Chapter 20 - Heart Healthy = Prostate Healthy and S.A.M. are the Ideal “Natural” Recommendations for Prostate Cancer

Abstract

Cardiovascular disease (CVD) has been the number one cause of death in the United States for approximately 114 of the last 115 years. The majority of the research on specific lifestyle factors that could contribute to CVD also suggests similar lifestyle factors cause or encourage the progression of prostate cancer. And, lifestyle changes that reduce CVD reduce the risk of developing prostate cancer. Minimal exercise, caloric excess, obesity, insulin resistance or glucose abnormalities, dyslipidemia, hypertension, and metabolic syndrome appear to increase the risk of both conditions. The largest randomized trials utilizing dietary supplements or pharmacologic agents for prostate cancer prevention (the Prostate cancer Prevention Trial – PCPT and SELECT) have also indirectly observed the relationship between CVD and prostate cancer. Lower rates of aggressive prostate cancer with low cholesterol levels and a higher risk for those with a history of heart disease were interesting findings. Dietary supplements that have not been found to be CVD protective, such as selenium and vitamin E, have not been found to be prostate protective. Additionally, overexposure to specific antioxidants in nutritionally replete populations may be encouraging cancer growth. Future trials of dietary supplements to prevent prostate cancer could be problematic because by the time a definitive trial is initiated the population in question may no longer be “deficient” in the nutrient being tested, which arguably occurred in the SELECT trial. Yet, it is also interesting that statins, aspirin, and metformin (S.A.M) are three “natural” (derived from yeast, willow bark, and French Lilac), generic, low-cost, heart healthy agents with some separate and overlapping mechanisms of action, which all appear to have the best benefit-to-risk ratio compared to any other agent available for prostate cancer prevention, especially aggressive disease, and may also play a role in slowing the progression of this disease. It is time to focus on the forest over the trees and embrace simplicity and recommend proven CVD protective lifestyle and evidence-based agents along with conventional measures for men concerned about prostate cancer.