Prostate cancer is on the rise – it’s become the single most common cancer among men, and the second most common cause of death. The incidence has quadrupled since the 1970s, and not just from improved screening. In the US, a man’s lifetime risk of a diagnosis is one in six, and predictions are that the risk for men in the UK will be the same within a decade. Currently, nearly 32,000 British men are diagnosed with prostate cancer every year and 10,000 die from it.
The prostate is a small gland, about the size of a walnut, that sits under the bladder by the urethra (the urine duct) and makes fluid that passes into the seminal duct to help sperm swim along. It’s a bit like a refuelling station in a sperm marathon.
So what can you do to make sure you, or the men in your life, never suffer from what I believe to be a preventable disease, caused by a combination of diet and lifestyle factors? There is also growing evidence that these same principles, when applied in the early stages of prostate cancer, may also reverse the condition.
While drug companies search for a ‘magic bullet’, a consistent picture is emerging that suggests that prostate cancer is caused by a combination of factors, the most significant being:
• Exposure to carcinogens
• Lack of antioxidants
• Excess hormonal growth signals
These factors are remarkably similar to the emerging story for breast cancer. This is not surprising since the cells that make up prostate tissue are, like breast tissue, under hormonal control. During adolescence, hormones trigger the prostate to grow from the size of a pea to the size of a walnut, in a similar way that they trigger breasts to develop in women.
|Problems with Your Prostate?||Screening for prostrate cancer|
|Non-invasive treatments for prostrate cancer.||What Causes Prostate Cancer?|
|Milk Makes Prostate (and Breast) Cancer Cells Grow Rapidly||Soya is a Superfood|
Problems with Your Prostate?
If the prostate swells (inflammation) or enlarges (overgrowth of cells) it can act like a clamp, making it harder to urinate. This is very common in men later in life. Sometimes overgrowth of cells can be benign. This is called benign prostatic hyperplasia (BPH) and affects one in three men over the age of 60. Although there is no clear link between BPH and prostate cancer, other than difficulty peeing, too many men avoid going to their doctor. In both cases, the earlier you know what’s happening the better.
Traces of prostate cancer are commonly found in older men who have died from other causes. According to Professor Jonathan Waxman of Imperial College, London, little spots of cancer occur in 70% of 70 year olds, 60% of 60 year olds and 50% of 50 year olds, but their relationship with the development of aggressive cancer is unknown. A non-aggressive type of prostate cancer is known as prostatic intra-epithelial neoplasia or PIN. Some doctors regard PIN as being a precursor of cancer, however not all agree.
Screening for prostrate cancer
The most commonly used screening test for prostate health is a blood test measuring PSA (prostate-specific antigen). This is produced by the prostate gland. High levels of PSA may be an early indicator of prostate cancer – but it is also raised in BPH, so a high level doesn’t always mean you are going to develop cancer. Generally, having a PSA below 2.5 if you’re under 60, or 4 if you are over 60, is consistent with good health. Doctors can also carry out a digital rectal examination (DRE), however this is also prone to false positives. I recommend having more than one PSA test over a period of months if the initial test is high. If your level is above 10, combined with a positive DRE, you will probably be recommended to have a needle biopsy. This identifies if there are any cancerous cells present, and the degree of abnormality.
Non-invasive treatments for prostrate cancer.
If you are diagnosed with prostate cancer, two of the most interesting and non-invasive treatments are HIFU (high intensity focussed ultrasound). This is targeted at the cancer cells only. Another is PDT (photodynamic therapy) which uses a laser light to activate chemotherapy drugs. If done well this means that the drugs designed to kill cancer cells don’t end up damaging other healthy cells, which is the fundamental problem with chemotherapy, and part of the reason why the side-effects are so bad. But none of these address the underlying cause, and what you can do to make sure you never get this far.
What Causes Prostate Cancer?
To search for answers to these questions I went to meet Professor Jane Plant, who became an expert on certain hormonal cancers after reversing her own breast cancer, at the stage when treatment was considered a waste of time, and who has written the highly-informative book Prostate Cancer (published by Virgin). I also contacted Dr Emily Ho from the Linus Pauling Institute, and studied the work of Colin Campbell in his book The China Diet. This is especially relevant since prostate cancer is virtually unknown in rural China (the incidence is one in 25,000). (The version shown below, available from Amazon, was updated in 2017)
The general view is that there are three contributory sets of conditions. Firstly, there is initiation, whereby prostate cells get damaged in some way so that they become cancerous. Secondly, there is generalised inflammation, which itself increases oxidants which, in turn, damage cells. And lastly, there is growth, encouraged by certain hormones and growth factors.
