Other than the heart, the weakest organ in men is the prostate. Prostatitis, benign prostatic hypertrophy (BPH) and cancer of the prostate are remarkably common. The vast majority of men will develop one or more of these problems at some point in life. Although the lifetime incidence of –symptomatic prostatitis is reported at only 16%, some studies suggest a much higher incidence of chronic non-symptomatic prostatitis. Indeed, there is significant evidence to suggest that subclinical prostatitis may be a major contributor to BPH, which affects a majority of men at some point in life. And, chronic prostatitis may also be a precursor of cancer.
When I was a freshman in medical school, the use of antibiotics to treat prostatitis was just being evaluated and the treatment of choice was regular prostate massage. As antibiotics became the usual treatment, massage was abandoned. There is remarkable evidence that prostate massage was superior to antibiotics, especially in the chronic state. There is also good evidence that prostate diseases are increased in men with less frequent ejaculation. As Wilhelm Reich emphasized, orgasm less than twice a week has many problems! Sitting most of the day is also harmful to the prostate and vigorous aerobic exercise is beneficial. And, conversion of testosterone to dihydrotestosterone (DHT) appears to be a major contributor to development of BPH and prostate cancer. Saw palmetto, which I will be recommending, stops the conversion of testosterone to DHT.
With maturity prostate cancer increases in incidence. By age 70, 70% of men have microscopic evidence of prostate cancer. BUT, the lifetime incidence of clinically diagnosed prostate cancer is only 13%. There is considerable controversy over many of the routine tests inflicted on men. Prostate specific antigen tests and even prostate exam by rectal evaluation leads to excessive recommendations for biopsy. There is no credible evidence that aggressive therapy for microscopically diagnosed prostate cancer is helpful – and it certainly leads to many complications. If it ain’t broke, don’t fix it is my motto!
Here are my recommendations for maintaining a healthy prostate:
- Empty the prostate a minimum of twice a week: thrice is probably better
- If you do not have a monogamous partner, masturbation is a safe substitute
- Stay physically active—at least an hour a day of moderate exercise
- By age 50 at the latest start on saw palmetto, double strength extract, 160 mg, twice a day. If you start balding earlier, start saw palmetto immediately
- If you have evidence of BPH by physical exam or symptoms, increase Saw Palmetto to 4 a day and keep increasing up to 12 a day to control symptoms. Incidentally, this also helps keep cholesterol low!
- If this does not control symptoms, add Cernilton, Swedish pollen, 2 twice daily. Cernilton is still available on the internet; but the major American producer, Graminex, has recently converted to PollenAid, which they claim to be superior to Cernilton
- Pygeum, 50 mg up to 4 per day may be tried
- Lucraco, Waltheria ovata, one teaspoon three times daily at least an hour away from food would be the next line of defense
- EGCG-epigallocatechin-3-gallate, green tea extract plus Boswellin is worth trying as the combo is highly anti-inflammatory
- If all else fails consider Delta-Star, a prostate probe which heats the prostate , 20 minutes daily 3 days on, 2 or 3 off
All of the above approaches are safe and worth consideration by all men. Interestingly there has been recent evidence that botulinum toxin injected into the prostate may be quite beneficial in both prostatitis and prostate cancer. Certainly in non-symptomatic prostate cancer I would recommend all of the above before going to any invasive approach.