Prostate Cancer: Primary Cause & Therapy

Part One

by Dr. James Howenstine, MD

The main factor responsible for the rapidly rising incidence of prostate cancer in men and breast cancer and uterine cancer in women appears to be the excessive exposure of modern men and women to estrogen. If testosterone had anything to do with prostate cancer there should be an epidemic of this disease in teenage males. All persons on planet earth are getting, for the first time in history, steady large exposure to estrogen from inhaled fuel exhaust, plastics, estrogen implants in meat and fed to chickens, herbicides, pesticides and propylene glycol.

All disease arises from metabolic imbalance.[1] When the underlying metabolic imbalance is corrected the disease goes away. If you fail to keep up the correction for the underlying metabolic imbalance (i.e. revert back to whatever created the metabolic imbalance in the first place), the disease will come back. This is called preventative medicine. Cancer is no different--it is caused by an underlying metabolic imbalance that turns normal cells into cancer cells.

How Does Excess Estradiol Cause Cancer of Prostate, Breast and Uterus?

Researchers such as Ercole Cavalieri Ph.D., Director of the Eppley Institute for Research in Cancer at the University of Nebraska have learned that a metabolite or byproduct of estradiol and estrone(the two most potent human estrogens) is destructive to adenine and guanine. These two purines along with the pyrimadines cystine and thymine compose the 4 nitrogenous bases of DNA. The diminished production of DNA permits gene mutations that can lead to cancer. Other estrogen metabolites are metabolized in the liver and excreted in the urine. The dangerous metabolite of estradiol and estrone is found most often in people eating more of dangerous transfats, fewer of good fats (extra virgin olive oil, fish oil) and less of sulfur containing amino acids found in beans, garlic, onions, cauliflower, cabbage.

The normal protection against gene mutation involves maintaining good physiologic levels of progesterone and testosterone. Stress increases the cortisol levels which makes the body resistant to other hormones and increases oxidation which is at the heart of how DNA damage is caused by these estrogen metabolites.

Males develop falling levels of testosterone and progesterone as they age. At the same time the level of estradiol is rising producing estrogen dominance in elderly males. Men with low levels of testosterone[2] are at greater risk of developing prostate cancer than men with higher testosterone levels.

Estrogen dominance activates the oncogene Bel-2 while progesterone and testosterone activate the protector gene p53. In laboratory cultures of prostate cancer cells, breast cancer cells and endometrial cancer cells the proliferation of cancer cells is produced by Bel-2 and prevented by p53.

What Causes Estrogen Dominance?

Estrogen dominance causes more cases of cancer of prostate, breast and endometrium than any other cause. Common causes for estrogen dominance include:

• Insulin Resistance Males with the highest rates of insulin resistance were compared to males with the best insulin sensitivity. When males with the highest insulin resistance and greatest waist to hip ratios were combined the risk of prostate cancer was increased by 8.21 times.
• Stress Cortisol blood levels rise in stress which impairs the action of insulin permitting blood sugar values to rise and insulin to be less effective(insulin resistance).
• Obesity accelerates estrogen production in males because fat cells convert testosterone and androsterone into estrogens which stimulates the growth of the prostate gland. Generally the more fat a man carries the higher his estradiol levels will be. To make matters even worse for males the enzyme aromatase converts testosterone to estrogen. This is less likely to occur when testosterone therapy is taken in cream form(compounding pharmacists make this)rather than by injection. This action of aromatase can also be blocked by extract of passion flower plant.
• Transfats found in pastries and processed foods promote weight gain, diabetes, arteriosclerosis and cancer
• Embryonic Damage[3] Excess estrogen exposure to differentiating cells particularly in the testes and ovaries between days 18 and 23 is common and important. This damage results in delayed puberty and infertility in males and miscarriages, precocious puberty and progesterone lack by age 35 in women.
• Xenoestrogen exposure Males working in factories making herbicides have 9X greater incidence of prostate cancer. Exposure to insect sprays, outgassing from carpets, etc in homes also puts estrogen into the body.
• Liver Diseases and Alcoholism Impaired metabolism of estrogens leads to excess estrogen and enlarged breasts in males.
• Other causes for estrogen dominance include sleep deprivation, working nights in bright lights and trying to sleep in daytime, fluoride exposure from water and toothpaste, environmental estrogens(outgases from carpets and home chemicals), sedentary lifestyle, polluted air(vehicle exhaust) and hypothyroidism.

