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updated 5/28/2004 12:37:13 PM ET 2004-05-28T16:37:13

Prostate cancer is the most common cancer in American men. But prostate enlargement affects even more men- about half of all men over age 50 and up to 90 percent of men over age 80. This condition, known as benign prostatic hyperplasia (BPH) does not indicate prostate cancer risk. Yet some researchers suggest that whatever hormones or other influences cause BPH to develop may also spur the onset of cancer.

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BPH occurs when normal (noncancerous) prostate cells grow abnormally. As the prostate enlarges, it presses down on the urethra, the tube that carries urine out of the bladder for voiding. This pressure can lead to the following symptoms: sensation that the bladder is not empty, even after urinating; feeling an urgent need to urinate; a weak urinary stream and dribbling; the need to stop and start several times when urinating; and the need to urinate several times during the night.

Although a few studies have been done in this area, it is still uncertain why some men get BPH and not others, or what might prevent the condition. The only established risk factors for BPH are age and family history. Hormones are believed, however, to promote prostate cell growth.

Study links high calorie intake
One study of the problem links higher calorie intake, as well as diets higher in protein and some kinds of polyunsaturated fats, with prostate enlargement. Researchers suggest that excess calorie consumption could somehow directly stimulate prostate enlargement.

The excess body fat that accumulates and its effects on hormone levels could also be the link.

Evidence from a number of studies that group too many calories, obesity and insulin resistance with cancer promotion suggest indirectly that if you avoid these three influences you can also reduce your risk of BPH. Other studies suggest that regular exercise can help protect against prostate cancer. Because keeping active directly affects hormone levels and helps weight control, activity may also discourage BPH.

Greek men who eat more fruit decrease their odds of developing BPH, according to one study. Since fruits are loaded with a variety of vitamin and natural antioxidant phytochemicals, free radicals (highly reactive compounds that can damage our cells' DNA) could be involved in BPH, just as many scientists believe they are in prostate cancer. A laboratory study found that lycopene, an antioxidant especially in cooked tomatoes, can slow the growth of prostate cells.

BPH symptoms, treatments
Men who are significantly bothered by the symptoms of BPH should discuss them with their doctor. Burning sensation, pain or blood that appears when urinating demand immediate visits to the doctor. While these symptoms could indicate BPH, the problem could also be an infection, cancer or another obstruction that needs medical treatment.

If BPH is the diagnosis, your doctor can offer treatment through medications or surgery. Supplements such as saw palmetto and pygeum are also popular alternatives to block the effects of hormones and reduce BPH symptoms. But since supplements are unregulated in the U.S., the quality and safety of these products is unreliable. Research is underway to evaluate if prostate cancer can be prevented through soy, selenium, vitamin E and vitamin D. But the potential impact of these substances on either prostate cancer or BPH is unknown.

To prevent BPH, maintaining a healthy weight by avoiding excess calories and keeping physically active is a good step based on today's evidence. Eating a balanced plant-based diet loaded with vegetables, fruits, whole grains and beans, which the American Institute for Cancer Research advocates for lower cancer risk, is another. For now, that's the soundest advice to avoid the seemingly unavoidable enlargement of the prostate.

Nutrition Notes is provided by the American Institute for Cancer Research in Washington, D.C.

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