For a gland the size of a golf ball, the prostate certainly causes a lot of trouble, and treatment can be life-threatening. That’s why this site has so much “patron forward” content. But guess what? There are other parts of the body to think about proactively! Don’t forget the rest of your body!
That means you still have to think screening for other cancers, such as colon cancer and skin cancer. You still need regular checkups for blood cholesterol, liver function, kidney function and diabetes – the lab tests doctors usually order in a routine annual physical. You need someone to listen to your heart and check your blood pressure. If, like many men, you don’t have a family doctor or internist, but only see a urologist, make sure your urologist knows this and be sure to bring up any health concerns you have during your office visit.
Be good in your heart
Right up there at the top of your health goals should be cardiovascular wellness. Here’s a big reason why: “If you have localized prostate cancer and are treated successfully, the greatest risk of death is a heart attack,” says Edward “Ted” Schaeffer, MD, Ph.D., chair of urology at Northwestern University. He pointed this out in our book.
“Even if you don’t have prostate cancer, Heart disease remains the number one cause of death in men,” he continues. “If you have advanced prostate cancer and are on androgen deprivation therapy (ADT), your risk of heart attack increases. So focus on being heart healthy!”
What is good for your heart? It’s pretty simple: Eat a diet rich in fruits and vegetables and low in processed foods, fried foods and sugar.
Now, what does that really mean? I’m not going to tell you to never have cookies, cakes, burgers, hot dogs, pizzas, etc. Just don’t make this the vast majority of what you eat. Consider an old-fashioned scale, such as the scales of justice. On one side are all the things you I am doing eat, whatever. On the other hand is what you no I eat. Of not eating vegetables and fruits. Not get enough protein – your sins of omission are just as bad, maybe worse, than any sin of commission (eating a cinnamon roll as big as your head). You need a lot more protein than you think: about 30 grams PER MEAL. For a 185-pound man, that’s at least 90 grams per day. No shame in protein shakes! It’s a great way to get a big dose of protein. Other sources: nuts (6 grams in one ounce of almonds), eggs (a hard-boiled egg has 6.3 grams), a meat bar like Epic make (7 grams in a bar), a Kind bar (7 grams in a peanut butter / dark chocolate bar).
Back to our scale: anything that goes on one side must be balanced on the other. If you eat a slice of pizza, get a salad or a side of vegetables. If you have a scoop of ice cream, make it healthier by topping with raspberries or blueberries. Try not to eat a lot of processed meats – but if you’re eating a hot dog, or chicken apple sausage, or salami or pepperoni, try to get the healthiest kind without additives. And know this:
The vast majority of processed foods are not good for you. It’s just convenient. Even pre-packaged foods marketed as “healthy” are actually often full of junk!
Take, for example, the Vegetable burger with 25 ingredients, which contains few vegetables and is loaded with additives. What the heck is carrageenan, anyway? (It’s in a lot of prepared foods, and it’s not good for you!) I just interviewed Weill-Cornell medical oncologist David Nanus, MD, who is the principal investigator of a study looking at a whole-grain, plant-based diet in men ADT. I will report on that shortly. initial findings are exciting and promising. Nanus offers these tips for anyone trying to follow a healthy diet: “If it has more than five ingredients, don’t eat it.”
Or consider chicken-teriyaki meatballs with 750 mg sodium in one portion – and one portion it is four small meatballs! Let’s not even get started on fast food and chain restaurants, which make money by offering high calorie, sodium and sugar foods that please the palate but add to the waistline. The stakes (and the steaks!) are high.
If you do drink alcohol, do so in moderation – although again, many studies show health benefits from red wine. Target some moderate exercise every day. It doesn’t have to be a heroic effort. just do something. Anything is better than sitting and staring at a screen.
Testosterone and your overall health
Note: If you have advanced or high-risk prostate cancer and need ADT, then do it. “That’s the most important issue right now,” Schaeffer says, “keeping cancer under control.”
