Complementary and Alternative Medicine and Lifestyle Changes and Prostate Cancer

Pursuing high doses of antioxidants to prevent or assist in the treatment of prostate cancer may be simply providing impetus for more disease. It is important to “first do no harm” and think of heart-healthy regimens or CAM products that could simultaneously prevent or reduce the progression of cardiovascular disease and prostate cancer. This method allows researchers to focus on the forest and the tree(s). Virtually every single heart-healthy lifestyle change from smoking cessation, exercise, weight and waist loss, improving diet, and normalizing blood pressure, cholesterol, and glucose has now all been correlated with a lower risk of prostate cancer and even the potential to slow the progression of this disease with conventional treatment. The mantra for any man concerned or with prostate cancer should be “reduce your heart disease risk to as close to zero as possible” and at least a 2 for 1 benefit could be achieved. The SAM option, or statins, aspirin, and metformin, is a heart-healthy generic choice that appears to have the largest benefit-to-risk ratio for those that qualify and is of the lowest cost in the area of chemoprevention or as ancillary treatment to conventional medicine for prostate cancer. If a CAM can mimic any of these SAM or heart-healthy interventions, then it would be of enormous interest. For example, red yeast rice (RYR) extract has statin-like effects and may be an option for those that cannot tolerate prescription cholesterol-lowering agents. Otherwise, other CAM options have had serious issues when not following a heart-healthy = prostate-healthy scenario and when attempting to follow a more is better philosophy. Selenium in excess (200–800 micrograms) has toxicity issues and could accelerate PSA velocity in some patients with prostate cancer, and vitamin E in excess can significantly increase the risk of prostate cancer. Beta-carotene supplementation appears to increase the risk of lung cancer in former and current smokers in dosages as low as 15 mg. Fish oil supplements have not yet appeared to consistently provide benefits as expected in the area of cardiovascular health, but dietary fish consumption and plant omega-3 intake, such as flaxseed, may reduce the risk or progression of prostate cancer. Multivitamins in excess could increase the risk of aggressive prostate cancer, but a single low-dose children’s or adult Centrum Silver multivitamin appears to have no or a slight beneficial impact and may modestly reduce the risk of being diagnosed with cancer. Vitamin C has been given in IV form to advanced cancer patients with a hint of quality-of-life improvement but no clear clinical disease responses, and there are minor increasing oxalate issues. Vitamin D and calcium have important roles for bone health but have also been associated with prostate and other urologic issues in excess. Zinc has toxicity issues in higher doses (80 mg and higher) and may increase the risk of urologic problems including prostate cancer. Multiple other CAMs are discussed in this chapter including what should be utilized or not with androgen-deprivation therapy (ADT), but urology more than any other medical discipline has arguably proven that heart health is tantamount to prostate health and less is more.