Can Anything Be Done About Estrogen Dominance?

The incidence of breast cancer in the United States is 141.1 and the incidence of breast cancer in Northern Thailand(Chiang Mai Province) is 13.7. Most of the males and females in this province consume a phytoestrogen herbal substance called Pueraria mirifica PM. This plant has a tuberous root which can be eaten. The plant appears identical to other local plants and can only be distinguished from other non-PM containing plants during the 2 weeks annually when it is flowering. Most of the PM being sold is misidentified and has none of the benefits of PM.

PM contains a valuable phytoestrogen named miroestrol. Miroestrol is similar to the safest human estrogen estriol. Miroestrol is 3000 times stronger than the estrogenic activity exhibited by soy isoflavones(genistein). PM has more than 1000 times the estrogenic activity of red clover. In addition to miroestrol PM contains substantial amounts of other phytoestrogens including daidzein, genistein, puerarin, and mirificin.

When miroestrol enters an estrogen receptor it modulates the effect on the receptor. PM supplements when the estrogenic activity is low and dilutes if the receptor estrogenic activity is high. Miroestrol has no effect on estrogen levels in the body as it only influences the estrogen receptor.

In a clinical study on menopausal women in Thailand miroestrol lowered hot flashes 11 fold and night sweats 4 fold within 30 days. Most women start to notice relief of symptoms within one week.

Approximately 70% of Japanese women taking PM noted an increase in breast size. This was more apparent in younger women than older women.

The dosage of PM in females was 2 mg. per kilo of body weight. In the first month of therapy for menopausal symptoms 3 mg can be taken. Each pill of Beyond Hormone Replacement Therapy HRT contains about 80 mg. so taking 3 pills would supply this. A US woman weighing 70 kilos should take one pill 80 mg. twice daily. In the clinical studies in Thailand doses no toxicity was noted even in doses 2000 times the usual dosage. Traditional Thai usage has menstruating women skip the therapy during menses.

Therapy With PM In Males

The dosage in males is one half that of women (1mg. per kilo of body weight). Males have not noticed any increase in breast size. Both males and females in this region of Northern Thailand continue to be physically active and retain their black hair into their 80s. Elderly women have firm breasts and youthful appearing skin. Elderly men continue to be sexually active. Their memories are good and they have not been ill. One man in his 80s was surprised when asked if he got up to urinate during the night. He replied "No one here wakes up to do that."

H.R.T. Plus

Dr. Gary Gordon's company Longevity Plus has formulated a new sublingual product that contains Pauraria Mirifica phytoestrogen complex along with Methylcobalamin and Nutri-Folate which has all forms of folic acid.

Methylcobalamin became available in 1998 and quickly gained recognition for it's ability to regenerate nerves. Research has shown that sublingual Vitamin B12 in this product Methylcobalamin MC was nearly as effective as injections of B12. Additionally protection can be obtained against the development of diabetic polyneuropathy, reversal of Bell's palsy, improvement in chronic depression, reduction in the frequency of disabling headaches and improvement in neurologic conditions. This form of B12 has improved testicular function allowing some patients to again become sexually potent.

Some patients in psychiatric institutions have been restored to normal life when their B12 deficiency is corrected. B12 therapy can also stimulate return of normal growth patterns in children, Patients who are pregnant, using birth control pills and all vegetarians are at risk for B12 deficiency.

Deleterious high homocysteine blood levels are quickly reversed by MC therapy which may also help prevent Alzheimer's Disease, aging, cancer and arteriosclerosis. Folic Acid deficiency is very common currently. Alcohol destroys stores of folic acid. As many as 50% of pregnant women are at risk of folic acid depletion which can cause spina bifida, cleft palate, brain damage and impaired learning in the newborn child.

