increase prostate cancer risk.

Australian researchers questioned over 1,000 men who had developed prostate cancer and 1,250 who had not about their sexual habits. They found those who had ejaculated the most between the ages of 20 and 50 were the least likely to develop the cancer.

Standard medical treatment, radiation therapy
A new therapy features lasers and a drug made from deep sea bacteria. A clinical trial of prostate cancer patients in Europe found that half had no remaining trace of cancer after undergoing the treatment. Many prostate cancer patients who have surgery or radiation therapy have lifelong impotence and urinary incontinence. But sexual and urination problems lasted no longer than three months among patients who had the new therapy, according to a 2016 study in The Lancet Oncology.

North American Journal of Medical Sciences. 2015. Prostate Cancer for the Internist. Although effective treatment options are available for clinically localized cancer, the potential burdensome co-morbidities and attendant healthcare costs from over diagnosis and over treatment have escalated the discussion and controversy regarding appropriate screening, diagnosis, and optimal management of prostate cancer. Although the lifetime risk of developing prostate cancer is approximately 1 in 6, the risk of dying from the disease is only 2%. The discrepancy between the cancer incidence and lethality has led to widespread scrutiny of prostate cancer patient management, particularly for low-grade, low-stage (indolent) disease. The vast majority of men diagnosed with clinically localized prostate cancer are treated with interventional therapies despite studies demonstrating that even without treatment, prostate cancer-specific mortality is low.

Of the quarter million American men diagnosed with prostate cancer each year, most will get surgery or radiation. But in many of those cases, the men might stay healthier without aggressive treatment. Surgery often leaves men impotent or incontinent and does not appear to save the lives of men with early-stage disease.

Treatment depends on the stage, how big the tumor is or how it has spread - called advanced prostate cancer or if it has spread, metastatic prostate cancer. For tumors that are still inside the prostate, radiation therapy (using x-rays that kill the cancer cells) and radical prostatectomy are common treatment options. "Watchful waiting" is also a good option. In this approach, no treatment is given until the tumor gets bigger. Watchful waiting may be the best choice for an older man who has a higher risk of dying from something other than his prostate cancer. Generally, tumors that have grown beyond the edge of the prostate can't be cured with either radiation or surgery. They can be treated with hormones that slow the cancer's growth. Side effects of prostate cancer treatment, such as impotence and urinary incontinence, are far more common than most doctors admit.
   When prostate cancer remains confined to the gland, it's safe to take a conservative approach to treatment.

Prostate Cancer Hormone therapy risks
Men who undergo hormone therapy for early prostate cancer experience a decline in their mental capacities. Treatment aimed at suppressing testosterone levels, called LHRH-agonist therapy, in men with prostate cancer may cause subtle changes in cognition. This may also put them at increased risk for developing insulin resistance and elevated blood sugar levels, which can affect heart health and loss in bone mineral density. Anti androgen therapy can lead to gynecomastia.
In elderly men with early-stage prostate cancer, receiving hormone therapy to decrease levels of androgens leads to an increase in all-cause mortality and the risk of developing colon cancer.

Androgen-deprivation therapy, hormone-suppressing treatment, given as a treatment in prostate cancer's early stages may, in turn, increase a man's odds for heart failure.

Treatment is influenced on which type of doctor you consult
The type of treatment a man gets has a lot to do with the kind of specialist he sees first. Prostate cancer can be treated using radiation, radioactive seeds or surgical removal of the prostate. Surgery or drugs to stop production of testosterone, known as hormone therapy, may also be used in high-risk patients. Doctors often also advise close medical observation, also known as watchful waiting. Each treatment is associated with different benefits and side effects. Prostate surgery can cause urinary incontinence and erectile dysfunction; radiation therapy can cause diarrhea and erectile dysfunction; and hormone therapy can cause hot flashes and breast tenderness. Although the 5-year survival rate for men with localized prostate cancer is nearly 100 percent, it is the third most common cause of cancer death in men of all ages, and the most common cause of cancer death in men over 75. If a man's doctor happens to be a urologist, the recommendation for men under 70 most often will be surgery -- 70 percent of the time. For men over 75 who see only a urologist, the choice is watchful waiting or hormone therapy in 90 percent of the patients. But if they see both a urologist and a radiation oncologist, 78 percent of younger men and 85 percent of older men get radiation therapy.

