As pointed out last year in a review of pollen extract
for prostate support, benign prostatic hyperplasia
(BPH, formerly called hypertrophy), involves a
renewed growth in the number of prostate cells
late in life.1 Unfortunately, of men between the
age of 40 and 59, nearly 60 percent can be shown to already
be suffering from benign prostatic hyperplasia. This usually
does not present a noticeable problem until after the age of
50; by the age of 80, however, some 85 percent of all men
suffer from one or more symptoms of BPH. The primary
effect of BPH is a progressive decrease in the ability to empty
the bladder as the prostate enlarges and applies pressure to
BPH is hardly the lone prostate and sex hormone related
issue that can be troubling to men. Aside from prostate
cancer, which for most men is so slow growing as to not
be life threatening, many men are concerned about low
testosterone, which has its own repercussions. Two of the
repercussions of low testosterone are a low level of muscle-maintaining
free testosterone and elevated levels of estrogen
produced from testosterone by a pathway referred to as the
aromatase pathway. Fortunately, there are a number of safe
natural compounds that can help to regulate both sides of
Protective herbs and nutrients have counterparts that
increase the risks of various conditions. Some of these
potentially damaging compounds are prescriptions given for
unrelated conditions and this provides a rationale for being
cautious about prescription drugs. What you do not know
definitely can hurt!
PROTECTIVE AND SUPPORTIVE NUTRIENTS AND HERBS
In 2013, experts slammed a claimed fish oil/omega-3 fatty
acid intake link to prostate cancer as “scaremongering.” The
trial in question purported to find increased risks for total
prostate cancer as well as increased risks of both low-grade
and high-grade prostate cancer, an increase of 71 percent in
this latter category.2 The responses were quick and brutal.
One nutritionist (Duffy MacKay, vice president of scientific
and regulatory affairs at the for Responsible Nutrition (CRN))
pointed out, quite correctly, that the findings of this study
were based on blood level differences so small that “[t]his
change [of 0.2%] literally could have occurred if somebody ate
a fish sandwich on their way to get their blood drawn.”3 Both
the consumers of the low and the high levels of long chain
omega-3 fatty acids were within the normal blood range.
Others pointed out that the findings of the study clearly
imply that men in countries with high levels of consumption
of seafood, such as Scandinavia and Japan, should exhibit
high levels of prostate cancer, yet the opposite is the case.
Alan Ruth, PhD, CEO of the Irish Health Trade Association
observed, “[i]n a 2010 meta-analysis of 31 studies published in
the American Journal of Clinical Nutrition, the risks of prostate
cancer diagnosis calculated for high fish consumption ranged
from a 61% decrease in risk to a 77% increase in risk, and
several showed no significant differences in risk at all…In the
same meta-analysis, pooled data from four studies on fish
consumption and death from prostate cancer (rather than
diagnosis of prostate cancer) found a 63% decrease in risk
for high fish consumption.”4
Especially interesting in this dust-up is the recent
attempt to rehabilitate omega-6 fatty acids. In pre-modern
times, the intake of omega-3 to omega-6 fatty acids in the
diet typically was in the range of one-to-two, whereas today in
the United States it regularly may be as low as one-to-twentyfive,
with prostate cancer rates climbing steadily over the last
60 years. In this instance, a headline is revealing: “Corn oil,
omega-6 could speed up prostate cancer.”5 Journal article
titles are more prosaic, yet just as damning: “A high ratio of
dietary n-6/n-3 polyunsaturated fatty acids is associated with
increased risk of prostate cancer.”6
Barry Sears, who has written for years on the health effects of fatty acids, both good and bad, tartly comments
in his blog, “Omega-3 fatty acids and prostate cancer? Oh,
really?”7 Among other things, Sears demonstrates how easily
a statistically significant blood reading of fatty acid profiles
can be attached to otherwise clinically irrelevant findings.
The take away message in this case is that the experience
around the world repeatedly has been that prostate risks,
especially death from prostate cancer, are lower in matched
populations that consume more fish. There is nothing in
recently published research that should make us doubt that
improving the omega-3 to omega-6 ratio in our diets is a
good goal at which to aim.
