Why are older men
vulnerable to BPH?
 As men get
older, there is a surplus in the amount of testosterone produced by the testicles. This excess is absorbed by
the prostate.
Testosterone can
convert to dihydrotestosterone which causes an increase in the growth of prostate cells
and the lifespan of these cells. The result is
growth of the prostate. Since the prostate surrounds
the urethra, this growth slowly begins to put pressure on the urethra as it exits the
bladder. Over time the pressure can cause
obstruction and reduce the flow of urine from the bladder.
Symptoms
Hesitancy
(difficulty in starting to pass urine)
A weak stream
The need to
strain to pass urine
The feeling that
the bladder isn't empty after urination
The need to pass
urine urgently
Dribbling, being
unable to completely stop the flow of urine
Frequent trips
to the toilet, including having to get up several times in the night
Feeling a
burning sensation or pain when passing urine
Treatments
Talk to your doctor about the various remedies and treatments available.
For mild cases, many doctors recommend Saw Palmetto, a herbal remedy, widely regarded as useful in reducing size of the
prostate, though not everyone responds. Some
products combine saw palmetto with nettle and other ingredients – see our product of
the month below.
While the most widely used conventional
treatment for BPH has been surgical intervention, in recent years pharmaceuticals that
inhibit the conversion of testosterone to DHT have been increasingly prescribed. The most
common surgical method to shrink the prostate
is transurethral resection of the prostate (TURP) where part of the gland is removed. This usually involves a few nights in hospital, some
weeks of recovery and possible side effects including impotence. Not a method to be undertaken lightly.
Newest for severe cases is laser treatment, which involves light pulsing on the prostate to reduce obstruction,
carried out in a day clinic. But few hospitals in
the UK can offer this at the moment. Many doctors
prefer to suggest herbal treatments as a first option.
PRODUCT OF THE
MONTH - December 2003
Saw
Palmetto Complex
Saw Palmetto Complex is a special formula comprised of standardized
extracts of saw palmetto, pygeum africanum and stinging nettle, all thought to be useful
for treating BPH and improving impaired bladder functions. Some studies show that
ingredients may even help shrink and normalize the prostate, safely.
Saw Palmetto Complex contains, per capsule:
Saw Palmetto (Serenoa repens) extract
(berry) 107mg
Stinging Nettle (Urtica dioica) extract
(leaf) 100mg
Beta-sitosterol 100mg
Pygeum (Prunus africanum) extract (bark)
33mg
Lycopene 5mg
Recommended
dosage: one capsule, three times daily with meals
 Saw Palmetto is a plant extract derived from a palm. It
is known as a phytochemical and many trials using Standardised Extract of Saw Palmetto
have been shown to help improve symptoms of
BPH.
It doesn't affect prostate-specific antigen levels (PSA) a test used for
indication of prostate cancer. Commonly prescribed drugs for BPH have been found to
significantly lower PSA levels, and this may mask the ability of PSA tests to detect
cancer. A twice-daily dose of 160 milligrams has shown improvement within 60 days.
Pygeum comes from a tree growing in parts of
Africa
.
Recent research with standardized Pygeum Africanum
Extract (PAE) suggests that it contains several types of phytochemicals thought to be
useful for treating BPH. Most studies have used 75 to 200 milligrams daily in one or two
doses, with improvement within two months.
Lycopene is a tomato-based product that may help
in preventing prostate cancer. It is considered a powerful antioxidant, and its
inclusion in Saw Palmetto Complex is thought to be a useful preventative.
Beta-Sitosterol: one of the phytosterols produced
naturally by plants and found in corn and soy
oil. It is considered by many researchers as a useful treatment with encouraging results
in trials.
Stinging Nettle has a diuretic effect, to help
make passing urine easier.
Saw Palmetto
Complex costs £38.95 for 90 capsules and is
available on line from the Nutri Centre (Code VRP 1620) and health food stores and
chemists.
Useful contacts
For all-round
information about prostate conditions, join
the Prostate Help Association. It’s a self-help group run by one dedicated man,
Philip Dunn who has recently come under criticism
for appearing to work as a charity, but without charitable status. In fact, this was stated in his newsletter where Dunn said being a charity caused too much
bureaucracy for a lone organiser.
Dunn single-handedly produces a quarterly newsletter
‘Prostate Focus’. An indigested read,
it nevertheless is full of information, patient-oriented, and keeps very up-to-date on
treatments and research.
Also available
is a publications list and 2000 pages of prostate information on CDs.
See the website: http://www.pha.u-net.com or email:
philip@pha.u-net.com.
For general
information about men’s health, see the
free website www.malehealth.co.uk, which is run
by the Men’s Health Forum, commended in the BMA’s 2003 Patient Information
Awards.
The site is
aimed at males of all ages. At its heart is
a Health A-Z section which covers 24 common health topics in a clear Q and A format. It
includes the Male Body - A User’s Guide, an overview of every part of the male
anatomy for beginners. There’s an instant
online health report and a home MOT health check, frank advice on lifestyle and
information on men’s favourite subjects: drink, smoking, sex, food and exercise.
There is even an online gym with a fitness programme.
Meanwhile, we
thank the publication What Doctors Don’t Tell You
for the following:
PSA:
It's a test that has had its day
We (WDDTY) have said it before, and now we have to
say it again-the prostate specific antigen (PSA) blood test doesn't work. In fact, it
works less well than even we thought. A new
study has found that it's failing to recognize eight out of every 10 cases of prostate
cancer.
Researchers from Harvard Medical School
analysed the test results of 6,691 men who had a PSA, and found that it failed to spot 82
per cent of cancer cases. The test also came up with just 2 per cent of 'false positives'
- where the test detected a cancer that wasn't actually there - a pretty low rating
compared to most other tests that throw up many more false positives.
 So what can be done? The test currently
assesses as healthy a PSA blood concentration of 4 ng/ml. If this was reduced to 2.6
ng/ml, researchers reckon that the test would detect around 36 per cent of cancers - but
it would also dramatically increase the rate of false positives. This is still not an acceptable detection rate.
It's perhaps time to discard the PSA and search for a more reliable test.
(Source: New England Journal of Medicine, 2003; 349: 335-42).
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