If under the age of 65, prostate cancer surgery by removing the prostate gland is a good option, particularly if a person is healthy otherwise. For those over the age of 65, particularly those with a chronic medical problem such as heart disease or diabetes, surgery may not be helpful.
     The time elapsed between a diagnosis of localized prostate cancer and surgery does not appear to have a large effect on the risk of cancer recurrence. There is no clear evidence that an increased time between biopsy and surgery is associated with a significantly poorer outcome. Any effect of a treatment delay is moderate, at least for a time period up to 6 to 12 months after diagnosis.

Biopsies taken to diagnose this condition commonly cause temporary erectile dysfunction and, in some cases, lingering urinary problems. Journal of Urology, 2010.
In older men, prostate biopsies raise the risk of hospitalization within the following few weeks.

For men with localized prostate cancer, waiting several months from the time of diagnosis before beginning treatment with external beam radiation therapy does not worsen their odds of survival or other outcomes -- even for high-risk patients.

   Adverse effects on the lower gastrointestinal (GI) tract after radiation therapy for prostate cancer may be more common than previously reported. Among men treated with radiation for prostate cancer a higher than expected rates of late GI toxicity persists even after several years after the radiation.
   Men who undergo radiation therapy have nearly double the risk of developing rectal cancer when compared to men who opt to have surgery.

Complications of treatment
For many men a diagnosis of prostate cancer can be frightening not only because of the threat to their lives, but because of the threat to their sexuality. In fact, the possible consequences of treatment which include bladder control problems and erectile dysfunction or impotence can be a great concern for some men.

The risk of dementia is increased for prostate cancer patients who are treated with testosterone-lowering drugs. Men who undergo androgen-deprivation therapy (ADT) have a higher risk for developing dementia than those who do not receive such therapy.

Screening guidelines and controversy
Screening for prostate cancer like mammography for breast cancer has long been the subject of intense debate, with advocates insisting that it saves lives, and detractors arguing that it leads to too much unnecessary treatment.

A 2010 meta-analysis does not support efficacy of routine prostate cancer screening but a single test for men at age 60 may be beneficial. Professor Philipp Dahm and colleagues at the University of Florida reviewed six trials, involving 387,286 men. The review finds screening helps diagnose at an earlier stage but does not have a significant impact on mortality -- and comes at the risk of unnecessary treatment and a lower quality of life. In the second study, Hans Lilja, a professor at the Memorial Sloan-Kettering Cancer Center, and colleagues show that a single prostate-specific antigen test at age 60 shows 90 percent of prostate cancer deaths occurred in men with highest PSA levels at age 60. However, men with average or low PSA levels had negligible rates of prostate cancer or death by age 85, the study says. The results suggest that at least half of men age 60 and older might be eliminated from further prostate cancer screening, according to Hans Lilja. British Medical Journal 2010.

Routine screening does not appear to help men live longer, at least in those who have at least one serious health condition such as heart disease, diabetes, high blood pressure, etc. Testing will pick up the disease, detecting 20 cases for every 1,000 men screened. But it didn't alter overall death rates or the odds that men will die from prostate cancer. BMJ, online September 15, 2010.

Prostate specific antigen test - PSA
There is controversy regarding the use of the PSA test. It has not been proven that older men would benefit from getting a prostate specific antigen test since prostate cancer is such a slow growing tumor. A prostate exam using a finger can give a clue of a potential cancer when done by an experienced doctor. The standard PSA test produces many false positives and false negatives meaning some men who think they do not have cancer actually do, while others may undergo uncomfortable biopsies only to learn there is no tumor after all.
In 2010, the American Cancer Society asked doctors to inform their male patients that the PSA test used to screen for prostate cancer could lead to unnecessary treatments that do more damage than good. It also says digital rectal exams should be an option rather than part of a standard screening. American men have long been prompted to have prostate cancer screenings, but over time studies have shown that most cancers found are so slow-growing that most men could have avoided treatment. The treatments can lead to incontinence or erectile dysfunction and have a negative impact on wellbeing and quality of life. The American Cancer Society suggests doctors stop giving the rectal exam as a standard prostate cancer screening because it has not clearly shown a benefit, though it can remain an option.
   The time it takes for prostate-specific antigen (PSA) levels to double can help predict the clinical outcome of patients with prostate cancer who have been treated with combined radiation and hormone therapy, researchers report in the International Journal of Radiation Oncology, Biology, Physics. Brief PSA doubling time can predict apparent prostate cancer recurrence. Those who take finasteride, also known as Propecia and Proscar, need to have their PSA test number doubled to make the interpretation of the PSA number more accurate. See finasteride for more info.

