Supplement Pills For Your Prostate-Probably Not Effective

Saw palmetto fruit extracts are widely used to treat lower urinary tract symptoms attributed to benign enlargement of the prostate gland. However, a new study shows that these extracts are no better than placebo at easing symptoms.
The findings were reported in the Journal of the American Medical Association (2011;306:1344-1351).
In the study, men were randomly assigned to receive a daily dose of saw palmetto extract, beginning 320 mg, or matching placebo. After 24 weeks, the saw palmetto dosage was increased to 640 mg per day. After another 24 week, it was increased to 960 mg per day, which is triple the standard dose. After 48 weeks there was no significant difference between placebo and saw palmetto supplements.
“Now we know that even very high doses of saw palmetto make absolutely no difference,” said study co-investigator Gerald Andriole, MD, Chief of Urologic Surgery at Washington University School of Medicine in St. Louis.

Bottom Line: Saw palmetto is probably not effective in treating or preventing prostate gland enlargement.

Alternative Treatments of the Enlarged Prostate Gland

Most men will have symptoms of prostate gland enlargement after age 50 Those symptoms include frequency of urination, getting up at night to urinate, urgency of urination, and dribbling after urination. There are numerous medications that are effective in reducing the symptoms of the enlarged prostate gland. There are large numbers of men who find that their symptoms are not of significance that require treatment or they are using so many medications that the men don’t want to add any additional medications to their already lengthy list of drugs. There are supplements and vitamins that can be used that may have a role for men who do not want to take additional medications.

Beta-sitosterol

Beta-sitosterol is the main active ingredient in the herbs saw palmetto and pygeum. Both of these herbs do not have enough beta-sitosterol to be of real value in giving you prostate health. Now, beta-sitosterol, which can be obtained from sugar cane pulp, can be purchased in capsule doses of 300 – 600 mg, which gives you an effective dose to eliminate your enlarged prostate. Pygeum can only provide around 30 mg and you need upwards of 600 mg daily.

Flax Seed or Fish Oil

The nutrient to use for the best prostate health diet is flaxseed oil.
Flax seed oil contains more omega-3 than omega-6 and so it makes it a good source of omega-3. The more omega-6 use, from olive oil and other vegetables oils, the more prone you will be to prostate cancer. This is not the case with omega-3 oil and this has been verified through clinical studies.

Omega-3 protects the prostates cells and has anti-inflammatory properties. Using fish oil can also be a better choice than flax seed oil since your body digests it better.

Use 1 – 2 grams of flax seed or fish oil per day.

Soy Isoflavones

Soy Isoflavones have been shown in clinical studies to have good effects on your prostate and should be added to your prostate health diet. These isoflavones are flavones and contain no photoestrogen so the have no estrogen effects in the body.

The active ingredients in the isoflavones are genestein and daidzein.Buy a brand that has up to 40 mg of isoflavones Use this quantity daily.

Ionic Minerals

The prostate needs minerals. Adding these to your prostate health diet is critical. You cannot have good prostate health without plenty of minerals and your regular diet cannot supply what you need.

In addition to these ionic minerals, you need to make sure you get plenty of zinc and selenium. The prostate has more zinc than any other part of the body. So take 15 – 20 mg per day and not to exceed 40 mg.

Vitamin D

Vitamin D is another critical vitamin that you want to make sure you get plenty of. If you are out in the sun a lot, then you will not need to supplement with this vitamin. Otherwise, use up to 800 IU of this vitamin.

Vitamin E

This is the next most important vitamin you should supplement with. Use up to 400 mg per day of the natural mixed tocopherols. Clinical studies have shown that vitamin E can reduce and suppress prostate cancer cells.

Bottom Line: Use, beta sitosterol, isoflavones, minerals, vitamin D, and vitamin E in your prostate health diet and see improvements in your prostate symptoms and health.