Grape Skin Extract & Resveratrol
In many areas in the US and the United Kingdom (Scotland
has not yet opted out of the Union), one cannot visit a
doctor without being queried about alcohol intake and then
the required lecture on the evils of alcohol. The distinction
as to the source of alcohol in the diet routinely drops out despite the fact that red wine has been recognized in Europe
for centuries as exhibiting various health benefits and little
downside as long as consumed in moderation. It turns out
that red wine, often thought of in terms of the heart, may
benefit the prostate, as well.
The trick to the studies is that the researchers must work
vigorously to screen for the different sources of alcohol over
the course of a man’s life. If this is done, then the research
is likely to confirm that a glass of red wine per day may be
protective against the risk of prostate cancer.8 Less clear is
which compounds in red wine are protective. Perhaps many
are. A recent study on grape skin extract and resveratrol
identified several protective mechanisms of action.9 Some of
the factors linked to resveratrol have been known for years,
whereas other mechanisms and, similarly, the benefits of
other red wine compounds, are being vigorously researched.
Grape seed components (proanthocyanidins) are another
example of a source of anti-cancer benefits.10 Given the
huge volume of papers being published today on the healthprotective
benefits of red wine and its ingredients, it is a
reasonable conclusion that most men may benefit from one
or two glasses of red wine per day consumed with meals.
Quercetin & EGCG
The dietary bioflavonoid quercetin is well known to readers
of this magazine, as is epigallocathechin gallate (EGCG).
Both compounds are considered to be health protective
and quercetin, in particular, is known to improve the uptake
(bioavailability) and the benefits of many other compounds
found in the diet and in herbs. Papers routinely show greater
efficacy or even benefits where none initially were found, when
quercetin is combined with resveratrol, with sulphorafane,
with EGCG, etc. One of the more interesting recent findings
is that these combinations sometimes not only can help to
prevent the transformation of cells from precarcinogenic
stages to active cancer, but also can interfere with or
eliminate entirely cancer stem-cell characteristics. Cancer
stem cells are the ultimate source of cancer self-renewal, so
this action by the combination of quercetin and EGCG is a
Bitter melon has received quite a bit of publicity recently with
regard to pancreatic cancer. It would be unfortunate were the
exploration to end there. Several researchers have reported
that treatment of bitter-melon-related products in a number
of cancer cell lines induces cell cycle arrest and apoptosis
without affecting normal cell growth.12 Researches targeted
specifically at prostate cancer have demonstrated that the
impact of bitter melon extends to this area.13
Admittedly, bitter melon is not a staple at the American
table. Perhaps that should change. See my earlier article,
“Going WILD with Bitter Melon for Blood Sugar Support.”14
Pomegranate is a fruit long associated with healing and
medicine. Indeed, the pomegranate is on the crest-of-arms
of the British Royal Society of Medicine and of many other
ancient organizations devoted to healing. A quick look at the
PubMed database shows that the keywords “pomegranate”
and “prostate” bring up 60 studies. Many of these studies
have been promising, especially when pomegranate was
added to other ingredients with related and differing
mechanisms of action. For instance, in 2013 the polyphenol
rich whole food supplement Pomi-T® (pomegranate seeds,
green tea, broccoli, and turmeric) was reported to have a
direct anti-cancer effect in men with prostate cancer.15 These
results were confirmed in a larger clinical trial published in
Thymoquinone and Black Seed
Few Americans have heard either of black seed or
thymoquinone (TQ). The former is famous for healing in
the areas in which it grows naturally, meaning much of the
eastern Mediterranean through the Near and Middle East all
the way to India. Mohammed is reputed to have said that the
seed cures every condition except death itself.
With regard to the prostate, black seed is useful for both
BPH and in preventing prostate cancer induction. One of
the important ingredients in black seed oil, thymoquinone,
promotes healthy apoptosis in prostate cells and therefore
helps the body to regulate the size and health of the
prostate.17,18 Similar effects have been found in, for example,
breast cancer, so TQ has a broad spectrum of applications.19
A couple of decades back, the herbal extract chrysin was
introduced to the athletics and body building world as an
answer to improving free testosterone levels and reducing
the pathway (aromatase) that transforms testosterone to
estrogen. Chrysin has some benefits, as long as one does
not expect too much and is willing to focus on the anxiolytic
qualities of the compound (found in passion flower).