Alternative Medicine
About one third of prostate cancer patients in the United States use some type of complementary or alternative medicine. Past studies have found that prostate cancer patients often begin taking alternative or complementary medicines after receiving their diagnosis. To investigate more specifically, researchers looked at use of more than 50 different types of complementary or alternative medicines in a group of 2,582 men in a registry of prostate cancer patients. One third reported using some type of alternative medicine, with 26% using mineral or vitamin supplements, 16% taking herbs, 13% taking antioxidants and 12% taking some type of alternative treatment for "prostate health," such as saw palmetto or lycopene. Men using alternative medicine tended to have higher incomes, more education, and more advanced cancer at diagnosis. Alternative medicine users also were more likely to have other illnesses. The men who used alternative treatments targeted to prostate health were younger and less likely to be obese. Urology, 2005.

Research study
A mix of dietary supplements including antioxidants and plant-based estrogens may slow the rise of a biomarker for prostate cancer progression in some men. Fruits and vegetables are prime antioxidant sources, while phytoestrogens are found in foods such as soybeans and soy products, whole grains and flaxseed. : International Journal of Cancer, 2005.

Consumption of red wine may reduce the risk of prostate cancer in middle-aged men. Dr. Janet L. Stanford, from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues studied data from 753 newly diagnosed prostate cancer patients between 40 and 64 years of age, and from a comparison group of 703 matched "controls" to assess the association between alcohol consumption and prostate cancer. The men with and without prostate cancer completed in-person interviews about lifetime alcohol consumption and other risk factors for prostate cancer. No clear associations were observed between the risk of prostate cancer and overall alcohol consumption, the team reports in published in the International Journal of Cancer. However, "each additional glass of red wine consumed per week showed a statistically significant 6% decrease in relative risk" of prostate cancer, they report.

It's possible to identify men with slowly progressive or latent prostate cancer, reflected by prostate specific antigen (PSA) levels that remain stable or fall over time. These men are good candidates for a "watchful waiting" approach to managing their prostate cancer. In other words, such patients can be monitored regularly and only treated if their prostate cancer progresses.

Some men with prostate cancer that hasn't spread may not need to undergo treatment, as long as a watchful eye is kept on their condition. They can do as well as similar men who undergo radiation therapy. "Observation is an option for men with nonaggressive prostate cancer who are older or have other medical co-morbidities," Dr. Eric M. Horwitz from the Fox Chase Cancer Center in Philadelphia, Pennsylvania, told Reuters Health. Horwitz and colleagues compared outcomes in two matched groups of men with localized prostate cancer: 69 who were just watched (because their disease was indolent, or they had other significant medical conditions, or they refused treatment), and 69 who were treated with radiation. Survival rates after eight years were estimated to be 73 percent in the observation group and 75 percent in the radiation group. After eight years, 93 percent of patients who were watched showed no sign of disease spread, as did 95 percent of the radiation patients. BJU International, 2004.

The fatty acids found in fish may slightly lower a man's risk of prostate cancer, but another type of fatty acid found in a range of foods may raise the risk, a large study suggests. Researchers found that among nearly 48,000 U.S. men followed for 14 years, those with the highest intakes of two fatty acids found in oily fish were 26 percent less likely than men with the lowest intakes to develop advanced prostate cancer. The opposite was true, however, when it came to alpha-linolenic acid, or ALA. Like the two fish-oil fats, ALA is an omega-3 unsaturated fatty acid that is thought to promote heart health; it is found in vegetable sources such as soybeans, canola oil, walnuts and flaxseed, and to a lesser extent in meat and dairy products. In this study, men with the highest intake of ALA were about twice as likely as those with the lowest intakes to develop advanced prostate cancer. And the risk was increased regardless of whether the ALA came from vegetable or animal sources, according to findings published in the American Journal of Clinical Nutrition.

