By Dr. Mercola
Prostate cancer is one of the most common cancers in men. According to the latest statistics, about 181,000 men get diagnosed with prostate cancer every year in the U.S.
However, while common, it has a survival rate of about 86 percent. Of those diagnosed, about 26,000 die from the disease each year.1
Unfortunately, conventional diagnostics and treatment options for prostate cancer leave much to be desired. Conventional diagnosis includes PSA testing and biopsy, which are prone to false positives and carry risks of side effects.
Treatment typically involves drugs, surgery and/or radiation, all of which are risky. There ARE safer, less invasive ways to diagnose and treat prostate cancer, however, so men would be wise to investigate their options.
Last year, I interviewed award-winning filmmaker and prostate cancer survivor Peter Starr on this topic, which is also covered in his latest documentary, "Surviving Prostate Cancer Without Surgery, Drugs or Radiation."2
A number of safe and all-natural strategies have been shown effective against prostate cancer, including nutritional ketosis, exercise and supplements. Most recently, researchers discovered a bioactive compound in the neem plant (Azadirachta indica) appears to have potent ability to quell prostate cancer.
Neem Has a Long History of Medicinal Use
Neem has been used in Ayurvedic medicine for thousands of years, and the ancient Vedas refer to neem as a tree "capable of curing every illness." It has well-established benefits for your skin, and is commonly used in personal care products.3
It also is used to ease gastrointestinal problems and strengthen immune function, and as both a spermicide and an insect repellent. As noted in the Biojournal of Science and Technology (BJST):4
"[Neem's] leaves, barks, fruits, seeds and roots contain compounds with proven anti-inflammatory, anti-pyretic, anti-histamine, anti-fungal, antibacterial, anti-ulcer, analgesic, anti-arrhythmic, anti-tubercular, anti-malarial, diuretic, spermicide, anti-arthritic, anti-protozoal, insect repellant, anti-feedant, anti-hormonal properties and anti-cancerous uses. …
From various research articles it can be presumed that [neem] has chemopreventive and chemotherapeutic potential against cancer models … [including] acting against the breast cancer cells, against gastrointestinal tract and associated cancers … [and] ovary cancer cells."
Neem May Be a Potent Ally Against Prostate Cancer
Now, animal research suggests nimbolide — a bioactive terpenoid compound found in neem — may shrink prostate tumors by as much as 70 percent, and suppress metastasis by about 50 percent when taken orally for three months.5,6,7,8 No noticeable side effects were observed.
According to lead researcher Gautam Sethi, Ph.D., associate professor of pharmacology at the Yong Loo Lin School of Medicine at the National University of Singapore:9
"Although the diverse anti-cancer effects of nimbolide have been reported in different cancer types, its potential effects on prostate cancer initiation and progression have not been demonstrated in scientific studies.
In this research, we have demonstrated that nimbolide can inhibit tumor cell viability — a cellular process that directly affects the ability of a cell to proliferate, grow, divide or repair damaged cell components — and induce programmed cell death in prostate cancer cells …
[A] direct target of nimbolide in prostate cancer is glutathione reductase, an enzyme which is responsible for maintaining the antioxidant system that regulates the STAT3 gene in the body.
The activation of the STAT3 gene has been reported to contribute to prostate tumor growth and metastasis. We have found that nimbolide can substantially inhibit STAT3 activation and thereby abrogating the growth and metastasis of prostate tumor."
Other Research Supporting Neem as an Anti-Cancer Aid
While exceptionally promising in rodents, nimbolide has not yet been tested in humans, so further research will be required. The team intends to continue investigating the compound to evaluate its efficacy in combination with commonly used prostate cancer drugs as well.
That said, consuming neem either in supplement or tea form will automatically provide nimbolide.
Even though the whole herb will provide only a small amount of nimbolide (compared to the straight compound given to the animals in this study), previous research has indeed found neem extract to be useful against prostate cancer. In 2006, researchers reported that:10
"[A]n ethanolic extract of neem has been shown to cause cell death of prostate cancer cells … by inducing apoptosis as evidenced by a dose-dependent increase in DNA fragmentation and a decrease in cell viability … So the neem extract could be potentially effective against prostate cancer … "
Lifestyle and Prostate Cancer
Treating and preventing prostate cancer (and other cancers) requires more than taking a supplement. Your diet is a vital part of the healing equation and exercise is another important metabolic optimizer.