However, much more successful compounds for this purpose
of increasing free testosterone, and so forth, have been
found. One of these is an extract of cactus flower (Opuntia
I ran across this almost a decade ago being sold in
Germany and Israel for BPH,20 but at the time could not find
a reliable source of supply. Since then, a friend with whom
I was working took this item and continued to dig until he
found a reliable source that he could market as increasing
serum free testosterone levels and reducing aromatase
(reducing estrogen production and inhibiting the binding
of dihydrotestosterone/DHT.) As my friend writes at his
website, based on preliminary laboratory research, “Opuntia
flower extract (1 mg/ml concentration) inhibited over 80%
of the activity of 5-alpha reductase in human prostate tissue
homogenate and inhibited over 80% of aromatase activity
in human placenta tissue homogenate.”21 This particular
product also contains supporting ingredients, such as an
extract of stinging nettle root.
Some Prostate-Questionable Foods and Pharmaceuticals
Now for a few items that men may want to remove from their
daily habits or environment.
- Non-and low-fat milk (but not whole milk or other dairy products) intake by men is linked to higher rates of prostate cancer22
- Long-term use of statins increases the risk of prostate cancer23
- Oral contraceptive use is associated with prostate cancer—this refers to these contraceptives getting into the environment at large and not to use by one’s partner24
There are protective foods, nutrients and herbs of which
men should take advantage to maintain and regain prostate
health as well as improve other parameters of health and
performance. Omega-3 fatty acids and the active compounds
found in red wine (grape skin anthocyanidins and other
compounds, resveratrol, grape seed proanthocyanidins,
quercetin), green tea (EGCG) and bitter melon are on this
short list. More exotic are black seed and thymoquinone as
well as cactus flower extract. For the most part, these can be
characterized as special foods since they can be consumed
over the long term and have few or no downsides even when
consumed chronically in large amounts. Indeed, this should
be the goal—a little prevention is always worth a whole lot
- 1. F. Hinman, Benign Prostatic Hypertrophy. New York: Springer-Verlag, 1983.
- 2. Brasky TM, Darke AK, Song X, Tangen CM, Goodman PJ, Thompson IM, Meyskens FL Jr, Goodman GE, Minasian LM, Parnes HL, Klein EA, Kristal AR. Plasma phospholipid fatty acids and prostate cancer risk in the SELECT trial. J Natl Cancer Inst. 2013 Aug 7;105(15):1132– 41. doi: 10.1093/jnci/djt174.
- 3. Experts slam omega-3 link to prostate cancer as overblown ‘scaremongering.’ http://www.nutraingredients.com/content/view/print/796071
- 4. Ibid.
- 5. http://www.foodnavigator-usa.com/news/printNewsBis.asp?id=65537
- 6. Williams CD, Whitley BM, Hoyo C, Grant DJ, Iraggi JD, Newman KA, Gerber L, Taylor LA, McKeever MG, Freedland SJ. A high ratio of dietary n-6/n-3 polyunsaturated fatty acids is associated with increased risk of prostate cancer. Nutr Res. 2011 Jan;31(1):1–8. doi: 10.1016/j.nutres.2011.01.002.
- 7. http://zonediet.com/blog/2013/07/
- 8. A glass of red wine a day keeps prostate cancer away? http://nutraingredients.com/news/printNewsBis.asp?id=54898
- 9. Hudson TS, Hartle DK, Hursting SD, Nunez NP, Wang TT, Young HA, Arany P, Green JE. Inhibition of prostate cancer growth by muscadine grape skin extract and resveratrol through distinct mechanisms. Cancer Res. 2007 Sep 1;67(17):8396–405.
- 10. Raina K, Singh RP, Agarwal R, Agarwal C. Oral grape seed extract inhibits prostate tumor growth and progression in TRAMP mice. Cancer Res. 2007 Jun 15;67(12):5976-82.
