Excessive masturbation can weaken the immune system

Prostate Cancer (Prostate Cancer) Prevention

The sometimes quite contradicting results are briefly summarized below. It should be kept in mind that a man's individual risk of prostate cancer cannot be precisely determined. In addition, while a certain measure may be useful in preventing prostate cancer, it may increase the risk of other malignant tumors or other serious diseases (e.g. cardiovascular system). This is all the more serious as it is principally healthy men and not patients who take these measures to maintain their health in the long term.

Selenium: offal, mushrooms, nuts and wheat

The trace element selenium (Se), in combination with certain enzymes, protects important compounds in the body from oxidation by free oxygen radicals, i.e. from damage by dangerous oxygen compounds. The best sources are offal (kidney), mushrooms, nuts (especially Brazil nuts), wheat (whole grains, bran, germs), fish and meat.

Until a few years ago, it was believed that both foods containing selenium and ingestion of selenium were likely to reduce the risk of prostate cancer. Recent studies suggest that as the selenium level in the blood and tissue rises, it first falls and then rises again. According to the often cited SELECT study (see also below for vitamin E), it increases slightly with an additional intake, as does the risk of diabetes mellitus, which was a reason for discontinuing this study. Overall, the studies so far do not provide any justification for recommending the intake of selenium for the prevention of cancer.

Vitamin D: cod liver oil and fish

Vitamin D is essential for the metabolism of calcium and therefore the bones. Most of the need can be produced by humans in the skin under the influence of UV light. Part of it has to be taken in with food, especially in winter: cod liver oil and fatty fish (eel, herring, sardines) have the highest content, mushrooms, milk and milk products are good sources, while plants only contain traces.

There is some evidence that the risk of prostate cancer decreases as the level of vitamin D increases. Artificial intake, however, does not seem to have any effect (for more on vitamin D, see below for milk and UV radiation).

Vitamin E: vegetable oils, nuts and flax seeds

Vitamin E also protects cells from oxidative damage and is therefore one of the antioxidants. It occurs mainly in vegetable oils (wheat germ oil, sunflower oil), flax seeds, nuts and margarine, but hardly in vegetables, fruit, grain, meat and fish.

For years it was believed that the additional intake of alpha-tocopherol (vitamin E) protects against prostate cancer, at least in smokers. This result of the ATBC study later turned out to be wrong, and according to the SELECT study the opposite is even the case: if selenium is given at the same time, the risk increases somewhat, but without selenium it increases significantly, so this study was discontinued has been. The intake of vitamin E does not prevent other forms of cancer and can increase the risk of heart failure (heart failure) and stroke.

Vitamin C: acerola and rose hips

Ascorbic acid (vitamin C) can be oxidized very easily, which is why it is often added to foods as an antioxidant. It participates in many metabolic processes, including as a radical scavenger. Fresh acerola cherries and rose hips contain by far the greatest amount of vitamin C. This is followed by fresh vegetables and fruits such as sea buckthorn (juice), black currants, parsley, paprika and broccoli, while citrus fruits are only in the lower midfield.

Contrary to previous assumptions, vitamin C probably does not protect against prostate cancer or other forms of cancer. On the other hand, there are no known dangers from overdosing.

Beta carotene: mint and carrots

In the body, beta-carotene, which is one of the carotenoids, is partially broken down into vitamin A, which is why it is also called provitamin A. It is also a powerful antioxidant and has other important effects. It colors fruits, vegetables and grains from yellow to orange and is used as a coloring agent for food. Its content is particularly high in mint, parsley, carrots, spinach, kale, broccoli and apricots.

Although beta-carotene is unlikely to have any effect on prostate cancer, an intake of up to 6 mg per day with food is recommended to protect against other forms of cancer (e.g. about 100 g of carrots or spinach). On the other hand, taking higher doses in particular could increase the risk of cancer. In the ATBC study, this did not protect smokers from tumors, but increased their risk of lung cancer and their mortality.

