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Stephan L. Werner, M.D., F.A.C.S The incidence of prostate cancer varies greatly between various areas of the world with the greatest incidence in the developed western nations and much lower incidence in Africa and the Far East. The debate over the influence of genetics versus life style has become heavily weighted towards life style causes by the high incidence of prostate cancer in African Americans as compared to native Africans, and to the rising rate of prostate cancer in second and third generation Asian Americans. Prostate cancer is very rare in Asia, but is becoming much more frequent as more native Asians adopt a western style diet. Until recently there was were no known preventative medications, only alternative options. In 2009 a major gateway was passed: Prostate Cancer Prevention with 5-ARIs Recent guidelines released by ASCO (American Society of Clinical Oncology) and the AUA (American Urological Association), suggest that the use of 5-ARI’s for the reduction of the incidence of prostate cancer (PCA) should be discussed with patients. The group suggested is men over 50 with PSA £3 who are undergoing or considering on-going prostate monitoring, (annual PSA + digital rectal examination), for prostate cancer. 5-ARIs currently available, finasteride, (Proscar™, Propecia™) and dutasteride, (Avodart™), are used for reduction of benign prostate enlargement, (BPH), lower urinary tract symptoms, (LUTS), and hair loss. The recent Prostate Cancer Prevention Trial (PCPT), showed that over 7 years, the use of finasteride decreased the incidence of PCA from 24.4% to 18.4%, (25% decrease) compared to placebo. The committees reviewed 15 studies in creating the guidelines 5-ARIs shrink benign prostatic tissue, sometimes improving urine flow and reducing PSA levels. 5-ARIs also decrease the incidence of low grade (Gleason grade <7) PCA while seeming to increase the incidence of higher grade prostate cancers. (Gleason grade >6) from 22% to 37% of cancers found. This increase is probably artificial. The amount of benign tissue decreases, so the likelihood of finding PCA increases; more nodules can be felt on examination and failure of PSA to drop significantly leads to more biopsies; a higher percentage of biopsies are likely to find cancer, (a needle in a bale of hay as opposed to a haystack); and there are fewer low grade cancers. 2-4% of patients on 5-ARIs report increased erectile dysfunction or gynecomastia, (growth of breast tissue), and decreases in semen volume and libido although these effects decreased with time. 6-7% of patients discontinued the medication due to side effects. There is no data on the effect of 5-ARIs on the incidence of prostate cancer beyond 7 years, nor whether 5-ARIs reduce cancer mortality or increase life expectancy. Stephan L. Werner, MD, DABU Jack D. Francis, MD, DABU © werner-francis urology assoc. llc. 2009 Permission is hereby granted to copy and distribute only in its entirety.
Alternative Options
We provide the following information for your evaluation, and make no recommendations as to your use of it. In the use of natural or food products preparation may play a great role. With the exception of Theralogix Prostate 2.3, we cannot advise you on the sources, effectiveness, purity or preparation of any of the below. Please do not ask us. While there is little data, for use of these factors in treatment of PCa, there is no reason to believe they would not help. Low Fat Diet Diets high in animal fats, especially when broiled or charred have been shown to increase the incidence of Prostate cancer. Restrictions may be appropriate. Vitamin E has been shown to decrease the incidence of prostate cancer significantly in a long term Finnish study. <200 international units daily may be the appropriate dosage. Do not overdose! Is there a difference between natural and synthetic? It appears that the natural gamma Vit.. E may be better than the synthetic alpha Vit. E. Vitamin D may help decrease the incidence of prostate cancer, 2400 units a day may be helpful. Selenium an element, has been shown in several studies to decrease the incidence of prostate cancer, though recent studies suggest that high doses increase the incidnece of PCa. 70 micrograms a day may be the appropriate dosage. Make sure to use selenium that is "yeast derived" it seems to be more active. We do not know the long term effects of this. Lycopene is a chemical found in cooked tomatoes, (spaghetti sauce, pizza, stewed tomatoes, etc.), three portions a week may be helpful. Lycopene can also be bought as a dietary supplement, may play a protective role. What type? What source? Preparation? How much? How often? may play a protective role. What type? What source? Preparation? How much? How often ?There are many other supposedly helpful products. We leave their discovery and use to the readers, without comment, only caution. Stephan Werner, M.D., F.A.C.S
Prostate 2.3 by Theralogix is a certified combination of naturally occurring forms of Vit. D, Vit.E, lycopene, selenium and soy in appropriate dosage. Its cost is comparative to other similar preparations. It is not available over the counter. It can be ordered at: 1 888 899 3899 or at Click here: Theralogix.com Use code 30089
it is certified by NSF as to content and purity. It should not be taken along with other supplements containing these products.. It should not be taken during or within 6 months after any radiation therapy or seeds (brachytherapy), as it may counteract the radiation To learn more or order (you need this PRN number: 30089 ) click here or go to: Rev: 03/09 |
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[Home] Werner - Francis Urology Associates llc - Mid Atlantic Urology Associates llc Greenbelt - Bowie - Laurel Maryland (301) 441-8900 Fax (301) 982 0453 7500 Hanover Parkway Suite 206 Greenbelt, MD 20770
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