PSA Screening For Prostate Cancer-New Guidelines

By now, you’ve probably heard that prostate-specific antigen (PSA) screening is no longer recommended for healthy men under age 75. This controversial draft recommendation was issued by the United States Preventive Services Task Force (USPSTF). Given previous recommendations from the medical community encouraging PSA screening, many men are confused. Following are answers to some questions you may have about this recommendation — and our advice on whether you should follow it.
Should You Have a PSA Screening Test? Here’s what Johns Hopkins recommends for patients:
By now, you’ve probably heard that prostate-specific antigen (PSA) screening is no longer recommended for healthy men under age 75. This controversial draft recommendation was issued by the United States Preventive Services Task Force (USPSTF). Given previous recommendations from the medical community encouraging PSA screening, many men are confused. Following are answers to some questions you may have about this recommendation — and our advice on whether you should follow it.
What is the USPSTF? The USPSTF is an independent group of 16 medical experts whose recommendations serve as guidelines for doctors throughout the country. In addition, the group’s recommendations ultimately impact what tests Medicare and private insurers will pay for.
Why did they make this recommendation? According to the USPSTF, the potential harms caused by prostate-specific antigen (PSA) screening of healthy men as a means of identifying prostate cancer far outweigh its potential to save lives. The group discourages the use of any screening test for which the benefits do not outweigh the harms to the target population.
What are the potential harms of PSA screening? An elevated PSA reading can lead to an unnecessary prostate biopsy. Although biopsies often reveal signs of cancer, depending on a man’s age, 30 to 50 percent will not be harmful — even if left untreated.
After a positive biopsy comes the decision about what to do. Most men choose radical prostatectomy, external-beam radiation therapy or brachytherapy. But each of these treatments has the potential to cause serious problems like erectile dysfunction, urinary incontinence or bowel damage. And men who choose active surveillance must live with the uncertainty of knowing that they have an untreated cancer that could start to progress at any time.
Why does the Task Force believe PSA screening does not save lives? The USPSTF evaluated data from five large randomized clinical trials of PSA testing, including the Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) Trial, which reported no mortality benefit among 77,000 men who underwent PSA testing and were followed for 10 years.
Do these recommendations apply to all men? These recommendations apply to all men regardless of age, race or family history as long as they do not have symptoms of prostate cancer.
My advice. Many leading cancer and patient groups and doctors agree that there is harm with PSA screening and the treatment that follows diagnosis. But a more targeted screening approach focusing on those at greatest risk of developing prostate cancer, and active surveillance for those who don’t need immediate treatment, could shift the balance of benefit and harm toward benefit.
PSA screening is the best test available for the detection of cancer cells in the prostate. Rather than discontinuing use of the only test available to detect the disease early and treat it successfully, efforts should focus on reducing harm.
Bottom Line: Every man should discuss the benefits and risks of PSA screening with his physician. If you choose to be screened and the result is positive, you and your doctor should discuss whether any further intervention is appropriate or necessary.

Take “One” Cialis And Call Me In The Morning-A New Treatment For Both Erectile Dysfunction and The Enlarged Prostate Gland

This past week the FDA has approved the use of Cialis, a drug commonly used in the treatment of erectile dysfunction, will also be approved for the management of benign enlargement of the prostate gland. Cialis, manufactured by Eli Lilly and Co., was approved for the treatment of erectile dysfunction (ED) in 2003. It can now be used to treat ED AND prostate gland enlargement, or both if symptoms of the two conditions occur together.

Benign prostatic hyperplasia (BPH), a condition in which the prostate gland becomes enlarged, is common in older men. Symptoms include difficulty starting urination, a weak urine stream, a sudden urge to urinate and more frequent urination including awakening at night to empty the bladder. BPH can have a big impact on a patient’s quality of life if a man gets up more than a couple of times each night. Cialis offers these men another treatment option, particularly those who also have ED, which is also common in older men affecting nearly 33 million men in the United States.

In two clinical trials, men with BPH who took 5 milligrams of Cialis once daily experienced a significant improvement in their urinary symptoms of BPH compared to men who were treated with placebo.
Cialis should not be used in patients taking nitrates, for example nitroglycerin, because the combination can cause an unsafe decrease in blood pressure, the FDA said. And the use of Cialis in combination with alpha blockers for the treatment of BPH as there is a risk of lowering blood pressure.

Bottom Line: If you are experiencing both difficulty with urination and also have inability to successfully engage in sexual intimacy as often as you would like, you should speak to your doctor about the use of daily Cialis, 5mg, which is effective in treating both conditions with a single pill.

“Just Say No” to Sex…Before Your Next PSA Test

For men over age 50 who are going to have a PSA test for prostate cancer, ejaculation within the past two days may artificially raise PSA levels. Men should be aware of the time of their last ejaculation and tell their doctors the last time they had an ejaculation in case results are high. Finally, while the digital rectal exam or other aspects of a prostate exam shouldn’t interfere with PSA levels, I suggest that blood be drawn before the rectal exam as a precaution.

