5 Ways to Protect Your Prostate —

and Yes,
Sex
Is One of Them

(Read original article here)

5 Ways to Protect Your Prostate —

and Yes, Sex Is One of Them

When it comes to cutting your risk of

prostate cancer (PCa), you have more
control over your risk than you think.

In a study published last May in JAMA

Oncology, Harvard researchers
analyzed long-term lifestyle data and
cancer risk among 89,571 women and
46,339 men.
Those practicing a healthy lifestyle (i.e.,
no smoking, moderate drinking and/or
abstinence, BMIs maintained between
18.5 and 27.5, and 75 minutes of
vigorous, or 150 minutes of moderate,
exercise per week) had much lower
rates of cancer and cancer deaths than
those who failed to practice all four of
these.

For men, the odds of getting any cancer

were cut by a third, and the odds of
dying from it by 44 percent.

Lead author Edward L. Giovannucci,

M.D., Ph.D., editor-in-chief of the
journal Cancer Causes and Control,
acknowledges that studies like this
can’t prove cause or effect.
“But we believe that in this case that we
are talking causation and not just
correlation,” he says, “in part because
we aren’t attributing the association to a
single factor, which makes causation
hard to tease out, but rather to an
overall healthy lifestyle.

If almost all of the cancer risk in the

population was due to chance, how can
one explain that people with the
generally better lifestyle have so much
lower rates?”

In terms of PCa specifically, Dr.

Giovannucci estimates up to 40 percent
of deaths might be preventable if all
American men embraced a healthy
lifestyle.
“Of course, even with the best
lifestyle,” he says, “some men will still
get cancer.

We have a lot of control, but not full

control.”

Discover what makes a difference in

risk:

No mechanisms have been definitively

proven to protect the lean and fit, but
preliminary evidence suggests a number
of possibilities.

One theory, says Dr. Brawley, is that as

weight increases, insulin becomes less
sensitive, which means that the bodies
of diabetic and prediabetic individuals
alike pump out extra insulin.
“Insulin,” he explains, “actually
stimulates tumor growth.”

By contrast, the combo of regular

exercise and a healthy BMI can
enhance insulin sensitivity, meaning
there’s less in circulation to potentially
cause problems.

In a study published in Nature

Communications in 2016, French
researchers discovered another problem
with obesity.

In lean and obese men alike, the

prostate gland is naturally surrounded
by fatty deposits called periprostatic
adipose tissue (PPAT).

The difference: obese men have a lot

more of it.
This is problematic because PPAT
secretes compounds that attract PCa
cells into leaving the gland and taking
up residence in this fat layer, which, in
turn, serves as a gateway for metastasis
throughout the body.

2. Your usual meal plan.

PCa risk for men living in rural China is

2 percent, but those who move to the
US and adopt a Western diet see their
risk quickly rise towards the 17 percent
risk of average American-born men.

Similarly, says Dr. Giovannucci,

studies of Seventh Day Adventists who
strictly adhere to a vegan diet lower
their risk by 35 percent.
“Such findings,” he says, are consistent
with other indications that high intake
of meat and dairy products seems to be
associated with increased risk.”

Exactly why remains uncertain, but Dr.

Giovannucci suspects that vegans
benefit from lower levels of
testosterone and insulin-like growth
factor-1, both of which are related to
PCa risk.

A diet rich in fruits and vegetables, by

contrast, may offer some protection.

Plants supply a broad array of

antioxidants and phytochemicals, from
the isoflavones in soybeans to the
lycopenes in tomatoes.
In an epidemiological review and
subsequent prospective study, both of
which were published in JNCI: Journal
of the National Cancer Institute, Dr.
Giovannuci found a compelling
evidence that frequent consumption of
tomato products is linked to a lower
risk of PCa.

Tomato sauce, in particular, was

associated with an even greater
reduction in risk.

“I recommend a diet high in whole

grains, fruits and vegetables, aiming for
diversity and including some tomato
products, like tomato sauce on pasta
several times a week,” Dr. Giovannucci
says.
“However, don’t use this as an excuse
to gorge on pizza.”

Why? Studies have shown that men

who consume the most cheese, milk,
and yogurt have the highest rates of
PCa.

What the tomato giveth, in other words,

the mozzarella could very well taketh
away.

3. Not falling for supplements.

Over the years, researchers have

investigated a variety of promising
vitamins, minerals, and other
supplements as potential protective
agents.

Take, for example, Vitamin D.

“It’s been shown in the laboratory that
Vitamin D suppresses cancer,” says Dr.
Brawley, plus there are these
fascinating correlation studies in the
population at large that show men with
higher levels of Vitamin D have lower
rates of PCa.”

Dietary intake is only one way we get

Vitamin D naturally—the other is
exposure to sunlight, which triggers our
skin into making its own supply.

Among men living above the 40

parallel (think of a line running from
Philadelphia to northern California),
PCa rates climb compared to more
southerly residents—a possible
consequence of inadequate sunlight
during winter months.
Another intriguing correlation has to do
with the color of your skin.