- 11. Tang SN, Singh C, Nall D, Meeker D, Shankar S, Srivastava RK. The dietary bioflavonoid quercetin synergizes with epigallocathechin gallate (EGCG) to inhibit prostate cancer stem cell characteristics, invasion, migration and epithelial-mesenchymal transition. J Mol Signal. 2010 Aug 18;5:14. doi: 10.1186/1750–2187–5–14.
- 12. Nerurkar P, Ray RB. Bitter melon: antagonist to cancer. Pharm Res. 2010 Jun;27(6):1049–53. doi: 10.1007/s11095–010–0057–2.
- 13. Ru P, Steele R, Nerurkar PV, Phillips N, Ray RB. Bitter melon extract impairs prostate cancer cell-cycle progression and delays prostatic intraepithelial neoplasia in TRAMP model. Cancer Prev Res (Phila). 2011 Dec;4(12):2122–30. doi: 10.1158/1940–6207.
- 14. http://www.totalhealthmagazine.com/articles/vitamins-and-supplements/going-wild-with-bitter-melon-for-blood-sugar-support.html
- 15. Goodman A. High Marks for Nutritional Supplement in Patients with Localized Prostate Cancer. Value-Based Cancer Care. September 2013 Vol 4, No 7. http://issuu.com/vbcc/docs/vbcc_september_2013_digital/50
- 16. Thomas R, Williams M, Sharma H, Chaudry A, Bellamy P. A doubleblind, placebo-controlled randomised trial evaluating the effect of a polyphenol-rich whole food supplement on PSA progression in men with prostate cancer-the UK NCRN Pomi-T study. Prostate Cancer Prostatic Dis. 2014 Mar 11. doi: 10.1038/pcan.2014.6.
- 17. Kaseb AO, Chinnakannu K, Chen D, Sivanandam A, Tejwani S, Menon M, Dou QP, Reddy GP. Androgen receptor and E2F-1 targeted thymoquinone therapy for hormone-refractory prostate cancer. Cancer Res. 2007 Aug 15;67(16):7782–8.
- 18. Kumar AP, Sethi G, Tan KH. Thymoquinone: potential cure for inflammatory disorders and cancer. Biochem Pharmacol. 2012 Feb 15;83(4):443–51. doi: 10.1016/j.bcp.2011.09.029.
- 19. Rajput S, Kumar BN, Sarkar S, Das S, Azab B, Santhekadur PK, Das SK, Emdad L, Sarkar D, Fisher PB, Mandal M. Targeted apoptotic effects of thymoquinone and tamoxifen on XIAP mediated Akt regulation in breast cancer. PLoS One. 2013 Apr 17;8(4):e61342. doi: 10.1371/journal.pone.0061342.
- 20. Palevitch D., Earon G., Levin I., Treatment of benign prostatic hypertrophy with Opuntia ficus-indica (L.) Miller. Journal of herbs, spices & medicinal plants. J. herbs spices med. plants 1993;2(1):45–49.
- 21. http://cleanmachineonline.com/science/how-it-works/ drawing upon Jonas A, Rosenblat G, Krapf D, Bitterman W, Earon G, Neeman I. Efficacy of cactus flowers miller treatment in benign prostatic hyperplasia due to inhibition of 5a reductase activity, aromatase activity and lipid peroxidation. HerbaMed paper; undated. Available at: http://www.herbamed.com/Portals/0/articles/Opuntia.pdf.
- 22. Park SY, Murphy SP, Wilkens LR, Stram DO, Henderson BE, Kolonel LN. Calcium, vitamin D, and dairy product intake and prostate cancer risk: the Multiethnic Cohort Study. Am J Epidemiol. 2007 Dec 1;166(11):1259–69.
- 23. Chang CC, Ho SC, Chiu HF, Yang CY. Statins increase the risk of prostate cancer: a population-based case-control study. Prostate. 2011 Dec;71(16):1818–24. doi: 10.1002/pros.21401.
- 24. Margel D, Fleshner NE. Oral contraceptive use is associated with prostate cancer: an ecological study. BMJ Open. 2011 Nov 14;1(2):e000311. doi:10.1136/bmjopen–2011–000311.