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25.10.2014 Feature Article

Why Prostate Disease Is Not Universal?

Why Prostate Disease Is Not Universal?
25.10.2014 LISTEN

I will prove to you in this Paper that prostate disease is not universal as some claims. This paper focuses on the epidemiological observations relating to the incidence and mortality of prostate cancer in Asia, and the theoretical considerations that might explain the patterns that are emerging, in particular, those relating to the effects of screening programmes(Kazuto Ito 2014)

Fig 1.Recognized data regarding prostate cancer in Asian countries.

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Source : Kazuto Ito(2014) Prostate cancer in Asian men.Nature Reviews Urology 11, 197–212

The data available on prostate cancer in many Asian countries are limited to incidence and/or mortality rates; however, additional or more detailed data have been studied in the populations of a few Asian countries, particularly in Japan, but also China, South Korea, and the Philippines. For example, stratification of serum PSA levels detected in population-based or hospital-based screening programmes by age (PSA distribution) has been performed in these countries as well as Iran, Jordan, Kuwait, Oman, and Saudi Arabia. Cancer registry data reporting the distribution of prostate cancer cases according to clinical stage are available in a limited number of Asian populations, as are data on relative, disease-specific, and/or overall survival published in international journals (survival data).

From the research trends relating to cancer prevalence can be identified within regions of Asia: stomach cancer is most frequent in North-West Asian males (except those in Turkey) and men in Japan and Korea in North-East Asia; lung cancer is most predominant in the majority of southern Asia. Israel, and specifically the Jewish Israeli population, is the only Asian country in which the most frequent cancer in men seems to be that of the prostate.

Among the 42 Asian countries or regions within Asian countries for which data are available, prostate cancer was ranked in the top three most frequent cancers, affecting men in 16 (38%). Interestingly, however, prostate cancer was one of the three most common cancers in Asian men immigrated to Hawaii or other regions of the USA, with the exception of Laotians (nine out of 10 populations assessed; 90%). According to research, prostate cancer was the most prevalent form of malignancy in seven of the 10 Asian–American groups analyzed. These data according to Kazuto Ito 2014 as well as the age-standardized incidence rates (AIRs) observed in these populations suggest that prostate cancer incidence in native Asian men is relatively low compared with other cancer types, but is substantially increased in Asians living in Westernized countries .

(Kazuto Ito 2014) data reveal a high incidence of prostate cancer in African–American and non-Hispanic white populations in the USA compared with all populations comprising individuals of Asian descent. Among Asian natives, the incidence rates of prostate cancer were highest in Israel, followed by Cyprus, Singapore, Japan, and the Philippines, which might be considered the most developed and/or Westernized Asian countries. Genetic and/or environmental differences might be major contributors to these disparities in the incidence of prostate cancer between Western populations, Westernized Asian groups, and native Asians. Indeed, a limited number of studies have investigated the impact of a Westernized diet, in particular, on the trend towards the increasing incidence of prostate cancer in Asians. Nevertheless according to Kazuto Ito 2014, genetic features and environmental exposures, such as diet, might not differ substantially within the same region in Asia. Of note, therefore, the incidence of prostate cancer in Iraq in 2005 was more than 40-fold lower than the rate observed in Cyprus between 1998–2002, despite the fact that these countries are both located in North-Western Asia. Furthermore Kazuto Ito 2014, AIRs of prostate cancer in the North-East Asian countries of Mongolia and Japan differed by over 50-fold in 2004. However, the effect of genetic and environmental factors is complex, and these influences probably vary considerably even between populations that are in close geographical proximity owing to variation in origins and histories, and continued cultural differences; thus, genetic and environmental factors might remain key factors in the huge discrepancies in AIRs of prostate cancer among these countries. In fact, countries that might share greater similarity in cultures and origins (such as Japan and Korea, or Iraq and Iran) generally had similar AIRs of prostate cancer (Kazuto Ito 2014).

Diets and Prostate Cancer Connection
The western lifestyle is a major cause of prostate cancer, and lifestyle factor most likely responsible is diet, “says Dr. Bill Nelson, an oncologist with Brady Urological Institute at Johns Hopkins Medical Institutions in Baltimore. “ The western diet has long been thought to be too rich in animal fats and meats and too poor in fruits and vegetables”.

Nelson, pioneer in the study of diet as preventive medicine, was the first scientist to discover that an enzyme calledglutathione-S transferase p is responsible for protecting the body against prostate cancer. “When a man develops prostate cancer, it is the result of potentially toxic agents overtaking and destroying this helpful enzyme, “explains. The result is that prostate cells become vulnerable to cancer because they no longer have adequate protection. “Without the cancer-fighting enzyme, the cells are less able to detoxify the carcinogens.”

