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The Prostate Puzzle:
Naturopathic Solutions
by Eva Urbaniak, N.D.
Problems on the rise
Nearly every male in the U.S. has heard the sad statistics. Senators Robert Dole and Jesse Helms have had it, as have two Supreme Court Justices and General Schwartzkopff. Prostate cancer is the number 2 killer of men next to lung cancer. Other conditions such as benign prostatic hypertrophy, or BPH, and prostatitis are also rising at an alarming rate. The National Cancer Institute admits that radiation or surgery to remove the prostate causes temporary or permanent impotence and incontinence in half of all cases. When cancer researchers themselves admit that their therapies (drugs, radiation and surgery) are not the solution to an ever-mounting problem, is it not time to wake up and look at the alternatives?

The prostate gland is part of the male genito-urinary system. It plays an important role in reproduction. It is located below the neck of bladder and encircles the urethra. It is shaped like a chestnut and is made up of 70% glandular tissue and 30% muscular tissue. It produces and secretes a thin, milky, alkaline fluid, a component of semen, which helps increase the chances of fertilization. Contraction of the muscles of the prostate squeezes the fluid into the urethral tract during ejaculation. The prostate contributes to the discomfort felt when a male experiences prolonged arousal which does not culminate in orgasm. Fluid is secreted during arousal and if it is not released, it continues to exert pressure. The dull ache and discomfort is felt more in the testicles because the prostate has fewer nerve endings. Most men aren't even aware that they have a prostate gland unless they experience problems.

Warning signals
The three most common problems that can affect the prostate are prostatitis, or inflammation of the prostate, BPH, and cancer. There is also a condition called passive congestion of the prostate. General symptoms of a prostate problem are frequent urination, especially at night, difficulty with urination, lowered force of flow, possible burning with urination, low back and leg pain, or sometimes the sensation of a tight band around the body below the umbilicus. There can also be difficulty in maintaining erection during intercourse and generalized fatigue. Prostatitis can be acute or chronic. Symptoms of acute prostatitis are pain in the region between the scrotum and rectum, fever, increased frequency of urination with burning, and blood or pus in the urine. The probable causes of prostatitis are bacterial, hormonal, or even allergic. Prostatitis left untreated can be very serious because the urethra can become totally blocked, urine retention can occur with subsequent infection which can travel up the ureters to the kidneys. In the chronic phase, symptoms are similar but not as intense. Chronic prostatitis can become an annoying, painful and dangerous problem.

Benign prostatic hypertrophy, or BPH, as its name suggests is a non-malignant abnormal enlargement of the prostate. Over 50% of men over 50 have it with 10-30% having symptoms. Of men over 65, 90% are affected, with 50% symptomatic. 75% of men over the age of 45 already have some degree of prostate enlargement, and one out of eleven will go on to get prostate cancer. The symptoms and complications of BPH are similar to those of prostatitis and cancer. Although there currently is insufficient data supporting a connection between BPH and prostate cancer, it is not uncommon to see each in the same patient, and risk factors for BPH and cancer are similar. Diagnosis of any of these conditions can only be made by a physician.

Treatments and drugs ineffective
Surgery may be necessary to relieve obstruction of the bladder, but as mentioned previously, conventional treatments for prostate problems are at worst, barbaric, and at best, ineffective. Drugs like Proscar (Finasteride), chemically block the effect of the hormones testosterone and dihydrotestosterone, which are implicated as one of the contributing factors in prostate disorders. Men taking Proscar become impotent, unable to achieve erection or orgasm, so they go back to their doctors complaining that they and their wives are unhappy. The treatment for this drug-induced impotence is testosterone injections. This creates a vicious cycle in which the poor prostate is never given a chance to heal. Transurethral resection of the prostate (TURP) is a procedure in which a thin tube with an electrocautery loop is inserted up the penis to the bladder and is used to cut away the enlarged tissue. This technique is used more commonly than the traditional surgery, in which an incision is made in the lower abdomen and the prostate is completely removed. Radiation therapy for prostate cancer has a poor outcome, not to mention the serious side effects.

Research supports natural therapies
For many years it has been known by naturopathic physicians and other enlightened health professionals that there are effective natural therapies for treatment of BPH and other prostate problems. Hydrotherapy, nutritional support, and powerful phyto-therapeutic agents (herbs) combined together with an individualized treatment plan for each patient have proven successful in numerous double-blind placebo controlled studies. Hot sitz baths or alternating hot and cold sitz baths increase the flow of blood to the prostate. Hot foot baths also may be used, which pull the blood circulation to the lower extremities; this is called the derivative effect. A lower half-body pack is another treatment in which a thick hot pack is laid across the lower abdomen and pubic area for 15 minutes, then the reddened area is rubbed vigorously with a cold sponge, and the whole process is repeated four times always ending with the cold. Hot retention enemas can help with prostatitis. In the case of prostatic passive congestion, a trained physician can do prostate massage designed to express glandular secretions and stimulate drainage from the numerous secreting areas of the prostate. But since this treatment cannot be performed every day, for practical reasons as well as patient's limit of tolerance, a substitute procedure should be used which can be carried out by the patient at home. Rectal irrigation with cold salt water, in small amounts in a serial fashion, which exerts a topical vasoconstrictive effect alternating with vasodilation, improves circulation to the prostate.