Lycopene: tomatoes and tomato products

Like beta-carotene (see above), lycopene is a carotenoid and an antioxidant. It occurs mainly in tomatoes and rose hips, which it gives the red color, and is used as a food coloring. The content is particularly high in tomato products (juice, sauce, soup, pulp, extract, ketchup).

According to the majority of studies, the intake of tomato and tomato products probably protects against prostate cancer, at least against tumors with a low degree of malignancy (low-grade PC, see classification of prostate cancer). The isolated intake of lycopene, on the other hand, probably has no preventive effect against prostate cancer.

Polyphenols: green tea, soy, flaxseed and red wine

Polyphenols are secondary plant substances (with no particular nutritional value) and are found in pomegranate and green tea, for example. The polyphenols include various groups of substances such as phenolic acids (e.g. caffeic acid), phytoestrogens and flavonoids:

The name phytoestrogen means plant estrogen (female sex hormone) and comes from the weak estrogen-like effect of these substances. They also have an antioxidant effect and include isoflavones and lignans. Isoflavonoids (e.g. genistein) are only found in a few plant species, particularly abundant in soybeans. Lignans, on the other hand, are widespread because they produce lignin, a component of plant cell walls; their content is particularly high in flaxseed and whole grain cereals. Flavonoids (e.g. quercetin, anthocyanins) are also often found, especially in onions, kale, celery, dark berries (including red wine) and black tea, which color them yellow, red or purple.

The high intake of polyphenols in Asian diets (especially soy) has often been associated with the low incidence of prostate cancer in Asians. It has not yet been proven that polyphenols protect against prostate cancer. However, numerous effects on hormone metabolism and other processes that are important for the development and growth of malignant tumors can be demonstrated. This includes an inhibition of the enzyme 5-alpha reductase. This has led to the investigation of drugs with a corresponding effect (see below). However, there is also evidence that soy and soy products can lower sperm counts.

Meat: red or white?

Meat provides the body with important nutrients such as protein, vitamin B12 and iron. Much more meat is consumed in the USA and Europe than in Asia, although excessive consumption is considered unhealthy because of the fat content, especially saturated fatty acids (see next section).

According to recent studies, red meat (e.g. from beef, pork, lamb, game) and processed meat (mostly red; smoked, cured, salted or otherwise preserved; e.g. sausage) increase the risk of numerous malignant tumors, in particular for colon cancer, but also for prostate cancer. That is why there are also recommendations (see below). White meat (poultry, including turkey) does not seem to have these disadvantages. Which ingredients are responsible for this is still unknown. Preservatives (e.g. nitrate, nitrite) and substances that are formed when the food is heated to a great extent (e.g. searing) are suspected.

Fats: animal fats and omega-3 fatty acids

Animal fats mainly contain saturated fatty acids, whereas vegetable fats contain unsaturated ones. In contrast to polyunsaturated fatty acids, the body can partially produce monounsaturated fatty acids (e.g. oleic acid) itself. They are found mainly in olive oil, but also in peanut, rapeseed and safflower oil. Polyunsaturated, for example, are linoleic acid (especially in grain, safflower, rapeseed and soybean oil), linolenic acid (a so-called omega-3 fatty acid, especially in purslane and other green leafy vegetables such as spinach, lentils and walnuts) and other omega -3 fatty acids (especially in fatty fish and fish oil).

The effects of these fatty acids are complex. For example, omega-3 fatty acids have an anti-inflammatory effect. Overall, unsaturated fatty acids are said to be healthier than saturated ones. The relationship between fat consumption and the risk of prostate cancer is controversial. Polyunsaturated fatty acids may lower the risk, but linolenic acid could also increase it. In any case, Asian food contains significantly less animal fat and overall less fat than European and North American food. Animal fats could also increase the risk of other malignant tumors (e.g. colon cancer). Since fat has a particularly high energy density (many calories), consumption has a strong influence on body weight (see below).

Milk and dairy products: calcium for the bones

It is well known that milk and milk products are the most important suppliers of calcium and contain other healthy nutrients (e.g. vitamin B12). However, as they are consumed, the risk of prostate cancer also appears to increase.