Nelson's research led him to believe that diet is responsible, at least in part, for both the toxic agents that develop within the body and the wearing down of its protective enzymes. That revelation, in turn , prompted him to study whether or not glutathione-S transferase p might be stimulated by certain nutrients and , thus more able to fend off prostate cancer!

You are what you eat and this is why Asian men have less prostate cancer incidence in the world! The answer to prostate cancer may be close as your dinner table!!

One promising cancer -fighting nutrient is lycopene, an antioxidant found in tomatoes. Pink grapefruit, papaya, aspricots and watermelon. According to a recent study conducted by Dr. Edward L. Giovannucci, a researcher and associate professor of medicine at Harvard edical School in Boston , two or more servings of tomatoes sauce per week were associated with a 35percent reduced risk of prostate cancer. “Lycopene is thought to protect against cancer by absorbing free radicals, “he explains. Free radicals are chemicals created during metabolism that can damage the genetic architecture of cells and likely lead to cancer. “ You absorb five times as much lycopene from a paste or a sauce as you do from the tomatoes in its raw form. The processing releases more of the powerful antioxidant .

Nelson interest is that lycopene-unlike many other substances-actually manages to reach the prostate gland.” You can't say that about everything you swallow,” he says, including some antibiotics as well as many nutritional supplements.

Another promising cancer-fighting nutrient is selenium. A trace mineral found in a variety of foods including, tuna, oysters, flounder, chicken, brown rice, oatmeal, eggs and brazil nuts, which pack a whopping 840micrograms per one-ounceservings. Nelson's research found that selenium levels in the blood drop in all men over time, regardless of whether or not they have prostate cancer. Conversely, no other cancer increases more rapidly with age than prostate cancer.Nelson and other Johns Hopkins researchers began to wonder if there might be a correlation.

As it turns out, there is. In a recent Johns Hopkins study, men with the lowest of selenium were the most likely to develop prostate cancer, while men with the highest levels were 50percent less likely to develop prostate cancer. “Selenium is an essential part of glutathione peroxidase, another enzyme that helps the body fight off potentially toxic substances,” says Nelson.

“There is a strong evidence that selenium supplementation could reduce the number of people diagnosed with prostate cancer”.

What is more interesting is that selenium may make a difference in a relatively short period of time –often within few years. “You can take it later in life and still potentially change the course of the disease, he says.

Vitamin E also may reduce prostate cancer risk. Vitamin E is a fat-soluble antioxidant found in variety of foods such as wheat germ oil, safflower oil, soyabean oil, almonds, peanuts, asparagus, and broccoli, spinach and turnip greens. A recent study by the Memorial Sloan-Kettering Cancer Center in New York found that men, who had higher blood levels of vitamin E, were significantly less likely to develop prostate cancer. In another study from Finland, men who took a daily vitamin E supplement for up to eight years had almost half the deaths from prostate cancer as other men

Supplements
It is best to get adequate amount of certain vitamins, minerals and other nutrients, popping pills isn't the best way to do it says, McCauley. “It's always preferable to get nutrients through the foods you eat. The absorption is higher.” But she admits it not always possible to get enough of a particular nutrient through food alone. Supplementation can make a difference! But however, single supplementation is not the good practice. She warns. Nutritional supplements should be taken in conjunction with a high-quality multivitamin, which ensures better absorption.”

Well how much is enough? The RDA, or require daily allowance, doesn't always provide the proper guideline for particular vitamin or mineral, she notes. RDA for selenium is 70 micrograms, but most nutritionist advocate taking more, typically 200micrograms per day.

VitaminE , RDA of 15 international units(IU) is woefully inadequate according to McCauley, who recommends dosages of 400 to 800 IU per day. She advises to purchase the natural source that contains tocopherol blend rather than a synthetic version because it much easier absorb.

She doesn't recommend lycopene supplements because she thinks they are too difficult to be metabolize and besides it's easier to get them in food. One glass of tomato juice every morning provides a lot of protection,” she says.

Nelson also advice on why we don't have to fire up the grill! He said, when meat is cooked on a charcoal grill, cancer-causing agents form. He said one of the agents, PhIP, although not chemically very reactive on its own, it transformed in the liver into a chemical that attacks prostate cell DNA. Charred meat is bad.” He says. If you can't imagine life without a grilled ribeye or New York strip, at least follow a few basic guidelines, McCauley suggests. Choose a high quality lean cut of meal, and buy smaller portions. Also microwave the meat for a couple of minutes before throwing it on the grill, and turn it several times while cooking.” That minimizes charring and smoke exposure,” she says

So you see black men it appears we are causing our own prostate woes! Diet has now become one of the major prostate cancer disparities in the black communities. (Erin L et al 2013)Researchers looked at the diets of 4,577 men diagnosed with prostate cancer that had not metastasized. Using data from food questionnaires, the researchers estimated how much fat and what types of fat each man ate.