PSA, PCA3 and Pee

At the present time the only way to screen for prosate cancer is the digital rectal exam and a blood test, PSA or prostate specific antigen.  Now a urine test is available to detect prostate cancer.  The PCA3 measures a gene produced by prostate cancer cells in the urine.  A positive PCA3 is helpful for men who have an elevated PSA test, which can be elevated due to benign causes such as benign enlargement of the prostate gland or prostate infections, decide that they may need a prostate biopsy.  Or the PCA3 test can be useful if the test is positive and the prostate biopsy is negative which may indicate that the cancer was missed during the biopsy.  It is hopeful that the PCA3 test will be helpful to differentiate slow growing cancer from a cancer that is more aggressive and more malignant and help the patient make a better decision regarding treatment.

Bottom Line: New and better tests are being discovered that will help diagnose prostate cancer.  PCA3 urine test is one of those new tests soon to be available from your urologist.

The French Have Done It Again- Dogs Can Use Their Noses to Sniff Out Prostate Cancer

Dogs can be trained to detect prostate cancer by smelling urine samples and signaling the presence of certain volatile organic compounds produced by cancer cells, according to French researchers.

Jean-Nicolas Cornu, MD, of Tenon Hospital in Paris, and colleagues obtained fresh urine samples that had been frozen for preservation from 66 men referred to a urologist because they had an elevated PSA level or abnormal findings on digital rectal examination. Of the 66 men, 33 had prostate cancer and 33 did not, as determined by prostate biopsy.

The dogs used in the study were trained in three phases. In the first phase, which lasted five months, dogs were trained to recognize cancer urine. In the second phase, which lasted 11 months, dogs were trained to discriminate cancer urine from control urine. In the final phase, dogs were presented with five urine samples and prompted to select the one sample that was cancer urine.

Dogs correctly classified 63 of 66 samples.  These results suggest that volitle organic compounds  produced by cancer cells can be detected in urine samples.

So if you come to a French doctor’s office and you find a dog in the exam room, don’t be alarmed.  The dog may just be one of the doctor’s helpers used to diagnose your illness!  For my office, I’m going to “go standard” and suggest for all men over the age of 50 that they have an annual PSA blood test and a digital rectal exam.  It’s the American way!

To your good health.  Dr. Baum

11 Suggestions For Decreasing Prostate Symptoms

The prostate gland is walnut sized organ at the base of the bladder.  In order men the gland increases in size and causes symptoms such as going to the bathroom frequently, dribbling after urination, and getting up at night to urinate.  Here are a 11 suggestions that you might consider to relieve those symptoms.

1.  Don’t drink anything several hours before you go to sleep.

2.  Avoid caffeinated beverages such as coffee and tea as the caffeine acts as a diuretic

3.  Limit your alcohol consumption especially at the dinner meal.

4.  Avoid spicy foods.

5.  Take medications such as your diuretics or water pills early in the day when going to the bathroom to urinate is not such an inconvenience.

6.  Avoid antihistamines and decongestants

7.  Don’t hold off going to the restroom

8.  Use the clock to help with urination. Make an effort to urinate every 3-4 hours.  Putting your bladder on a schedule is very helpful and a good habit to have.

9. Go and then go again. Stand at the toilet and empty your bladder, walk away from the toilet for a minute or two and then return and try emptying the bladder again.

10. Avoid cold seats such as at football games in the winter.

11. If you bike ride, especially for long distances, stand on the pedals every 10 or 15 minutes to take the pressure off of your prostate gland.

Bottom Line: These steps won’t cure the enlarged prostate but they will lessen the symptoms.  If your symptoms persist, consider a visit to your urologist

Bladder Testing-Urodynamics

Urodynamics are simply a combination of several useful tests which provide information about your lower urinary tract. This information is obtained much in the same way that an electrocardiogram (EKG) proxies information about your heart. Urodynamics “draws a picture” for your doctor and helps to determine the diagnosis and what will be the appropriate treatment of your urinary problem(s).

Urodynamics testing is done at the office and usually takes 30-45 minutes.

During the test you will be catherized at least once. Your bladder will be filled one or more times with carbon dioxide gas or water or both. You may have a very small tube placed in the rectum. The nurse will tell you beforehand whether you are to have this done. Muscle activity in your pelvis will be recorded during the tests by small electrodes which are placed on the skin near the rectum. These electrodes are very similar to those used for an EKG.

Preparation for Urodynamics

It is important to have a full bladder when you arrive for the studies; please be ready to urinate! There are no other special preparations or food restrictions for this test. If you wear padding, external catheters, etc., you may wish to bring extra supplies for replacement after the test. You can help to make the test easier by remaining relaxed. Each step of the evaluation will be explained to you throughout the test by the experienced nurse who performs the studies. Every effort will be made to make you as comfortable as possible during the procedure. A urodynamics evaluation usually includes the following tests:

CystometrogramlElectromyogram (CMG\EMG)

This test involves filling your bladder through a catheter with sterile gas or water. The nurse will ask you when you feel the urge to urinate, and when your bladder feels completely full. Pelvic muscle activity will be recorded as already described.