It is still unclear which ingredients are responsible for this effect. There is a lot to be said for calcium. It is important for the functioning of bones and muscles and is therefore considered healthy. However, a high intake reduces the activation of vitamin D (see above), which influences the bone metabolism. And with a calcium-rich diet, as found in the western industrialized countries, the risk of prostate cancer increases significantly with the intake, according to most studies.

UV radiation: sun, black light and solarium

Sunlight promotes wellbeing, and the ultraviolet radiation it contains promotes the formation of vitamin D in the skin (see above). Perhaps the latter is the reason why prostate cancer occurs more frequently in northern Europe than in the sunnier southern Europe (see also frequency of prostate cancer). Thus, UV light, which is also used as black light and in solariums, would protect against prostate cancer. However, it also increases the risk of skin cancer, which is why one should only expose oneself to this radiation to a limited extent and should be warned about it.

Movement: sport instead of sitting

The predominantly sedentary lifestyle of residents of industrialized countries today is said to promote numerous diseases of civilization obesity (significant overweight, see also the next section), diabetes mellitus (diabetes), hypertension (high blood pressure), coronary heart disease (coronary artery narrowing) and osteoporosis (bone loss).

Many studies suggest that exercise and sport not only reduce the risk of these diseases, but also of various forms of cancer (e.g. colon cancer). This is the reason to include physical activity in these recommendations (see below). Studies on prostate cancer showed either no effect or a reduction in the risk of aggressive or advanced forms.

Body weight: BMI and unhealthy belly fat

The body weight depends primarily on the energy intake and thus in particular on the consumption of fat. Overweight is expressed in an increased BMI (body mass index, increased from 25 kg / sqm, more on this in the lexicon under overweight). It is considered a risk factor for diabetes mellitus (diabetes), cardiovascular diseases and various forms of cancer (e.g. colon cancer), especially if there are large accumulations of fat in or on the abdomen. Therefore, reducing obesity is also part of the recommendations (see below).

Studies on prostate cancer show inconsistent results. There is some evidence that the risk increases with the BMI, at least for aggressive and advanced forms. This could be explained by the fact that adipose tissue influences hormone metabolism. The reason could also be that the tumors are only discovered later. Because if you are significantly overweight, the PSA value is slightly lower and the prostate is larger than with normal weight, so that a prostate biopsy is carried out later, only when the PSA value rises, and the focus of the cancer tends to be missed (see also in the magazine: Overweight can diagnose prostate cancer delay).

Alcohol: at most in moderation

Alcohol does not seem to affect the risk of prostate cancer, but it does affect other forms of cancer (e.g. colon cancer). It has a high energy density (many calories) and can therefore increase body weight (see above). Excessive consumption can also have other serious consequences, including for the liver. That is why there are also recommendations for intake (see below). It is controversial today that low alcohol consumption protects against heart disease, for example. Conversely, however, it could not be proven that it does any harm.

Smoking: unhealthy anyway!

There are contradicting results on the role of smoking. According to the ATBC study, it slightly increases the risk of prostate cancer, according to another study it increases the risk of an advanced tumor. It is certain that smoking causes lung cancer and can lead to bladder cancer, kidney cancer and chronic obstructive pulmonary disease (COPD), for example. So become a non-smoker!

Sex life

Sex life is unlikely to affect prostate cancer risk. According to more recent (not very informative!) Studies, frequent masturbation at a young age (20-39) could increase the risk.

Multivitamin supplements and other combinations

Such preparations, which are legally defined as food, contain nutrients and other substances in high concentrations. However, you should urgently warn against uncritical ingestion. Because there is a risk of serious health consequences, for example through overdosing, through interactions with medication or when certain individual factors are present (e.g. lung cancer risk from beta-carotene in smokers, see above).