Men who consumed the most fat from vegetable sources after being diagnosed with prostate cancer were least likely to have the disease progress and become deadly. The main sources of vegetable fats in their diets were oils (such as olive oil) and nuts. The authors estimate that replacing 10 percent of calories consumed in the form of carbohydrates (such as white bread, white rice or soda) with vegetable fats could lower the risk for lethal prostate cancer by 29 percent.

Ronald M Bazar author of the book Healthy Prostate lamented on why are so many elderly people so unhealthy and reliant on drugs? Why have chronic disease and the loss of functional mobility become so rampant among the elderly? Why are we not vital until old age like the Okinawans of Japan who live and work to a very old age with none of the awful health problems of most of our elderly?

From research it appears that the food we eat has no immediate effect. However, the cumulative result of poor food choices adds up over time and takes its toll. We cannot discharge all the toxins quickly enough and, as a result, we develop health problems as we age. It is clear what causes prostate diseases. It's also clear that natural health choices begin the healing process.

Prostate problems are rare in cultures that eat traditional, natural foods. Men's prostate health requires healthy, natural food choices.

Poor prostate health results not from the fact that we live longer as some researchers would have you believe, but from accumulating toxins from our modern devitalized non-food products (e.g., chips, commercial dairy and meat, and instant foods). Time and repetition of poor food choices takes its toll. Guaranteed. That's why we have an epidemic of prostate disease in the black communities.

In a study of black men in Soweto(Walker et al 1992) according to the authors regarding the future trend of prostate cancer in the South African black population, inevitably there will be increases. This population, both in rural and in urban areas, is highly partial to the Western diet and when enabled with rising prosperity, readily forsakes the traditional diet (Segal &Walker, 1986). Only the high cost of meat and dairy produce limits their consumptions. Already in the more prosperous segments of urban blacks, fat supplies 35% or more of energy. Was it not that brown bread is cheaper (from State subsidization) than white, the latter would be the more popular choice.

Most studies of the relationships between diet and prostate cancer have originated from Western countries. A systematic review of the associations between diet and cancer, published by the World Cancer Research Fund and the American Institute for Cancer Research in 2007, demonstrated that foods containing lycopene or selenium, and purified selenium supplements, which have antioxidant effects, probably decrease the risk of prostate cancer, whereas pulses (legumes) and foods containing vitamin E or the related α-tocopherol might also have a limited role in preventing prostate cancer. The authors also stated that ingesting high levels of calcium probably increases the risk of prostate cancer, and that processed meat, milk, and dairy products might have at least a partial role in the development of prostate cancer. As the effects of long-term dietary exposures and underlying genetic susceptibility on the risk of prostate cancer might differ between ethnic groups, an original study to investigate the potential protective effects of an Asian diet and the converse role of a Western diet should be conducted in Asian individuals. Although well-designed prospective or informative retrospective studies investigating this aspect are limited at present, particularly in Asian populations, the impact of isoflavones, soybeans, tofu, and green tea on the development of prostate cancer in such individuals has been investigated(Kazuto Ito 2014)

A meta-analysis of data from three prospective cohort studies and one case–control study in Japanese individuals, two case–control studies in Chinese cohorts, and one prospective cohort study in an American population found that Asian individuals who consumed green tea more frequently had a decreased risk of developing prostate cancer compared with Asian people who consumed green tea less frequently (OR 0.62; 95% CI 0.39–1.01).

However, no relationship with the risk of developing prostate cancer was observed in the American cohort who had ever consumed green tea compared with the population who had never consumed green tea (OR 1.47; 95% CI 0.99–2.19). In the seven studies analysed, the levels of exposure to green tea in the high-exposure groups varied from 'ever' to >10 cups per day, and consumption of green tea also varied in the low-exposure groups from 'never' to ≤1 cup per day. Thus, the observed influence of green tea in Asian and Western populations has limitations and, therefore, the effect of this dietary factor remains uncertain.

The effect of soy consumption on the development of prostate cancer has also been analyzed in a meta-analysis that included eight studies on isoflavone consumption, eight studies on consumption of nonfermented soy foods, and six studies on consumption of fermented soy foods, which were conducted in the USA, European countries, China, and Japan. The Prostate Cancer Foundation says we believe that diet causes prostate cancer.

RAPHAEL NYARKOTEY OBU: ND
The writer is a registered Naturopathic Oncologist and CEO of De Men's Clinic & Prostate Research Lab and Founder of Men's Health Foundation Ghana. We lead change, campaign for better services for men and we believe men deserve better treatments for prostate cancer. Tel :0541090045

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