“We did a study of black and white

health professionals, all highly educated
men with a good lifestyle and access to
medical care,” says Dr. Brawley.

“In fact, the African-American men had

even more PSA screening rates.

Nonetheless, they were twice as likely

to die of PCa.

We examined genes, many lifestyle,

diet, medical factors, and various
hormones.

The only factor that we found that was

dramatically different between whites
and blacks was a much, much lower
level of vitamin D in the black men.”

One prime reason: when exposed to

sunlight, dark skin does not make as
much Vitamin D as light skin.

So why not just boost Vitamin D levels

via supplements in northerners and
black men alike?

Alas, Vitamin D supplements failed to

show even slight magic bullet powers.

In a study just published in the New

England Journal of Medicine,
researchers conducted a nationwide,
randomized, placebo-controlled trial of
25,871 participants, including 5,106
black participants.
Their conclusions: Vitamin D
supplements did not lower incidence of
invasive cancer or cardiovascular
events compared to placebo.

At least it didn’t prove harmful.

High levels of selenium and Vitamin E

correlate with reduced risk in men who
naturally have these.

“But when we did a study giving men

Vitamin E and selenium supplements,”
says Brawley, “we found that
administering selenium actually
increased their PCa risk, and Vitamin E
boosted their risk of stroke.”

Similar red flags have been raised with

multivitamins, with men who take more
than seven a week increasing their PCa.
4. Using medicinal drugs right.

Some research has suggested that

aspirin taken over long periods of time
might slightly cut PCa risk, though this
awaits confirmation.

“We don’t have super great data on PCa

yet,” says Dr. Brawley, “but the data on
aspirin and colon cancer is really very
good.”

Even if aspirin is eventually shown to

reduce the chances of PCa, he adds, it’s
a “double-edged issue.

If you put 100,000 guys on a full tablet

of aspirin daily, you’re going to buy
yourself some hemorrhagic strokes in
the process.”
Another drug class of interest are the
so-called 5-alpha reductase inhibitors,
drugs like Proscar, Avodart, and
Propecia, which are used to treat an
enlarged prostate and hair loss in men.

They work by preventing the

conversion of testosterone into a more
potent form called dihydrotestosterone,
a compound that fuels growth of the
prostate and the miniaturization of hair
follicles.

The NCI-funded PCa Prevention Trial,

which ended in 2003, found that men
on such drugs for seven years saw a 25
percent reduction in PCa throughout
that period. In a follow-up study just
published in JNCI, researchers at the
Fred Hutchinson Cancer Research
Center looked at nearly 19,000 men
from the earlier study and found that 16
years later, those who’d taken the active
drug still enjoyed a 21 percent reduced
risk of PCa compared to those on
placebo.

This suggests that the drug provides

benefits long after men stop taking it.

The drawback: though side effects are

generally rare, some men on 5-alpha
reductase inhibitors suffer decreased
libido and ejaculate volume and even
impotence.

As a consequence, the FDA hasn’t yet

approved their use just to lower PCa
risk.

5. Having more sex.

Of all the potential prevention
strategies, the one most likely to attract
buy-in from guys is sex.

In the clinical vernacular,

“ejaculatory frequency” appears
inversely related to PCa risk—i.e., the
more often you climax, the less likely
you are to suffer the disease.

Researchers asked 29,342 men

between the ages of 46 and 81 to
report their average number of
ejaculations per month in young
adulthood, mid-life, and in the most
recent year.

Ejaculations could be product of

sexual intercourse, wet dreams, or
masturbation.
The results, published in Journal of
the American Medical Association in
2004, showed that men who ejaculated
21 or more times a month enjoyed a 33
percent lower risk of PCa compared
with men who reported four to seven
ejaculations a month throughout their
lifetimes.

An Australian study of 2,338 men in

BJU International came to strikingly
similar conclusions: compared men
who ejaculated less than 2.3 times per
week, guys averaging 4.6-7 weekly
ejaculations were 36 percent less likely
to be diagnosed with PCa before age
70.

Given the relatively short follow-up

in both these studies, Dr. Giovannucci
wondered if perhaps low-frequency
ejaculators already suffered some early,
undiagnosed PCa that made ejaculating
difficult.

In a 2016 study in European Urology,

he and his colleagues re-analyzed the
JAMA data after another 10 years.

“With further follow-up,” he says,

“we found that ejaculatory frequency
still predicts PCa even decades in
advance of the disease.”

If frequent ejaculating really does

protect against PCa, how does it do it?

Giovannucci acknowledges that exact

mechanisms remain far from proven,
but he believes the so-called
“stagnation hypothesis” makes the most
sense.

In men who have not ejaculated in a

long time, he explains, seminal fluid
undergoes oxidative changes that
potentially, at least, render it toxic to
the prostate.

“There may be benefits from not

letting these fluids stagnate but
instead clearing them out periodically,”
he says.

“At this point, this is based more on

intuition than strong scientific
evidence.”

For many of us, of course, it’s more

than enough evidence to put this
strategy into practice.
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