Additionally, while one ingredient may protect against prostate cancer, another could increase your risk, including another disease. The interaction of several substances cannot be predicted with certainty based on the current state of knowledge. Under no circumstances, according to the health authorities in the USA, should several preparations be taken at the same time. Please inform yourself carefully before taking it and seek advice, preferably from your doctor.

5-alpha reductase inhibitors and other drugs

5-alpha reductase inhibitors (5ARI) inhibit the enzyme 5-alpha reductase, which converts testosterone into its most effective form, dihydrotestosterone (DHT), also in the prostate. The two active ingredients finasteride and dutasteride as well as extracts from the fruits of the saw palmetto (saw palmetto, Serenoa repens, Sabal serrulata), all of which are used against benign prostate enlargement (see drugs for BPD treatment), have such an effect. Phytoestrogens (see above) also inhibit this enzyme.

Because the 5-alpha reductase activity in the prostate is particularly low in Asians and they rarely develop prostate cancer (see also frequency of prostate cancer), studies were carried out with the inhibitors. Thereafter, taking 5ARI reduces the frequency of the detection of prostate cancer and its precursors, high-grade prostatic intraepithelial neoplasia (HG-PIN). However, there are no data on the effect on mortality. 5ARI also lower the PSA value, which delays the diagnosis and could (partially) explain these results. In the case of preventive administration, careful consideration must be given to the expected benefit and possible harm. Because it is healthy men who take the drug and therefore have to reckon with undesirable effects. In Germany, 5ARIs are not approved for the prevention of prostate cancer.

Numerous other active ingredients are currently being tested for their preventive effects, for example NSAIDs (non-steroidal anti-inflammatory drugs such as acetylsalicylic acid), receptor modulators (SERM) and statins (see also in the magazine: Statins and the prevention of prostate cancer). However, an exact assessment is not yet possible and final results are pending.

Recommendations for preventing cancer

According to the current interdisciplinary German prostate cancer guideline (S3), men should be advised about a healthy lifestyle, including diet, physical activity and their psychosocial (emotional and social) situation. For the prevention of cancer and other diseases, the authors recommend following the guideline of the American Cancer Society (ACS):

  • Aim for a healthy weight: find a balance between energy intake and physical activity, reduce excess weight by avoiding sugar (e.g. cakes, ice cream, sweetened drinks), saturated fats and alcohol
  • Be physically active: At least 30, better 45-60 minutes of moderate to vigorous exertion (e.g. by walking quickly or jogging) in addition to everyday activities on at least five days a week
  • Eat a healthy diet with an emphasis on plant-based products: Different fruits and vegetables every day, whole grains rather than white flour, few meat products and red meat
  • Reduce your alcohol consumption: no more than two alcoholic drinks per day (24 g alcohol; 1 drink = 0.33 l 5% beer or 0.14 l 12% wine)

The recommendations in the World Cancer Report are largely in line with this, but include a few other points:

  • Keep yourself as lean as possible within normal body weight
  • Be physically active in your daily life
  • Limit your intake of foods with a high energy density, avoid sugary drinks
  • Eat mostly plant-based foods
  • Limit your red meat intake, avoid processed meat
  • Limit your alcohol consumption
  • Limit your salt intake, avoid moldy grains and moldy legumes
  • Try to get the nutrients you need through your diet only (not supplements)
  • Follow these recommendations even after suffering from cancer

Conclusion: healthy lifestyle with Mediterranean and Asian food

In summary, no single substance appears to be able to effectively prevent prostate cancer if it is administered artificially. In contrast, vitamin D, lycopene, phytoestrogens and polyunsaturated fatty acids in natural foods show positive effects. Perhaps these substances only work together with other ingredients, but other, as yet unknown substances in these foods may also be responsible for the effect.

To prevent prostate cancer and other diseases, we recommend leading a healthy lifestyle with plenty of exercise and avoiding obesity, smoking, too much alcohol and excessive UV radiation. The diet should be rich in vitamins, minerals and fiber as well as balanced and wholesome: lots of fresh fruit and vegetables, sufficient grain and fish, little meat and animal fats. A Mediterranean and Asian diet are best suited for this.