Combining specific herbs with nutrients that support healing of the prostate has been shown to be very effective in over 85% of cases. Saw Palmetto (Serenoa Repens) leads as one of the most effective herbal substances for reducing all symptoms of prostate disorders. It is prepared from the berries of this southeastern palm plant. It contains sterols, fatty acids and other volatile oils. This plant has the ability to inhibit the enzyme 5-alpha-reductase, which in turn prevents the conversion of testosterone to dihydrotestosterone, or DHT. DHT, as mentioned previously, is the more potent form of testosterone responsible for development of the prostate. DHT levels increase with age. Serenoa reduces uptake of DHT into tissues by roughly 50%. Pygeum africanum is an herbal medicine extracted from the bark of an African evergreen Prunus africans. It also contains sterols and fatty acids, and is highly effective in treating urinary symptoms and improving sexual performance. Other herbs such as marshmallow, parlsey, juniper, licorice, queen of the meadow and bearberry extract soothe the urinary system and act in a synergistic manner to heal the prostate naturally. Nutrients such as the amino acids, glutamine, alanine and glycine, given alone to research subjects showed an average of 65% improvement in all BPH symptoms, with no side effects. Another nutrient which is absolutely essential for a healthy prostate is zinc. Because of depleted levels of this mineral in our soil, supplementation may be the only way to ensure adequate intake. Zinc deficiency is directly linked to prostate enlargement and testicular atrophy. Men need up to three times more zinc than women, and the largest percentage of zinc in a man's body is found in the prostate. Essential fatty acids such as those found in flax seed oil and pumpkin seed oil are also important in normalizing prostate function. Pumpkin seeds regulate and tone the bladder, restore flexibility and improve neurologic reflexes governing urinary flow. Pumpkin seed oil is also one of the most potent detoxifiers of ammonia in the human body, helping to convert it to harmless urea. Flax seed oil is one of the highest sources of essential fatty acids. Besides acting as hormone precursors, EFAs are building blocks from which all cell membranes and prostaglandins are made. Prostaglandins have hormone-like functions, regulating and carrying messages throughout the body. However, they are not secreted by glands. Every cell in the body keeps a tiny store of these materials and produces them on demand. Although they are in every cell in the body, prostaglandins take their name from the prostate gland. They were originally isolated in the 1930s, and found to be in high concentrations in the prostate gland.

Simple tests detect problems
There are two definitive tests used for identifying prostate problems; one is the digital rectal exam, in which the doctor inserts a finger into the rectum and palpates the prostate gland from its posterior aspect. This test gives a doctor a great deal of information about the health of the prostate, is quick, relatively non-invasive and painless but there are so many men in their forties and fifties who have never had one. There is no need to be embarrassed about a simple and easy test, especially one that could ultimately save one's life! The prostate specific antigen test or PSA, is a blood test which detects a protein produced in the prostate that may be elevated when cancer is present. The problem with the PSA test is that PSA levels can vary even in healthy men, and although a very high PSA level can indicate cancer about 90% of the time, tumors that are detected at this point are usually large and have spread outside the prostate. A normal PSA level, on the other hand may not mean that there is no cancer present, since some cancers do not cause a rise in PSA levels. Other diseases of the prostate like those mentioned here, can also cause a rise in PSA, which can lead to unnecessary, painful and expensive diagnostic procedures, and biopsies, which are also controversial because of the possibility of spreading cancer if it is present by breaking the basement membrane of a tumor.

Who is at risk?
Age is a relevant factor. A diet high in fat, sugar, trans-fatty acids or hydrogenated processed foods, alcohol, meat, and coffee has shown to be a risk factor. Certainly, exposure to chemicals, poisons, and heavy metals can also contribute to prostate problems. Black men seem to also be at higher risk, possibly due to dietary factors. Bicyclists have shown to have higher incidence of prostate and testicular problems possibly due to compression of the penile artery and nerve while riding.
Natural remedies for prostate problems like those mentioned here are available through your naturopathic pharmacy or health food store. It is prudent to suggest that healthy men with no symptoms of BPH could remain so with prophylactic phytotherapy lasting 30-60 days at least once per year. It is very important to see your doctor to identify special needs. For example, a man who is more prone to bladder infections could benefit from including Bearberry bark (Uva Ursi), an indigenous plant of the Northwest, in his treatment plan. Uva Ursi is a urinary antiseptic, diuretic and astringent.

Most importantly, if you are experiencing any of the above-mentioned symptoms, please visit your naturopathic doctor. He or she can offer sound advice, provide the necessary tests in a health-oriented atmosphere, and certainly provide healthy alternatives to drugs, radiation and surgery. A high quality nutritional and herbal support formula along with a commitment by the patient to living a healthier lifestyle can help restore the prostate to normal function.

References:
Johns Hopkins Medical Letter: Better Prostate Cancer Predicitions Sept. 1994
Pizzorno JE, Murray M: A Text. of Nat. Med: Chap. 6 1989
Nutrition Action Health Letter: The Cancer Men Don't Talk About. March 1993
Hoag, J.M., D.O., Osteopathic Medicine. Chapter 41 Disorders of the Male Genitourinary System. Sterrett, H.W., Jr., pp. 668-9. McGraw Hill 1969
Cancer Facts and Figures: American Cancer Society 1994
University of California at Berkeley Wellness Letter: PSA test: how well does it detect prostate cancer? Aug 1993 Vol.9 Issue1

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