Eating broccoli and tomatoes together may offer better protection against prostate cancer than eating either vegetable alone. Tomatoes are especially hailed as protective against prostate cancer, and scientists believe the lycopene that makes them red may be responsible. But lycopene supplements did little to prevent cancer in rats. Broccoli is also believed to help prevent cancer, because it contains compounds called glucosinolates and perhaps other healthful molecules. For the latest study the researchers fed rats dried, powdered tomato, dried broccoli, or a combination of both. A fourth group of rats was fed finasteride, a drug shown to reduce the benign growth of the prostate and also being tested for its potential to prevent prostate cancer. The rats were all injected with human prostate tumors. This mimics human cancer to a certain degree, although not perfectly. The rats developed tumors, but in those given the food supplements the tumors grew more slowly and stayed smaller than in those given finasteride. The rats given both broccoli and tomato had the smallest tumors.

Dietary intake of n-3 (fish oils) and n-6 fatty acids and the risk of prostate cancer.
Am J Clin Nutrition. 2004.
Laboratory studies have shown that n-3 fatty acids (mostly in fish oils) inhibit and n-6 fatty acids stimulate prostate cancer growth, but whether the dietary intake of these fatty acids affects prostate cancer risk in humans remains unclear. We prospectively evaluated the association between intakes of alpha-linolenic (ALA; 18:3n-3), eicosapentaenoic (EPA; 20:5n-3), docosahexaenoic (DHA; 22:6n-3), linoleic (LA; 18:2n-6), and arachidonic (AA; 20:4n-6) acids and prostate cancer risk. A cohort of 47 866 US men aged 40-75 y with no prostate cancer history in 1986 was followed for 14 y. During follow-up, 2965 new cases of total prostate cancer were ascertained, 448 of which were advanced prostate cancer. ALA intake was unrelated to the risk of total prostate cancer. In contrast, the multivariate relative risks (RRs) of advanced prostate cancer from comparisons of extreme quintiles of ALA from nonanimal sources and ALA from meat and dairy sources were 2.02 and 1.53, respectively. EPA and DHA intakes (fish oils) were related to lower prostate cancer risk.  Increased dietary intakes of ALA may increase the risk of advanced prostate cancer. In contrast, EPA and DHA (fish oils) intakes may reduce the risk of total and advanced prostate cancer.

Effects of a mushroom mycelium extract on the treatment of prostate cancer.
Urology. 2002.
Shiitake mushroom extract alone is ineffective in the treatment of clinical prostate cancer.

Nutrients that may have positive benefits in Prostate Cancer
A mix of dietary supplements including antioxidants and plant-based estrogens may slow the rise of a PSA. The study of 37 men with the disease found that 6 weeks on the supplements generally lowered patients' levels of androgens such as testosterone, which stimulates prostate cancer growth. PSA is a protein produced by the prostate gland; rising PSA levels in a man's blood often signals cancer or, in men already diagnosed with the disease, cancer progression. The supplement mixture included a powder-based drink that contained green tea extract, a soy extract supplying estrogen-like compounds called phytoestrogens, and carotenoids such as lycopene. The men in the study, all of whom had prostate cancer and rising PSA levels, used the supplements for 6 weeks; each also used inactive, or placebo, supplements for another 6 weeks. The patients' androgen levels were lower when they were on the supplement compared with when they were taking the placebo. The current findings are in line with studies of the general population that suggest diets rich in antioxidants and phytoestrogens may lower the risk of prostate cancer. Fruits and vegetables are prime antioxidant sources, while phytoestrogens are found in foods such as soybeans and soy products, whole grains and flaxseed. Many phytoestogens found as supplements include beta sitosterol, genistein, and daidzein.
o interesting notes: 1. Mortality rates for most men diagnosed with prostate cancer in the United States are not much higher than those in the general population. Most men diagnosed with prostate cancer can expect to live as long as men their age without the disease. 2. The value of prostate specific antigen (PSA) screening tests in reducing prostate cancer mortality is still in question.

Prostate Cancer natural treatment and prevention emails
Q. I have prostate cancer at least for the last four years. I am on watchful waiting. I did take Proscar and Prostasol last year before sep 2005 then I got struck with west Nile virus. When I was diagnosed with prostate cancer my psa was 5 and progressed to 15, then started to fall back to .5 before west Nile virus. After that PSA started to up slowly in one year to 24. of course I did start Prostasol two months even then PSA go on rising. I have also added Proscar of 5 mg in the morning with breakfast. and early in the morning 2 caps of Prostasol. during lunch dinner 2 caps of Prostate Power Rx formula. Luckily my prostate cancer seems to confined as per MRI and CT scans. I wish to speak and discuss with Dr.Sahelian to give more detail if he would like to give any other suggestions. My urologist do not want me to wait any more and to take aggressive procedures like radiation or Lupron shots. I will appreciate if I can discuss with Dr. Sahelian.
   A. Thank you very much for your email, however we are not in a position to offer individual advice. We can only offer general information on the website. We wish you an optimal outcome.

