Prostate cancer typically occurs without symptoms, however, occasionally people will note symptoms such as:

Blood in the urine
Difficulty urinating
Pain or burning while urinating
Lower back pain or pain in the upper thighs
Weak urine flow

Many of these symptoms can occur for other reasons such as infection, prostatitis (inflammation of the prostate) or benign prostate enlargement. For this reason, you should be assessed by a physician whenever you have any symptoms with the urinary tract. The likely is that these symptoms will turn out to be benign, however, it is best to be sure.

What tests are involved to diagnose prostate cancer?

The most common tests are the digital rectal exam and the standard PSA, which stands for prostate specific antigen. The digital rectal exams involves the doctor feeling the prostate for enlargement and abnormalities. The PSA is a blood test that is widely used to screen men for prostate cancer, unfortunately PSA can be elevated for many non-cancerous reasons and can cause unnecessary alarm and biopsy. A PSA is considered normal by the medical establishment as long as it stays below 4 dl/ml, however, some doctors prefer to see it below 2.5 dl/ml. PSA that are excessively elevated may signal more aggressive cancer.

To demonstrate how misleading the PSA can be, it is estimated that the standard PSA misses 82% of prostate cancers in men under the age of 60 and misses 65% of cancers in men over the age of 60. It has been noted that up to 1 in 6 men with a normal PSA actually have prostate cancer and in men who have a PSA score between 4 and 10 only 20-25 percent actually have cancer.

The PSA has an alarming rate of signaling prostate cancer in men without the disease. This can cause fear and panic in many healthy men. According to the research, the PSA test can signal cancer in 12 out of 15 men without cancer. This is an unacceptably high rate of false positives and it is very common for men who have an elevated PSA test to see those numbers drop to normal within a year. With this information it is a good idea to have PSA reassessed a couple months later before you subject yourself to biopsy.

To increase the accuracy of the PSA test, be sure to follow these guidelines:

Abstain from sex or ejaculation for at least 48 hours as ejaculation artificially elevates the PSA.
Make sure that you have the PSA test before the digital rectal exam as prostate manipulation increases PSA
Do not take part in physical activity, especially bike riding, for at least 48 hours before the test as this can artificially elevate PSA.
Stressed people are 3 times as likely to have an artificially elevated PSA than non –stressed men. So take part in some stress relieving activities.
Certain medications can artificially lower PSA. These medications are Proscar, Propecia and Avodart.
Saw Palmetto does not artificially loser PSA
The Bottom Line: The PSA is not an ideal tool for screening for prostate cancer. In fact, the doctor who attributed as being the father of the PSA test no longer recommends the PSA saying that the PSA is no longer a useful marker for detecting prostate cancer. In men who are 75 years and older the PSA question is more cut and dry as the U.S. Preventative Services Task Force recently advised that men who are 75 years old or older no longer get the PSA test. Men in this age group are highly unlikely to die of prostate related problems The fact is, even if they did develop a prostate tumor they are likely to die of other causes well before the tumor would claim their life.

Other Tests for Prostate Cancer Screening

There are a number of other tests that may help to screen for prostate cancer, however, none of them are completely accurate and only a few are reasonably accurate.

Free PSA – PSA is a protein that exists in two forms in the blood, bound and unbound. Approximately 85% of the prostate specific antigen is bound to protein, the remaining 15% is free floating. The higher the amount of the free floating PSA, the lower your risk of cancer is. The main benefit of this test is the low number of false positives (men diagnosed with prostate cancer who do not have it).
Transrectal Ultrasound – This test can visualize prostate size and abnormalities in the shape of the prostate that may indicate prostate cancer.
Prostate Biopsies – Inaccurate and Possibly Dangerous

Biopsies are not a controversial matter in medicine…but they should be! First, it is important to note that most biopsies are performed because of an elevated PSA, one of the most inaccurate cancer screenings in the medical world. In fact, one study in 1500 men who underwent biopsies found only 10% actually had prostate cancer. Given the discomfort and subsequent risk of prostate inflammation or infection, perhaps we should reevaluate the standards for sending a man in for a prostate biopsy.

