Prostate cancer is the most common cancer diagnosed in Australia and is the third most common cause of cancer death. 85% of cases are diagnosed in men over the age of 65, however there are unfortunately no reliable screening methods for detecting the development of this cancer at present. Non-specific symptoms such as frequent urination (particularly at night) especially with accompanying pain, blood in the urine or a weak stream, and other general symptoms such as unexplained weight loss, bone pain, or fatigue may all indicate the need for further testing.
Treatment for prostate cancer usually involves one or a combination of the following treatments: surgery, radiation therapy, or androgen lowering therapy. The use of androgen (specifically testosterone) lowering agents has evolved from observations in the 1960’s that physical castration in patients who had been diagnosed with prostate cancer resulted in shrinkage and in many cases disappearance of the cancer. Further research saw the development of synthetic estrogenic agents that could effectively lower circulating testosterone to the point of mimicking androgen levels of castrated men. Other chemical agents have since been developed that can also effectively lower testosterone to these levels, and are widely used in the treatment of prostate cancer.
Unfortunately evidence of the effectiveness of the use of androgen lowering therapy in prostate cancer patients to extend survival rates is limited. Furthermore, there are many anecdotal reports of the use of androgen lowering agents as monotherapy in prostate cancer causing a worsening of survival rates over the long term.
Relatively recent research is starting to uncover what many naturopaths and functional medicine practitioners have known for decades – that prostate cancer is much more likely to be caused by an excess of oestrogen than an excess of testosterone. It seems however that both hormones must be present to initiate a cancerous change, and this makes sense when the mechanism of action is examined. Excessive oestrogens encourage androgens in the male to mutate into the potentially cancer promoting dihydrotestosterone (think of DHT as ‘unhealthy’ testosterone) rather than the functional healthy form.
This also explains why you will see a shrinkage of the cancer when androgens & testosterone are temporarily removed from the system – there is no substrate left for the oestrogen to work upon and turn into DHT. However this removal of testosterone also further throws out the balance of hormones so that the patient becomes heavily oestrogen dominant. When the course of treatment is finished and the body starts to make testosterone again, conversion to DHT ramps up to levels even higher than before treatment and the likelihood of another cancer forming increases dramatically.
The effectiveness of physical castration seen in the 1960’s also makes sense in light of the information above. Castration permanently removes the predominant source of testosterone in the body, thus levels of this hormone never again rise to levels capable of converting into significant amounts of DHT. Now I’m certainly not advocating for a reintroduction of physical castration as a front line treatment for prostate cancer (my legs are crossed as I type this!). A far more sensible option would be to screen every prostate cancer patient for their hormone levels at the beginning of treatment. If their oestrogen levels are high (and I suspect they almost always would be), then a course of treatment designed to lower these oestrogens and promote the development of healthy testosterone would be advisable.
Of course should this approach ever be adopted by conventional medicine, pharmaceutical companies will rush to develop (or repurpose) a drug that can either remove oestrogen rapidly from the body or block its ability to stimulate its receptors. This would inevitably result in a raft of side effects and complications that would likely result in the co-prescription of other drugs to mitigate these effects (the pharmaceutical industry certainly have developed a robust business model for maximising profits).
Luckily for those who are willing to do some research and embrace a more natural and healthy approach, there are some excellent holistic therapies that can safely lower oestrogens in the body without any adverse effects. In fact the pharmaceutical approach of introducing synthetic oestrogens into the body was partially founded upon the observation that in Japan men who consumed a traditional diet high in phyto-oestrogen (plant forms of oestrogen) containing soy products had much lower incidence of prostate cancer. The misguided assumption was that these phyto-oestrogens protected from cancer development by balancing and lowering testosterone, when in actual fact their effect is to latch on to and more weakly stimulate oestrogen receptors in the body than more powerful self-produced (or synthetically introduced) oestrogens. Thus the more harmful oestrogens are effectively taken out of action and are unable to stimulate the DHT production.
Other agents that may be used to clear excessive oestrogens include indole-3-carbinol, milk thistle, curcumin, and green tea.
Of course prevention is far better than cure, and the following (although by no means exhaustive) list comprises some of my recommendations for decreasing the pool of circulating oestrogens in my male patients:
- Lose weight and maintain a healthy muscle mass: adipose tissue has been demonstrated to become an endocrine gland when present in excess, and the predominant hormone it produces is oestrogen. Lean muscle on the other hand is an excellent promoter of healthy testosterone production.
- Avoid the use of plastics: these are the predominant source of xeno-oestrogens, synthetic oestrogenic compounds in our environment. Use stainless steel or glass containers for your drinking water, and never heat food stored in a plastic container in a microwave.
- Avoid the use of commercial household cleaning products: many of these off the shelf items contain xeno-oestrogens (amongst many other health destroying chemicals). Use natural, environmentally friendly products that do not contain man made chemicals.
- Eat organic foods as much as possible: many of the chemicals sprayed on food crops have hormone disrupting properties. Conventionally raised animals are often injected with vast quantities of hormone disrupting agents and chemicals.
- Support your liver: this is your primary organ for clearing oestrogenic compounds from your body. Avoid excessive use of alcohol, tobacco and pharmaceutical drugs. I use a liver detox protocol with many of my patients to help restore function in the liver and clear stagnant chemicals and metabolites.
I hope this helps you to think outside the square when it comes to treating prostate cancer, or even better helps you to make changes now to minimise the risk of developing this condition in the future.
In wellness,
James
