Health

How to keep your prostate healthy

September is Prostate Awareness Month. Lifestyle changes are the first line of defence against prostate problems, says David Hughes

IT IS a sobering thought that 90 per cent of men who reach the age of 80 will end up with Benign Prostatic Hyperplasia (BPH). The ‘benign’ bit doesn’t mean it’s actually good for you, just that it could be worse.

Other not so benign prostate problems include prostatitis – an inflammation of the prostate gland – and prostate cancer, diagnosed in more than 40,000 men a year in the UK

The good news is that BPH doesn’t increase the risk of developing either prostatitis or prostate cancer, and there is much that can be done to improve all three conditions.

The prostate gland is found only in men. It surrounds the urethra, the tube which carries urine out of the body, is about the size of a walnut, and tends to get larger with age. No one is exactly sure why it becomes larger, but the enlargement doesn’t mean you’re on the way to prostate cancer.

Enlargement of the prostate is usually noticed in terms of increased discomfort – difficulty in starting or stopping urinating, a weak flow of urine, or needing to urinate more frequently. The same symptoms can be an early sign of prostate cancer, so if you notice them it’s worth getting a check-up with your GP, even though the outcome is vastly more likely to be the harmless BPH.

Even prostate cancer is not entirely bad news, in the sense that although it is the most common form of cancer for men, it usually progresses very slowly, which means that it may be just a case of monitoring it rather than needing treatment. So, men often die with prostate cancer rather than because of it. The chances of developing prostate cancer are greater in those with a close male relative with the disease, and in men of Afro-Caribbean origin.

Prostatitis, where the prostate gland becomes swollen, is sometimes caused by bacterial infection, although by no means in all cases. This condition is more painful than BPH, and is usually treated with a combination of painkillers and alpha-blockers, which can help relax the muscles of the prostate and bladder neck. Antibiotics may also be prescribed. Most men recover within a few weeks or months.

For the much more common BPH, a number of strategies and treatments are available. Lifestyle changes are the first line of defence, both in preventing problems and reversing them, to be followed if necessary by medications, catheters and surgery

The NHS recommends drinking fewer fizzy drinks, and less alcohol, caffeine and artificial sweeteners (particularly in the evening) as these can irritate the bladder and make urinary symptoms worse. It also recommends common-sense strategies like going to the toilet before long journeys, and double voiding, which means waiting a few minutes after urinating before trying to go again, thus emptying the bladder properly.

Eating appropriate foods is very important for prostate health (see below). Other, perhaps less reliable, sources, mention that sexual activity benefits the prostate (you can add your own jokes here).

Exercise in general is beneficial, though, as is a full night’s sleep, and they are effective ways of dealing with stress.

If lifestyle changes are insufficient, medicines are available in the form of alpha blockers, which relax the muscle in the prostate gland and at the base of the bladder, making it easier to pass urine. Anticholinergics will also relax the bladder muscle, 5-alpha reductase inhibitors will shrink the prostate gland if it’s enlarged, and then there are diuretics, which speed up urine production; if taken during the day, they reduce the amount of urine produced overnight.

For those who have continual trouble passing urine, a catheter can be fitted; and ultimately, surgery may be considered to remove part or all of the prostate, shrink the prostate, or hold it away from the urethra. New and less invasive techniques are also being developed, such as Focused Laser Ablation (FLA), which uses a combination of magnetic resonance imaging and electromagnetic radiation to treat an enlarged prostate in a single session under local anaesthetic.

Foods that are good for prostate health:

Our food choices are important in increasing or reducing the risk of prostate cancer, and maintaining overall prostate health.

Sesame seeds: A rich source of zinc, important in prostate health. Men with either BPH or prostate cancer tend to have much lower levels of zinc – up to 75 per cent lower – than those with healthy prostates. Other food sources include almonds and pumpkin seeds

Salmon:Good for Omega-3 fatty acids, which help protect against a number of health risks, including obesity, which is associated with prostate problems. Other omega-3 sources include walnuts and flax oil

Tomatoes:These contain lycopene, which may reduce the risk of developing prostate cancer, and, according to the American National Cancer Institute, can also help men with BPH. Lycopene is also found in watermelon, apricots and pink grapefruit, and is best absorbed when combined with a fat such as avocado, nuts, oil or butter

Avocados:Apart from helping to absorb lycopene, avocados are also rich in beta-sitosterol, which is thought to reduce the symptoms of BPH. Other sources include pumpkin seeds and wheat germ

Vegetables:Particularly green leafy vegetables, rich in antioxidants, and cruciferous vegetables such as broccoli. Vegetables are an excellent source of polyphenols, vitamins, minerals and fibre, which reduce inflammation and help prevent cancers

Green tea:An excellent source of catechins, which inhibit cancer cell growth. If you don’t like green tea, you can get your catechins from dark chocolate, cherries, pears, red wine and blackberries instead

Bell peppers:A one-stop-shop for your vitamin C needs; a cup of bell peppers contains 200 per cent of daily vitamin C requirements. Also found in broccoli, cauliflower and kale – among other vegetables and fruit – vitamin C is thought to have a role in fighting BPH.

Find out more: NHS Choices, website: www.prostatecanceruk.org

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