In 2000, scientists from Institute for Male Urology in Encino, Calif., found 82 percent of patients who received a specially formulated blend of the bioflavonoid quercetin experienced a 25-percent improvement in the National Institutes of Health (NIH) pain and quality of life symptom score.3 A year later, some of these researchers found an oxidative stress causative component, which they concluded could potentially benefit from antioxidant therapy.4 Then in 2006, Chinese researchers discovered increased oxidative stress and damage induced by chronic bacterial prostatitis in patients, noting a connection to the pathology of the disease.5Beyond chronic prostatitis, other degenerative diseases threaten male prostate health. Benign prostatic hyperplasia (BPH) is enlargement of the prostate gland that causes urinary tract dysfunction and discomfort. BPH accounts for at least 1.7 million doctor’s office visits per year, according to NIH. Researchers have focused on dihydrotestosterone (DHT) and 5-alpha-reductase as primary causative factors. Saw palmetto (Serenoa repens) is considered an inhibitor of 5-alpha-reductase.6 This herb is used for stage one and two BPH cases, including as a prescription preparation in Germany. Saw palmetto extract possesses anti-estrogenic activity and increases urinary flow rate while decreasing nocturia, residual urine and painful urination. Early trials showed promise for saw palmetto in BPH,7,8 but a 2006 NEJM trial publication reported no benefits to BPH symptoms in men taking saw palmetto.9 However, the American Botanical Council (ABC) and other herbal experts noted the trial focused on men with moderate to severe BPH symptoms, as opposed to men with mild to moderate symptoms, the focus of more than 21 previous trials showing positive benefits of saw palmetto. Fellow herbal remedy pygeum is often taken in combination with saw palmetto for prostate health. It contains phytochemicals such as beta-sitosterol, pentacyclic terpenes and ferulic esters that help control harmful testosterone activity in the prostate gland. Research has shown pygeum extract can help control DHT and counteract gland enlargement indicated in BPH pathology.10 Another BPH supplement is pumpkin seed, which may inhibit DHT and inflammatory factors in BPH.11 Despite the availability of herbal supplements, elements of basic nutrition are important to inhibiting development of BPH. A 2007 Johns Hopkins Bloomberg School of Public Health, Baltimore, study report inversely linked risk of BPH with consumption of fruits and vegetables, due mainly to nutrients such as beta-carotene, lutein and vitamin C—vitamin E did not show a connection.12 More recently, 2008 research from the Fred Hutchinson Cancer Research Center, Seattle, found a slight effect of vitamin D, lycopene and zinc on BPH risk, though failing to connect antioxidants in general.13 Researchers also noted moderate alcohol consumption correlated to decreased risk of symptomatic BPH; however, a 2004 study found heavy drinkers are at higher risk of BPH. Alcohol is a risk factor in BPH development, possibly via lower hormone levels due to high consumption.14 The other major prostate concern among men is cancer, which kills around 30,000 men each year among the 230,000 men afflicted with the disease, including the 186,000 new cases expected in 2008, according to the National Cancer Institute (NCI). In prostate cancer research, lycopene again has taken center stage. Lycopene has been linked to decreased risk of developing prostate cancer, decreased PSA scores and reduced prostate tumor size.15 However, FDA rejected a health claim for lycopene’s role in prostate cancer, approving a series of qualified claims instead. This tomato carotenoid took its hardest hit in 2007, when scientists from Fred Hutchinson and NCI reported serum levels of lycopene and other carotenoids had no impact on prostate cancer development, while increased beta-carotene actually correlated to increased prostate cancer incidence.16 As with BPH, plants help inhibit and manage prostate cancer development and progression. Acetyl-11-keto-beta-boswellic acid (AKBA), a component of Boswellia serrata, has been shown to promote apoptosis induced by cytokines and chemotherapeutic agents, as well as inhibit invasion and suppress osteoclastogenesis through inhibition of NF-kappaB-regulated gene expression.17 Similarly, pomegranate extract inhibited cell growth and induced cancer cell apoptosis in an animal prostate cancer trial.18 Likewise, both garlic and soy have been found protective against prostate cancer.19 In fact, garlic was found to lower PSA scores,20 as was soy and its isoflavones genistein and daidzein, which can also limit prostate tumor growth and development.21 In 2008, a research report surfaced detailing how genistein could help prevent the spread of prostate cancer in patients.22
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