Okay, so you might argue that 165 men out of 1500 had cancer and now they can receive “life-saving” treatment. Not necessarily…you see, most prostate cancer is not going to result in death. In one study of men over the age of 70 who had passed from other causes not related to prostate cancer, over 80% had prostate cancer. The truth is most men will develop prostate cancer in their lifetime and will not be bothered by it, they will live their lives ignorant to the fact that they have abnormal cells and will end up succumbing to something else.

Prostate biopsies can be dangerous because of the traumatic way in which the cell samples are taken. Remember, localized cancer is far less dangerous than metastasized cancer (cancer that has moved to other areas of the body). A biopsy involves taking numerous needle punches of the prostate tissue in hopes that a needle will catch some abnormal cells. It is fairly common that the luck of the draw misses the abnormal cells and results in a false negative result. If the doctor gets lucky and punctures an area with abnormal cells then you may run the risk of sending some of the abnormal cells into circulation where they can result in metastases.

According to one study, the best approach for prostate cancer screening is:

Digital Rectal Exam to feel for abnormal shape, nodules or size.
An ultrasound done rectally to visualize nodules or cancerous areas
PSA in relation to prostate size. If the prostate is enlarged, then PSA is not as good of a predictor and should not be used as a primary screening tool.
By following this procedure, it is estimated that we could avoid over 200,000 unnecessary biopsies annually.

Article Written by: Ray Hinish, Pharm.D.,CN,C.P.T.

There are two main types of medications used to treat an enlarged prostate. First is Hytrin (or like drugs), which is a blood pressure medication which seems to decrease the symptoms associated with an enlarged prostate by relaxing the tone of smooth muscles, including the bladder neck and prostate. As a blood pressure, medication the most common side effects may include dizziness and/or low blood pressure. This medication does nothing to slow or stop the growth of the prostate. Thus, as the years go on, and the prostate continues to grow, the medication can lose its efficacy. The second medication is Proscar (Finasteride). This medication stops the body from changing the hormone testosterone into a form that causes the prostate to grow. Thus, the prostate can shrink and prevent the worsening of the condition. The most common side effect of this medication is erectile dysfunction. The best benefit of this drug appears to happen in men whose prostates are in the worst shape (the most enlarged). It also can take up to 6 months to work. Finally, there is the surgical option. Surgery (often called the Roto-Rooter) is usually reserved for severe cases of enlarged prostate or for those who have not responded well to other treatment. This procedure can be costly and the results are varied, with some people receiving dramatic improvement, some receiving little or no improvement and still others may have worsening symptoms. Side effects of the surgery can be erectile dysfunction and lifelong incontinence. Discuss all of the potential benefits and side effects with your urologist.

Following is a discussion of the natural alternatives to help build a healthy prostate. Clinical trials have found that many of these components alone and in combination can successfully reverse this condition without the side effects and complications found with the prescription medicines or surgery.

Saw Palmetto:
Saw Palmetto is one of the top ten herbs sold last year, and for good reason. In a recent article published in the Journal of the American Medical Association, one of medicine’s most reputable journals, researchers analyzed 18 research articles published on Saw Palmetto’s benefits in prostate enlargement. It was found that Saw Palmetto was as effective as Finasteride, one of the prescription medications discussed earlier. Saw Palmetto also stood the test of 16 double-blind placebo controlled studies (studies that test the herb against a sugar pill). The suggested dosage of Saw Palmetto standardized to 80-95% fatty acids is 320 mg per day, usually divided into 2 or 3 doses.