Professor Plant is convinced that exposure to herbicides, pesticides, hormone-disrupting chemicals and toxic elements such as cadmium may initiate these ‘cancer seeds’. Dr Ho believes that a pro-inflammatory diet of fried food, meat, refined foods and lack of antioxidants helps generate more oxidants and less antioxidants, potentially leading to cell damage. “Chronic inflammation may be the cause for as much as one third of all cancers,” she says. “Tissues may be chronically inflamed and large quantities of [oxidants] produced locally can cause tissue damage and even alterations in DNA resulting in mutations”. All agree that a diet high in organic fresh fruit, vegetables and wholefoods, low in meat, but including anti-inflammatory omega-3-rich oily fish, would minimise this risk. Incidentally, cadmium is found in orange-coloured cooking dishes. This can degrade and enter food, so do make sure you cook in stainless steel.
Two key antioxidants are zinc and selenium. Zinc is found to be deficient in prostate cancer patients, and low levels are a good predictor of risk. Zinc is both antioxidant and anti-inflammatory, as well as helping to repair damaged DNA. Most of us don’t get anything like enough. I recommend supplementing 10-20mg a day and eating zinc-rich foods (seeds, nuts and seed and nut butters such as tahini). Low selenium is also a good predictor of prostate cancer. Professor Plant recommends people supplement about 100mcg of selenium.
Lycopene in tomatoes, quercitin in red onions, vitamin C and E are all important anti-oxidants with good evidence suggesting an anti-prostate cancer effect both from foods and isolated nutrients. A recent study found that a glass of pomegranate juice helps lower PSA levels, while a high vegetable diet lowers risk for benign prostatic hyperplasia (BPH).  Spices are amazing antioxidants, especially turmeric, cinnamon, chilli and ginger. I recommend you maximise your use of all these foods in your diet.
Milk Makes Prostate (and Breast) Cancer Cells Grow Rapidly
Cancer only develops if cancer cells grow. Their growth is under the influence of hormones and growth factors. Professor Plant and Colin Campbell are convinced that the single major cancer growth promoter is dairy products. Milk is naturally high in oestrogen, as well as growth factors such as insulin-like growth factor (IGF1). This is hardly surprising since milk’s job is to make cells grow. Milk consumption is the second most predictive risk factor, with age being the first. According to the National Cancer Institute (NCI), 19 out of 23 studies have shown a positive association between dairy intake and prostate cancer. “This is one of the most consistent dietary predictors for prostate cancer in the published literature,” reports NCI. “In these studies, men with the highest dairy intakes had approximately double the risk of total prostate cancer, and up to fourfold increase in risk of metastatic or fatal prostate cancer relative to low consumers.” 
There’s no question that milk, and all dairy products, contain both oestrogens and IGF, and raise IGF levels in your blood if you eat them. Most people don’t realise the scale of the problem. You can literally predict a country’s incidence and mortality rate from prostate cancer just from knowing the average dairy intake. Switzerland, for example, has the highest dairy intake and the highest numbers of deaths from prostate cancer, while rural China has the least. Industrialised meat is also high in hormones. The only meat I’d recommend is wild game or organic lamb. I’ve not eaten any for 30 years.
Fish and fish oils, on the other hand, may be protective against prostate cancer. A study published in the Lancet followed more than 6,000 Swedish men age 55 for up to 30 years.  Its conclusion: eating fatty fish, such as salmon, sardines, herring and mackerel, could reduce the risk of prostate cancer by a third. Supplementing purified omega-3 fish oils (EPA and DHA) provides a guaranteed PCB-free source of these powerful anti-inflammatory agents. If you’re suffering from BPH or prostatitis, supplementing the equivalent of 1,000mg of EPA a day can have an anti-inflammatory effect.
Middle-aged men (now being 50, I consider this middle-aged) naturally have lower levels of testosterone, oestrogens and IGF1. But the average intake of milk and meat changes this. It basically creates a hormonal environment similar to puberty, so it’s no surprise this would cause cell growth. Many of the drugs used to treat prostate cancer attempt to block the growth signals of hormones. Yet some of these are less effective after a couple of years as the cancer is said to become ‘drug resistant’. This is hardly surprising if you don’t change your intake of growth factors.
One of the most potent anti-cancer vitamins is vitamin D, which is made in the skin in the presence of sunlight. Having enough can halve your risk of prostate and other cancers (see Special Report 18). If you live in the Northern hemisphere, especially in winter, you just won’t make enough. Nor will diet alone give you enough – oily fish being the best source. Interestingly, a high-meat-protein diet, and high-calcium diet, which is what you get from dairy products, blocks the ability to create active vitamin D. Most experts agree we should all be supplementing somewhere between 15 and 50mcg a day. The pharmaceutical industry have cottoned on to this and are trialling a vitamin D derived drug for prostate cancer.
Soya is a Superfood
The dietary antidote to an overload of growth promoting hormones is soya, the staple source of protein for the Chinese. The evidence consistently shows that a regular intake of soya, and other phytoestrogen rich foods such as beans, lentils and peas, greatly reduces risk of both breast and prostate cancer, as well as menopausal problems. “Soya is a superfood,” says Professor Plant. “I have non-GM organic soya every day. The idea that it promotes cancer is absolute rubbish. If we just ate soya, instead of feeding it to cows and eating them, it would save masses of energy, water and greenhouse gases.” She believes that much of the anti-soya propaganda is ill informed and has little or no scientific basis. “If it were so bad,” she says, “why does the dairy industry feed it to their cows? I recommend you have a glass of soya milk, or a serving of tofu a day, and make peas, beans and lentils a regular part of your diet.” Phytoestrogens, from plant foods, are about 1000 times less oestrogenic than other oestrogens, but bind more effectively to hormone receptors on cells, hence they lower the oestrogen load by protecting your cells from too many growth signals. Phytoestrogens are high in many fruits and vegetables – from strawberries to oats. A plant-based diet, deriving protein from these foods, is consistent with a much lower cancer risk and may help reverse the condition.