Previous research suggests losing weight can reduce your risk of prostate, breast and colon cancer by as much as 20 percent, and this effect is thought to be due to reductions in these proteins and other inflammatory compounds stored in fat cells.11
According to a 2011 study published in PLoS One,12 aggressive prostate cancer was associated with obesity.
Another cohort study published in Cancer Epidemiology, Biomarkers & Prevention13 in 2013 found that men who were overweight or obese increased their risk of prostate cancer by 57 percent.
Here, the association between obesity and prostate cancer held for all cases — low-grade and high-grade, early stage and late, nonaggressive and aggressive prostate cancer.
When it comes to exercise, research suggests maintaining a high level of cardiorespiratory fitness (CRF) in middle age helps cut men's chances of dying from prostate cancer by nearly one-third (32 percent).14,15
Exercise reduction of cancer is most likely related to improving insulin receptor sensitivity and PGC 1-alpha that increases mitochondrial biogenesis.
Optimizing your vitamin D level, which is ideally done through sensible sun exposure, is another key ingredient for cancer prevention. Vitamin D deficiency has been linked to several common cancers, including cancers of the breast, colon and prostate.
Researchers at Northwestern University Feinberg School of Medicine recently discovered that men diagnosed with aggressive prostate cancer tend to have vitamin D levels below 23 nanograms per milliliter (ng/ml). According to this study, vitamin D may actually be used as a biomarker to predict cancer:
"[B]ecause vitamin D is a biomarker for bone health and aggressiveness of other diseases, all men should check their levels, [lead investigator Dr. Adam] Murphy said. 'All men should be replenishing their vitamin D to normal levels,' Murphy said. 'It's smart preventive health care.'"
You can also improve your benefit from vitamin D by increasing your healthy levels through sensible sun exposure and not by swallowing it.
Other Important Anti-Cancer Nutrients
In addition to vitamin D, vitamin K2 appears to be a noteworthy player in prostate cancer.
German doctors evaluating the effect of vitamins K1 and K2 on the development and treatment of prostate cancer found that those who consumed the greatest amount of K2 had a 63 percent reduced incidence of advanced prostate cancer.16,17
Vitamin K1 intake did not offer any prostate benefits. Other nutrients and foods shown to influence your prostate cancer risk include (but are not limited to) the following:
• Foods rich in omega-3 fats have been shown to prevent prostate cancer from spreading.
One clinical study18 published in 2006 found that while omega-6 fats (the kind found in most vegetable oils) increased the spread of prostatic tumor cells into bone marrow, the spread of cancer cells was BLOCKED by omega-3 fats, suggesting that a diet rich in omega-3 fats could potentially inhibit the disease in men with early stage prostate cancer.
A more recent meta-analysis19 of available research, published in 2010, found that fish consumption was associated with a 63 percent reduction in prostate cancer-specific mortality, even though no association between fish consumption and a significant reduction in prostate cancer incidence could be found. This is related to the fact that toxin-free seafood is the ideal source of DHA, not omega-3 fats from plants that are poorly converted to DHA.
• Sulforaphane found in cruciferous vegetables like broccoli has been shown to cause apoptosis (programmed cell death) in prostate cancer cells.20 Three servings of broccoli per week may reduce your risk of prostate cancer by more than 60 percent.21
Supplements That Support Prostate Health
Besides neem extract, other nutritional supplements that promote prostate health may be helpful in the prevention and/or treatment of prostate cancer, such as:
• Saw palmetto. This herb is widely used to improve prostate health, and can help raise testosterone by inhibiting up-conversion to dihydrotestosterone (DHT) by as much as 40 percent.22 As explained by drug industry insider Rudi Moerck, Ph.D., (see hyperlink above), while many conventional experts believe elevated testosterone can promote prostate cancer, this risk appears more strongly correlated to the testosterone breakdown product DHT.