Pygium Africanum:
This herb has been studied extensively and shows significant improvements in symptoms of an enlarged prostate and laboratory measurements. In one study, published in a German journal, 263 men with enlarged prostate were given either Pygium extract or a sugar pill. Compared to the sugar pill, Pygium led to a significant improvement in symptoms such as night-time urination and day-time frequency. In addition, the bladder emptied better and the flow of urine was stronger (Bartlet et al, 1990). A review of 10 studies on Pygium confirmed the results of this study (Andro et al, 1995). The suggested dose of Pygium, standardized to 13% Beta Sitosterol, is 100 mg daily. Stinging Nettle, a different herb, has been shown to work well in conjunction with Pygium and is usually dosed at 300 mg daily.

L-Alanine, L-Glycine and Glutamic Acid:
In the early 1960’s researchers noted that when these three amino acids (building blocks of proteins) were administered at a dose of 400 mg each daily there was partial to complete relief from the symptoms of an enlarged prostate. To my knowledge there has been no more research to study these components. In our clinical experience, formulas that contain these inexpensive amino acids works better then those that do not.

Lycopene:
This is a plant pigment similar to that of beta carotene. It is found in such fruits as tomatoes, watermelon, and strawberries. Recent research demonstrates that lycopene can prevent, and perhaps even treat, prostate cancer. You get the highest concentrations from processed tomato products such as tomato soup, juice, or sauce. Additional supplementation may also be of benefit. There is no true scientific guideline for using lycopene as a supplement, however, we like to see 5 – 10 milligrams in a daily supplement for prevention.

Although all of these individual ingredients have been demonstrated to be successful when administered alone, our clinical experience shows that there is greater symptomatic relief when given together. Many patients have noted dramatic improvements in the symptoms associated with an enlarged prostate. Usually, the first thing they notice is that they are not waking up as often at night to urinate. They also note an improvement in the flow of urine and the decrease in the frequency of urination during the day. In addition, it is not uncommon, upon re-examination, for the doctor to be impressed by the smaller size of the prostate when they do their annual poking and prodding. We always counsel our patients to give a quality prostate formula a full 3 months before evaluating whether or not it is working, but usually patients are calling us back within 2 weeks reporting an uninterrupted night of sleep, sometimes their first in a long while.

Many physicians feel it is only a matter of time before every man shows up with an enlarged prostate. We feel there are many reasons why this may be true. A lifetime of eating the standard American diet, one based on cooked and processed foods, and one that does not supply adequate amounts of needed nutrients, including zinc, is one of these reasons. But when it comes to the treatment of an enlarged prostate, or BPH, first have it properly diagnosed, and then find the least invasive, least likely to cause side effects way of treating it.

The Some of those symptoms include:

1.An inability to build muscle
2.Loss of muscle mass
3.Low libido or impotence
4.Heart disease
5.Obesity
6.Diabetes
7.Osteoporosis
8.Depression

Some of these symptoms may not be recognized immediately. A drop in muscle mass or libido may be attributed to the aging process, not realizing that testosterone levels have dropped below the normal range of 300 nanograms per deciliter. Unlike women’s menopause, men’s hormones tend to drop gradually over a number of years so the symptoms are also gradual. The symptoms of low testosterone cannot be assumed to indicate that testosterone levels have dropped below normal. Blood or saliva tests are necessary to determine actual levels.

There are many reasons for testosterone levels to drop aside from the natural aging process. These include:

1.Alcohol
2.Eating beef with hormones
3.Exposure to pesticides in large amounts
4.Drinking from plastic bottles & heating food in plastic

How Lifestyle Impacts Testosterone
Lifestyle changes can have a positive effect on testosterone. The most important factors that promote a healthy testosterone level include:

1.Proper sleep is beneficial for both testosterone and human growth hormone levels. Aim for 7-8 hours every night.

2.Proper diet including adequate protein and fat. It is a little known fact that a low-fat diet can result in a testosterone deficiency. Never decrease fat intake below 20% of your caloric intake.

3.Resistance Training – Lifting weights helps to build and protect your muscle while stimulating the production of testosterone and growth hormone.

