Prostate problems?

Gentleman managing a vegetable plot Forget the pint of bitter, or the whisky, the modern man intent on keeping his urine flowing freely into middle age and beyond would be better to have a couple of tomato juices after he goes home than a nightcap. On the other hand if he, like me, still enjoys his drink(s), he makes certain that he supplements Glenmorangie with a daily high quality lycopene capsule, or some other lycopene product, together with a reputable multivitamin and mineral supplement. He need no longer have qualms about pouring the tomato ketchup on his chips - it is the ketchup, and the lycopene it contains, which may be extending his life by providing the flavonoid antioxidants capable of keeping his prostate healthy by defeating the marauding army of free radicals which may lead to prostatic cancer.

Surprisingly, processed or cooked tomatoes render the lycopene more readily available than if eaten raw. Some forms of plant extract may possibly alleviate the symptoms of BPH but some recent investigations have suggested that female hormones may have been added to some products. Even so there is data which shows that the risks of benign enlargement of the prostate is reduced by the small amounts of natural plant oestrogen in some foods including soya.

Sunlight too is beneficial to the prostate and may reduce the likelihood of prostate cancer. Office workers may have to make do with a vitamin D supplement.

The brighter the better

Tomatoes are rich in lycopene but that they are not the only sources of the antioxidants in vegetables and fruits. In general the brighter the colour the higher the antioxidant content. Why struggle with piles of bedraggled lettuce - almost without food value - when yellow and red peppers, courgettes, chilli, broccoli, or even the humble carrot has so much more food value. Men are also well advised not only to take antioxidant vitamin rich foods, but to remain slim and to take regular brisk exercise.

The antioxidant vitamins such as carotene and lycopene are not the only supplements which are important for male health. Selenium, a trace element, which has long been known to have an important role in maintaining heart health, has more recently been shown to have a marked effect on prostatic health. I recommend that my patients should take Selenium ACE, a combination of selenium and vitamins A, C and E as well as antioxidant vitamins.

Fatty foods and a life enriched with good food and good living have been implicated as risk factors which increase the chance of prostate cancer. Prostatic cancer is rare in the fisherman who cast their nets on lonely Pacific shores but their chances of developing it increases if they migrate to the western world. The good news is that we can get some of those advantages of the simple life once enjoyed by the emigrating fishermen if we swallow Omega 3 and Omega 6 essential fatty acids. We can do this by eating oily fish a couple of times a week, or by taking fish oil supplements in capsular form.

Find me a loo!

Just as surely as most men will grow bald, grey and paunchy, so for most, the time will come, when they will have to memorise a map of the lavatories in their neighbourhood. Likewise they will make certain before they settle down to a formal dinner, or a cinema performance, that they are in a seat convenient for a quick exit to the loo. Like nearly half of all men over the age of 65 they will be showing the symptoms associated with enlargement of their prostate.

The prostate surrounds the urethra, the tube leading from the bladder to the penis and beyond, just after it leaves the bladder. It produces around half of the semen including that part of it which liquefies it so that the sperm may swim as vigorously as an Olympic athlete. It also nourishes the sperm en route to its destination - the ovum. As the prostate lies behind the root of the penis, and in front of the rectum, it is not part of the body likely to be featured on page 3, or even be talked about with your mother in law. A survey earlier this year showed that the majority of men still don’t know where to find their own prostate gland, or what its function is.

Symptoms to look for

Whether the enlargement within the prostate is benign or cancerous it produces symptoms which are the same. The man begins to notice that his urinary stream is not what it was. He finds it difficult to start and once started, it is so lacking in force that it tends to dribble over his shoes and the floor. The man is unable to stop peeing to order so that he ‘dribbles on’, and his trousers display the too frequently seen damp patch, which may reveal a medical problem that should send him hurrying to the doctor. The man with an enlarging prostate will have to urinate very frequently, hence the need for the map and a seat by the door at public occasions. When he wants to urinate there is no putting it off, he has to make a dash, and even then may be caught short. After, other men will have noticed they have finished peeing, they will still feel that the bladder is not empty. Nights may be disturbed and it is not only the man with prostate trouble whose sleep is disrupted but that of his partner and the rest of the household is also disturbed. An enlarging prostate stretches the bladder over the gland and may produce blood in the urine, as can a cancer of the prostate for rather different reasons. By the time a prostate enlarged by cancer is causing troubles the tumour may already be too big to give the best chance of a complete cure. An answer - not the perfect answer, but the best available - is the simple PSA blood test which can alert doctor and patient to the possibility of a cancer at an earlier stage.

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Dr Thomas Stuttaford

Dr Thomas Stuttaford 

Dr Thomas Stuttaford was trained in medicine at Oxford and has been the medical columnist of The Times for twenty one years. He contributes regularly to national magazines and is a frequent broadcaster. 

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