By Lisa M. Belisle, MD, MPH
Originally published September 7, 2006, Community Leader

Ah, the prostate. If I had a dime for every time a patient told me how much he detested the prostate (i.e. rectal) exam, I’d be rich doctor indeed. Nobody likes a prostate exam. Yet having regular exams, and caring for the prostate in general, is an essential part of male wellness. Located at the base of the penis, this gland produces the fluid that carries sperm out of the body. Given its small size (it is usually compared to a walnut); it can cause a surprising number of problems. These range from merely annoying to possibly life-threatening.

Chief among the problems impacting the prostate are prostate cancer and Benign Prostatic Hyperplasia. According the American Cancer Society, 220,900 American men are diagnosed with prostate cancer each year: it is the second leading cause of cancer-related deaths (see www.cancer.org). In addition, 50% of men over fifty suffer from symptoms related to Benign Prostatic Hyperplasia (BPH), a non-cancerous enlargement of the prostate which can cause incontinence and difficulty urinating.

Because the prostate can have such a significant effect on health, it is important to keep this little gland happy. In recognition of this, and of the fact that September is “Prostate Cancer Awareness” month, here are a few suggestions for doing so:

• See your doctor or healthcare provider regularly: men over fifty (over 45 if high risk) need yearly rectal exams. For community-based screening programs, call the MaineHealth Learning Resource Center at 207-781-1730.
• Strongly consider an annual PSA: the Prostate Specific Antigen blood test is somewhat controversial, but currently the best available. The American Cancer Society recommends that it be done each year after age 50. Discuss this with your doctor.
• Engage in regular exercise: this is not prostate-specific exercise, but exercise in general. Research has shown that older men who engage in ‘regular, vigorous’ exercise can actually slow the progression of prostate cancer.
• Be careful with supplements: while a non-iron containing multivitamin is probably a good idea, resist taking high doses of specific vitamins and minerals. High doses of zinc (more than 100 mg daily) have been linked to prostate cancer. Other supplements, such as saw palmetto, stinging nettle and pygeum may be beneficial for BPH complaints, but should be initiated with the assistance of a knowledgeable practitioner.

Diet is another area of interest in prostate health. While results of recent studies have been mixed, some current recommendations are to:

• Decrease your intake of total calories, especially if overweight. Look for the right combination of foods for your activity level. For more information, visit www.mypyramid.gov,
• Increase omega-3-fatty acids from sources such as seafood and flaxseed,
• Avoid omega-6-fatty acids from highly processed foods such as chips and crackers,
• Substitute olive and grapeseed oil for other less beneficial oils during meal preparation,
• Eat a diet rich in fiber, particularly soluble fiber from vegetables such as broccoli, Brussels sprouts, kale and cauliflower, which are rich in cancer-preventing indole-3-carbinol,
• Indulge in carotenoid-containing foods such as tomatoes, citrus fruits, spinach, pumpkin and pomegranate, which have been strongly associated with prostate cancer-prevention,
• Add in selenium-saturated items such as seafood, liver, brown rice, oats and brazil nuts,
• Enjoy moderate amounts of isoflavone-imbued soy products, such as tofu,
• Take advantage of beta-sitosterol, which can be found in the margarine product Take Control, as well as soy and pumpkin seeds. Beta-sitosterol is the plant version of cholesterol, and has been used for BPH relief,
• Develop a taste for black and green teas, with their health-promoting polyphenols,
• Consider pesticide-free organic produce, meat, eggs and milk. While no specific information links pesticides or hormones to prostate cancer or BPH, these contaminants certainly contribute to what is called the ‘body burden,’ which may increase the risk of disease over a lifetime.

Though diminutive, the prostate has the potential to be an irksome organ. Fortunately, we now have ways decrease the likelihood of prostate cancer and BPH. With proper diet and exercise, we can keep the prostate happy. Then there’s the issue of the annual exam. I think it’s time to hand over that dime.