Standard Treatment for Low Testosterone

The standard treatment for low testosterone is hormone replacement with bio-identical hormones. There are potential risks to this treatment as there is with any hormone replacement therapy. The degree of benefit varies from person to person. About 10% see little to no improvement in their symptoms, 90% see some improvement and approximately 1% see significant benefit. There are some other options that can be used as an alternative to hormone replacement. There are specific contraindications to testosterone therapy such as having prostate cancer, prostate hypertrophy, congestive heart failure, sleep apnea and high red blood cell count. Generally speaking, bio-identical testosterone treatment can be a safe and effective means of increasing testosterone levels, when not contraindicated.

Supplements for Increasing Testosterone

DHEA is a precursor to testosterone and can be taken in supplement form. It is not uncommon for people to have a deficiency of this important building block; correcting the DHEA deficiency can sometimes allow the body to resume production of testosterone. A standard starting dose is 25 mg, however, it is recommended that you have a blood test for DHEA-S in order to properly dose and monitor its effects.

A comprehensive formula, known as Night Gain by Natura Health Products contains a number of products to balance the testosterone levels. This formula contains L-Arginine, which assists in the natural production of testosterone. DIM and Chrysin which helps to prevent the testosterone from being converted into estrogen (a problem for older men). Three powerful herbs that help to stimulate the production of testosterone: Longifolia jack, Tribulus terrestris and Macuna pruriens. For best results, take 3 capsules before bed and 3 capsules in the morning.

Protecting the Prostate During Testosterone Replacement

As testosterone levels normalize, the body may inadvertently produce more of a compound called Dihydrotestosterone (DHT). DHT is a more potent form of testosterone the can promote prostate enlargement. It is recommended that men on testosterone replacement therapy take a comprehensive prostate formula to prevent the DHT from triggering prostate growth. I recommend Ultra Natural Prostate , by Life Extension Foundation, 1 capsule twice daily. A suitable alternative is New Chapter’s Prostate 5-LX formula.

Article Written by: Ray Hinish, Pharm.D.,CN,C.P.T.

The change in Dr. Rowen’s opinion came after a lecture by an integrative urologist named Dr. Wheeler. In this lecture, Dr. Wheeler presented evidence that the PSA is a nearly 100% accurate test for assessing inflammation in the prostate! So why is that important?

Inflammation is a bodily reaction to dysfunction. What this means is where there is damage, infection, abnormal cells or any kind of cellular problem, inflammation seems to follow. This inflammation is not just an indication of problems, when it is sustained it becomes part of the problem! These problems include prostatitis, prostate enlargement and even cancer. That is right, chronic inflammation in the prostate could ultimately set the stage for prostate cancer.

So how do we know if we have a problem?

According to Dr. Wheeler, whenever the PSA is above 1.0, there is a near 100% chance of inflammation in the prostate. He believes that the ultimate goal is to retain a PSA level below 0.5 and with proper care you could even retain a level close to 0.1.

So what now?

The first step is to have your PSA tested or dig up your last test within the past year. Once you know your baseline, we can do the work necessary to get and keep the prostate healthy. If you are in need of a PSA test, I recommend that you read the article entitled “Screening for Prostate Cancer – Tests to Get Tests to Avoid” in the Men’s Health section of our website. This way you will be able to have your doctor order all of the right tests.

So how do we keep inflammation in the prostate down?

It turns out that many of the herbs and nutritionals that we use to deal with prostate enlargement appear to mitigate inflammation in the prostate as well. These herbs include saw palmetto, pygeum and stinging nettle. The formula that I have used most in my practice for helping to get and keep the prostate healthy is a formula called Ultra Natural Prostate by Life Extension . This formula contains many herbs and nutritionals that will help to take the “fire” out of the prostate. Simply take two to three capsules daily.

Article Written by: Ray Hinish, Pharm.D.,CN,C.P.T.