Testosterone levels in healthy men typically decline with age, which is one of the factors involved in prostate cancer, as your prostate gland requires testosterone to remain healthy. One doctor who is trying to re-educate people on this point is Harvard-based Dr. Abraham Morgentaler. He has meticulously demonstrated that restoring testosterone levels in aging men does not increase their risk of prostate cancer.
On the contrary, those with low testosterone are the ones at greater risk. For an interesting article that contains a lot more information about this, read Abraham Morgentaler's report "Destroying the Myth About Testosterone Replacement and Prostate Cancer."23
While the evidence is limited, a small number of laboratory studies suggest saw palmetto may be helpful against prostate cancer by targeting mitochondria, activating the apoptopic pathway and reducing inflammation.24,25
When choosing a saw palmetto supplement, be sure to look for an organic supercritical CO2 extract of saw palmetto oil, which is dark green in color. Since saw palmetto is a fat-soluble supplement, taking it with a small amount of healthy fat, such as coconut oil, MCT oil, avocado or eggs, will enhance the absorption of its nutrients.
A more recent meta-analysis of available research, published in 2010, found that fish consumption was associated with a 63 percent reduction in prostate cancer-specific mortality, even though no association between fish consumption and a significant reduction in prostate cancer incidence could be found. This is related to the fact that toxin-free seafood is the ideal source of DHA, not omega-3 fats from plants that are poorly converted to DHA.
• Astaxanthin in combination with saw palmetto. Research suggests taking astaxanthin in combination with saw palmetto can provide significant synergistic benefits. One 2009 study found that an optimal dose of saw palmetto and astaxanthin decreased both DHT and estrogen while simultaneously increasing testosterone.26
• Ashwagandha. This ancient Indian herb is known as an adaptogen, which can help boost stamina, endurance and sexual energy. Research published in 201027 found that men taking the herb Ashwagandha experienced a significant increase in testosterone levels. I recommend using only 100 percent organic Ashwagandha root, free of fillers, additives and excipients, to ensure quality.
Toxins May Increase Your Prostate Cancer Risk
Avoiding toxins is also important. As with breast cancer, many of the chemicals that are ubiquitous in our homes and environment have been shown to increase your risk of cancer. Some of the most common culprits are those that disrupt your endocrine function.
Based on a review of more than 1,300 studies, an Endocrine Society task force recently issued a new scientific statement28,29 on endocrine-disrupting chemicals, noting that everyone needs to take proactive steps to avoid them.
Similarly, a report30 co-produced by the World Health Organization (WHO) and the United Nations Environment Program (UNEP), issued in February 2014, suggests an outright ban on endocrine disrupting chemicals may be needed to protect the health of future generations.
Touted as the most comprehensive report on endocrine disrupting chemicals to date, it highlights a wide variety of health problems associated with exposure, including prostate cancer. Some of the most ubiquitous endocrine disrupters to watch out for include:
• Atrazine.31 This herbicide is the second most commonly used agricultural chemical, and one of the most common water contaminants in the U.S.Atrazine is a potent endocrine disruptor, and studies show it can chemically castrate and feminize wildlife, and may induce both prostate and breast cancer.
• Bisphenol-A and bisphenol-S (BPA and BPS). BPA, which mimics the hormone estrogen, has been linked to increased prostate size, decreased sperm production, hypospadias32 (penis deformation), erectile dysfunction33 and stimulation of prostate cancer cells.
Be aware your exposure may be far greater than you ever suspected. A 2011 study34 found that simply eating canned soup for five days increased study participants' urinary concentrations of BPA by more than 1,000 percent compared to eating freshly made soup.
Should You Get Screened for Prostate Cancer?
According to a report by the Institute of Medicine, approximately 30 percent of all medical procedures, tests and medications may be unnecessary.35 The American Academy of Family Physicians' (AAFP) "Choosing Wisely" campaign has also identified more than a dozen procedures that appear to have little value, and in many cases do more harm than good.36 Included in this list is routine screening for prostate cancer using a prostate-specific antigen (PSA) test.
The PSA test tends to result in over-diagnosis of prostate tumors, many of which are benign and do not actually require treatment. The U.S. spends $10 billion per year treating prostate cancer, but studies suggest the 30 million men who get screened annually for prostate cancer are actually put at risk due to the ridiculously high numbers of false positives.