Another superfood is broccoli, high in DIM, a phytochemical that mops up excess growth hormones. Growth hormones stop cancer cells committing suicide, a process called ‘apoptosis’. DIM switches back on this suicide signal. [6, 7] One study involving 12 men (two with PIN) taking 100mg of DIM as a supplement, found that PSA levels dropped in 11 of them and PIN had disappeared in both cases. I recommend eating lots of broccoli and possibly supplementing a concentrate containing DIM.
Dr Dean Ornish put this kind of diet to the test on a group of people with early prostate cancer. There was clear evidence of a reversal of all the indicators of prostate cancer. “Intensive lifestyle changes”, he concludes, “may affect the progression of early, low grade prostate cancer in men.” 
Professor Jane Plant agrees. “If you cut your growth factors right back, I think you can reverse the cancer process. I always tell people to continue their conventional medicine but radically change their diet. A man came to see me four years ago with a terrible prognosis, and was considered not worth treating. He changed his diet and is now alive and well. His PSA dropped from above 100 to about 0.1.” You can see other success stories on her website www.cancersupportinternational.com.
The most consistently helpful herbs are saw palmetto and pygeum. Saw palmetto has been proven to help inhibit cancer growth and to reduce inflammation. This makes it the perfect herb for both BPH, prostatitis and prostate cancer. Studies have shown reduction in enlargement of the prostate with daily supplementation. It also inhibits an enzyme, called 5-alpha reductase, which turns testosterone into DHT, which is the form of testosterone that promotes prostate cancer.  And it has been shown to inhibit the growth-promoting effects of IGF-1 in milk.  Personally, I think there’s enough evidence now to recommend any man over 50, or at risk, to supplement saw palmetto. Since it’s the fatty acids in saw palmetto that seem to be most biologically active, choose a supplement that is standardised to 45% fatty acids. This means it’s high quality. I recommend 120mg a day for prevention and 360mg a day if you have BHP or prostate cancer.
The other prostate-friendly herb that shows many similar beneficial properties is the African bark Pygeum. It also lessens the harmful effect of too much IGF-I and, in animal studies, is profoundly anti-cancer. 
1. E Ho, ‘Dietary influences on endocrine-inflammatory interactions in prostate cancer development’, Archives of Biochemistry and Biophysics (2004), vol. 428, pp. 109-17.
2. J Allan et al, ’Phase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancer’, Clinical Cancer Research (2006), vol. 12(13), pp. 4018-4026.
3. S Rohrmann et al, ‘Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men’, American Journal of Clinical Nutrition (2007), vol. 85, pp. 523-529.
4. J Stanford et al, ‘Prostate cancer trends 1973-1995’, Bethesda, MD:SEER Program, National Cancer Institute, 1998.
5. P Terry et al, ‘Fatty fish consumption and risk of prostate cancer’, The Lancet (2001), vol. 357(9270), pp. 1764-1766.
6. Y Li et al, ‘Regulation of FOXO3a/ -Catenin/GSK-3 Signaling by 3,3′-Diindolylmethane Contributes to Inhibition of Cell Proliferation and Induction of Apoptosis in Prostate Cancer Cells’,
The Journal of Biological Chemistry (2007), vol. 282, pp. 21542-21550.
7. D Kong et al, ‘Inhibition of Angiogenesis and Invasion by 3,3′-Diindolylmethane Is Mediated by the Nuclear Factor– B Downstream Target Genes MMP-9 and uPA that Regulated Bioavailability of Vascular Endothelial Growth Factor in Prostate Cancer’, Cancer Research (2007), vol. 67, pp. 3310-3319.
8. D Ornish et al, ‘Intensive lifestyle changes may affect the progression of prostate cancer’, The Journal of Urology (2005), vol. 174(3), pp. 1065-9.
9. W H Goldmann et al, ‘Saw palmetto berry extract inhibits cell growth and Cox-2 expression in prostatic cancer cells’, Cell Biology International (2001), vol.25(11), pp. 1117-24.
10. T L Wadsworth et al, ‘Saw palmetto extract suppresses insulin-like growth factor-I signaling and induces stress-activated protein kinase/c-Jun N-terminal kinase phosphorylation in human prostate epithelial cells’, Endocrinology (2004), vol. 145(7), pp. 3205-14.
11. F Yablonsky et al, ‘Antiproliferative effect of Pygeum africanum extract on rat prostatic fibroblasts’, The Journal of Urology (1997), vol. 157(6), pp. 2381-7.