Q. For many years before my prostate cancer was diagnosed at age 74, I used DHEA, pregnenolone, avena sativa, etc.. Following radical prostatectomy, my urologist told me to cut out all supplements that stimulated the production of testosterone or caused it to be retained in my body -- in order to prevent a possible recurrence of the cancer. Is this something physicians agree on, or is there room for debate? I sure miss my testosterone-boosting supplements.
   A. There is scientific agreement that excess testosterone promotes prostate cancer, and it is our opinion that androgen supplements such as DHEA and pregnenolone could also promote prostate cancer.

Q. A lot of older men may feel they have prostate cancer and know that increasing testosterone means increasing rate of cancer. Would you please list herbs, vitamins, supplements that increase the risk for testosterone stimulation?
   A. The two over the counter supplements that we definitely do not suggest for those who have prostate cancer or at a higher risk for prostate cancer are the hormones DHEA and pregnenolone. There are some herbs that may stimulate testosterone release, at least in the short term, but many herbs also have anti-cancer benefits. Even if some of these herbs stimulate testosterone release, their effects may be short lived and may not be clinically relevant in the long run. No easy answers are available as to which herbs are not recommend for prostate cancer since long term human studies are lacking. Two herbs that are thought to stimulate testosterone, at least initially, are tribulus terrestris and tongkat ali.

Q. Which supplement or combination of can be used to successfully inhibit DHT and excess estrogen resulting in elevated PSA after prostate removal. Have made diet and life style changes; any other suggestions?
   A. You may wish to review the supplements mentioned towards the top of the page and have your doctor read this info and together come up with a plan.

Does acai berry extract help with prostate cancer treatment or prevention?
    I have not seen any human studies regarding the use of acai extract  for this purpose.

I have prostate cancer - it spread to my right iliac crest. This was determined by increased PSA and a bone scan in March of 2008. After the original treatment in 1998. I take 3500 IU/day vitamin D3. In addition I take a Centrum silver vitamin tablet. My Calcidiol blood concentration now is 55 ng/ml- which is supposed to be effective. What daily dose of vitamin D3 do you recommend? I buy genistein soy complex so that genistein can interact with vitamin D to stop cancer growth.
    We cannot make individual treatment decisions or dosage suggestions. Research with nutritional supplements as a prevention or treatment for cancer of the prostate gland is scant.
        Thanks for a prompt response. I am on ADT with Trelstar Depot. Your article on Prostate cancer confirmed what I have learned by reading literature on line. Dr. Sahelian is one of the only physicians I know who is aware of these risks of heart disease, metabolic syndrome, and Type II diabetes. Recent articles show that Vitamin D in levels above 30 ng/ml is helpful for many of these ill effects. The doctors I deal with here in NYC do not know anything about these topics.

I have been diagnosed with prostrate cancer level 6 out of 10. i ordered carctol from India but the FDA refused to let me have it. Is carctol a good cure for prostrate cancer? Can u help me with any reliable suplement to that can cure my cancer at this early stage. I was advice to go for surgery, I dont want it.
    I am not familiar with Carctol.

Q. I've recently read your interesting viewpoints on nattokinase and serrapeptase. Do you have any thoughts about taking both together? I have advanced prostate cancer and several of the members of an online support group I am a member of use both and don't seem to have any issues.
   A. I am not aware of studies that have combined nattokinase and serrapeptase together therefore it is not easy to predict the outcomes, and much depends on the dosages used.

Q. Do you know of alternative treatments for prostate cancer other than chemo, immuno, or hormonal therapy, radiation, cryo or surgery. Have you heard of or used Bee Propolis, PectaSol-C or ProstaCaid? There are a few scientific articles touting their efficacy, but only in-vitro.
   A. Research regarding alternative treatments for prostate cancer are limited.

Additional substances that could help
Mangosteen herb
Capsaicin, which makes peppers hot, can cause prostate cancer cells to kill themselves. Suggestions on a healthy diet.