Flow Rate

A flow rate is done simply by asking you to void into a special toilet which records the pattern of your urine stream on a graph and the amount of urine you void. Muscle activity in your pelvis will usually be recorded while you void via the electrodes already described. The amount of urine left in your bladder after you void (the residual urine) will also be measured at this time.

Cystoscopy

Cystoscopy is a test that allows your doctor to look at the interior lining of the bladder and the urethra. The cystoscope is a thin, lighted viewing instrument that is inserted into the urethra and advanced into the bladder.

The cystoscope is inserted into your urethra and slowly advanced into the bladder while your doctor looks through the scope to examine the inside of the urethra. Your doctor then examines the inside of your bladder for stones, tumors, bleeding, and infection. Cystoscopy allows your doctor to look at areas of your bladder and urethra that usually do not show up well on X-rays. Tiny surgical instruments can be advanced through the cystoscope that allow your doctor to remove samples of tissue (biopsy) or samples of urine from each kidney.

Cystoscopy can also be used to treat some bladder problems. Small bladder stones and some small growths can be removed by using tiny surgical instruments that slide through the cystoscope. This may eliminate the need for more extensive surgery.

After Urodynamics:

After urodynamics, you may experience some burning on urination or some increased frequency of urination for a short time. If you drink plenty of fluids afterwards, it will help to alleviate this sensation. You may also have some blood in your urine for a short while, which should be minimal. To decrease the risk of urinary tract infection, you will be given a few days of antibiotics to take by mouth.

You should notify your doctor if you experience fever, chills, severe bleeding or severe discomfort after your urodynamic study.

Living With Prostate Gland Enlargement-Lifestyle Changes

Prostate enlargement or benign prostate hyperplasia (BPH) is a common, non-cancerous condition affecting nearly 14 million men over the age of 50.

The symptoms of prostate gland enlargement include decrease in the force and caliber of the urinary stream, frequency or urination, urgency, feeling of not emptying the bladder and nocturia or the need to get up at night to urinate.

Although lifestyle changes will not cure the problem, they can alleviate some of the symptoms.

Making some lifestyle changes can often help control the symptoms of an enlarged prostate and prevent your condition from worsening. Try these measures:

Remember what goes in must come out.  Therefore don’t drink anything several hours before you go to sleep.  Especially avoid caffeinated beverages such as coffee (also causes insomnia) and tea as the caffeine acts as a diuretic and causes increased urine output that may result in getting up at night to empty your bladder,

Limit your alcohol consumption especially at the dinner meal.  Again alcohol acts as a diuretic causing increased production of urine causing your bladder to fill up sooner than you would like.

Avoid spicy foods.  These appear to irritate the bladder and can result in urinary frequency and nighttime voiding.

Check your medications.  Some medications like lasix and hydrochlorothiazide are diuretics and increase urine production.  I suggest you take those medications early in the day when going to the bathroom to urinate is not such an inconvenience.  You may also speak with your doctor about lowering the dosage of the diuretic especially the evening dose if you are bothered by nighttime urination.

Avoid antihistamines and decongestants as these cause the bladder to decrease the force of contraction and results in the bladder not to empty as well.  If you have to take anti-histamines, use them earlier in the day.

Don’t hold off going to the restroom.  This habit distends the bladder and can result in a weaker muscle to expel the urine from the bladder.

Use the clock to help with urination.  If you find that you are going to the bathroom infrequently and then more at night, make an effort to urinate every 3-4 hours.  Putting your bladder on a schedule is very helpful and a good habit to have.

Go and then go again.  Double voiding is a technique to ensure adequate emptying of the bladder.  If you stand at the toilet and empty your bladder, walk away from the toilet for a minute or two and then return and try emptying the bladder again.  This helps to expel more urine from your bladder than just standing there one time and voiding.

Avoid cold seats such as at football games in the winter.  The cold temperature seems to cause the muscles around the prostate gland to contract and makes urination difficult.  Instead take a blanket or a cushion. Your prostate gland will be glad that you did.

If you bike ride, especially for long distances, stand on the pedals every 10 or 15 minutes to take the pressure off of your prostate gland.  Also consider using a seat that has a groove down the middle which alleviates the pressure on your prostate gland.

Bottom Line: These steps won’t cure the enlarged prostate but they will lessen the symptoms.  If they don’t help, see your doctor for medication one of the treatments that reduces the obstruction of your prostate gland.