But for men who is not in ADT, men who no have prostate cancer or men who have been successfully treated for localized prostate cancer is in a different situation. These I am doing they need testosterone for good health. “Male hormones play a big role in keeping your body healthy,” says Schaeffer. “Ideally, men should have testosterone levels in the normal range.”
This can be a difficult concept to graspsays Johns Hopkins neurourologist Arthur Burnett, MD “Since (Nobel Prize-winning scientist) Charles Huggins made the observation 70 years ago that in advanced prostate cancer, if you shut down the male hormones, the disease will go away, there is a widespread idea that if you have prostate cancer, you should reduce testosterone. The reality is, if you are cancer free, if you have low testosterone, you should get to a normal testosterone level.Even in men who have not been treated with ADT, testosterone can be low for other reasons, such as age, obesity, and certain chronic medical conditions.
Burnett, with researchers at Harvard, is conducting a trial of testosterone supplementation in men after prostatectomy. The hypothesis is that restoring low testosterone to the normal range “is safe and effective, that it may improve cognitive function and some physical limitations that some men have when their testosterone is low, and that there may be some sexual benefit to returning of testosterone in the normal range. For men who have a radical prostatectomy or radiation therapy for localized disease who happen to be testosterone deficient, instead of condemning them to the rest of their lives with very little testosterone, how do you help them achieve peak health?”
The key is to keep testosterone in the normal range between 300 and 800 ng/dL, Shaffer says. Among other things, “very low testosterone levels can increase the risk of heart attack or stroke, reduce muscle mass, weaken bones, impair cognitive function, increase the risk of metabolic disease, weakness, and depression.” If you experience symptoms such as fatigue or low sex drive, talk to your urologist or primary care doctor.
“Sexual health is a barometer”
Both surgery and radiation therapy for localized prostate cancer can cause temporary or long-term erectile dysfunction. But other medical conditions can cause erectile dysfunction (ED), very. Burnett, a pioneer in the field of men’s sexual health – whose scientific discoveries about the role of nitric oxide in erection led to the development of the drug Viagra – has written about this in detail in his book, The Manhood Rx: Every Man’s Guide to Improving Sexual Health and Overall Wellness.
For example: “Heart disease and DM, the two entities are linked,” he says. We’ve discussed it here before. “An erection is a matter of vascular function in the genitals. Heart disease affects more than just the heart – the entire cardiovascular system. It can cause cerebrovascular disease, peripheral vascular disease and penile vascular disease. An erection is about blood flow and how it’s regulated.” In fact, “ED is an indicator, not only for heart disease, but for diabetes, metabolic syndrome, certain autoimmune diseases, and systemic inflammation (diseases such as gout, inflammatory bowel disease, gastritis, and prostatitis). Being overweight can also affect erectile function. Basically, fat cells increase estrogen levels and decrease testosterone.
There are many ways to treat ED, including drugs such as Viagra and Cialis, penile injections, and surgery to implant a penile prosthesis. “Sexual health after prostate cancer requires a multifaceted approach that starts with the patient,” says Burnett. “Healthy living, maintaining your best health after prostate cancer – eating a balanced diet, exercising, avoiding smoking and moderating alcohol intake – can help maximize blood flow to the penis. You won’t get your 25-year-old penis back, but it can help you maintain the function you have. And more proactively, talk to your urologist. Look for interventions. If you don’t respond to a PDE5 inhibitor (Viagra or a similar ED drug), there are non-surgical options, including pumps or injections into the penis and surgery, implanting a prosthetic penis. Do not give up!” Seriously. Look through this website. There’s a lot about ED, including the inspiring story of Serge Thomas. There is always hope.
Additionally with BookI have written about prostate cancer on the Prostate Cancer Foundation website, pcf.org. The stories I have written are in the “Understanding Prostate Cancer” and “For Patients” categories. I firmly believe that knowledge is power. Saving your life can start with going to the doctor and knowing the right questions to ask. I hope all men put prostate cancer on their radar. Get an initial PSA blood test in your early 40s, and if you are of African descent or if cancer and/or prostate cancer runs in your family, you should be screened regularly for the disease. Many doctors don’t do this, so it’s up to you to ask.
©Janet Farrar Worthington