According to the Prostate Cancer Foundation, 30 to 40 percent of men treated for prostate cancer actually have harmless tumors that would never have caused a problem.37 As noted by Dr. Jessica Herzstein, a preventive-medicine consultant and member of the U.S. Preventive Services Task Force, "You're going to die with them, not of them."
Estimates suggest 15 prostates must be removed in order to prevent just ONE prostate cancer death, and these surgical procedures carry serious side effects including impotence and incontinence.
More than half of older men have pathologic evidence of prostate cancer, so PSA screening makes little sense. The PSA is an indicator of inflammation, and inflammation can be an indicator of health problems besides prostatitis, benign prostatic hyperplasia or cancer. It's certainly not a definitive test, and should not be the sole basis for the decision to do a biopsy, as the biopsy itself can cause significant damage.
One alternative is to get an annual digital rectal exam. Your doctor can feel your prostate to find out whether it's hard, or whether there are noticeable nodules. Then, rather than getting a biopsy done right away, consider getting a 3D-color Doppler ultrasound done first. For more information, please see my previous article, "How to Survive Prostate Cancer Without Surgery, Drugs or Radiation."
To Prevent Cancer, Remember the Basics
Remember, your lifestyle can be more or less predictive of your cancer risk, so always start with the basics: Make sure you're eating a nutrient-dense, non-toxic diet, which basically means ditching processed foods and focusing your diet around whole, fresh foods, ideally organically grown to avoid toxic pesticides that can increase your cancer risk.
Avoid animal products from concentrated animal feeding operations (CAFOs), as these animals are routinely raised with hormones, antibiotics and glyphosate-contaminated genetically engineered (GE) grains. Processed foods in general are anathema to good health, but particularly when you're trying to prevent or heal cancer.
If a toxicology screen reveals high amounts of toxins in your body, a detoxification program would be in order. My absolute favorite form of detox is a full spectrum infrared sauna that has near-infrared frequencies and low EMF. Most infrared saunas have only far-infrared and are high in EMF. I believe selecting a sauna that keeps your head out of the heat is also important and I am working on developing one that meets this spec early next year.
You may also want to do a saliva panel to check your hormone levels. Low testosterone and/or excessive estrogen may be factors that need to be corrected. For low testosterone, you could start out with herbal supplements, high intensity exercise and/or intermittent fasting rather than jumping right into testosterone replacement therapy.
Also remember to check your vitamin D. For optimal health and cancer prevention, make sure you maintain a clinically relevant level of 40 to 60 ng/ml year-round. If you already have cancer, you may want to consider an even higher level.
You Can Prevent, and Beat, Prostate Cancer
Checking for insulin resistance goes along with your dietary intervention. If you're insulin resistant, you need to be particularly careful about cutting down on sugar, ideally limiting your total fructose consumption from all sources to less than 15 grams per day. Thankfully, nutritional ketosis is one of the best ways to improve your insulin receptor sensitivity.
If you are overweight, you can use fasting as a very powerful therapeutic tool and the best resource for that is Dr. Jason Fung's book "The Complete Guide to Fasting." I would strongly encourage you to listen to my recent interview with Fung.
Another powerful tool to maintain nutritional ketosis is intermittent fasting. Nutritional ketosis is not something you maintain for your entire life, but is part of a feast and famine cycling that allows your body to repair and regenerate while maintaining its ability to burn fat.
Once you've cleaned up your diet, adding certain herbal supplements such as saw palmetto (with or without astaxanthin) and Ashwagandha may help support your prostate health.
These are just some suggestions that can minimize your risk of prostate cancer and help treat it should you be diagnosed. There are many others. For example, increasing selenium and magnesium while decreasing calcium may reduce your prostate cancer risk, and simple strategies such as prostate massage can be a helpful adjunct to prostate cancer treatment.
The main take-home message is that you have options when it comes to prevention, diagnostics and treatment. Also remember that, while any cancer diagnosis is distressing, when it comes to prostate cancer, you likely do have time to pursue alternative routes of treatment. Rarely is it necessary to jump right into drugs, surgery or radiation. So try not to let fear rule your decision-making process.