Folic acid depleted individuals are vulnerable to viral, fungal and bacterial infections. Nutri-Folate contains all the forms of folic acid including natural 5'MTHF. Vitamin B6 can reverse carpal tunnel syndrome, helps prevent problems caused by excessive sugar intake and improves utilization of protein.

The dose of H.R.T. Plus is one or two tablets taken sublingually daily. Swallow after the tablet has dissolved. This therapy provides the valuable estrogenic substance PM along with Methylcobalamin and all the valuable forms of folic acid.

Footnotes:
1. Lee, John Hormone Balance For Men What your Doctor May Not Tell You About Prostate Health and Natural Hormone Supplementation Copyright 2003 by Hormones Etc P.O. Box 84900, Phoenix, AZ 85071 (800) 528-0559 e-mmail:info@hohnlee.com pg. 9
2. Morgentaler A, et al Occult prostate cancer in men with low serum testosterone levels.JAMA 1996 Dec 1;276(23):1904-6
3. Colborn Theo Our Stolen Future

Prostate Cancer : Primary Cause & Therapy

Part Two

by Dr. James Howenstine, MD

Inflammation Damages The Prostate Gland And Contributes To The Development Of Prostate Cancer

The prostate gland is very sensitive to inflammation. Urologist Ronald E. Wheeler thinks that the common, ineffectively treated condition chronic prostatitis, is a major cause for prostate cancer. Patients with chronic prostatitis often have large numbers of white cells visualized when prostate secretions are examined under a microscope. Possibly lack of effective therapy for chronic prostatitis allows prolonged inflammatory changes in prostate tissue to progress to cancer.

Additionally Dr. Wheeler has noted that elderly males with symptoms of frequent urinating, poor stream, difficulty voiding and discomfort when urinating are often advised to undergo prostate surgery for presumed obstruction to bladder emptying when their symptoms are really due to prostatitis not blockage of urine flow out of the bladder.

Chronic prostatitis may be a sexually transmitted disease as it is often found in young males who have become sexually active. This disease is notorious for failing to respond to antibiotic therapy which suggests that it might have a viral etiology.

An important paper from The Cleveland Clinic has linked genetic mutation with viral infection as a possible cause for prostate cancer. Dr. Eric Klein presented this paper at the 2006 Prostate Cancer Symposium in San Francisco, Ca. Feb 24, 2006. An antiviral protein called RNasel is activated by a viral infection. Prostate cancer tissue from 36 radical prostate surgical operations was studied. Viral sequences for cDNA were looked for by DNA microarray. Tissue localization of viruses was evaluated by immunohistochemistry and fluorescence. In 20 men who were homozygous for RNasel 45% had viral sequences found whereas in 66 controls who had one or no RNasel mutations only 1.5% were observed to have viral sequences. Viral cloning studies revealed that the same (one) virus was identified. This virus named ZMRV is related to the zenotrophic murine leukemia viruses known to cause cancer in mice. The viruses were found in the tissue adjacent to the tumor cells.

Dr. Wheeler has performed another valuable service by slowing down the frantic rush to do radical prostate surgery and radiation implants simply because a patient has an elevated PSA value. Furthermore, the placing of a needle into prostate cancer tissue[1] in the biopsy procedure can cause cancer cells to be found in the blood.

Researchers from the Karolinska Institute in Sweden have learned that fish oils, which cut down on inflammation, can reduce the risk of prostate cancer. They studied the dietary histories of 3100 pairs of male twins who provided a dietary history for 34 years. They found out that males who ate 3 or 4 servings of fish weekly had only one half the risk of getting prostate cancer and one third the risk of dying from prostate cancer[2] when compared to men who ate little or no fish. Fish oil is a potent inhibitor of inflammation and when inflammation is suppressed there is less stimulus to estrogen to produce rapid cell growth. Other substances which might stop viral inflammation in prostate tissue include the nanotechnology silver product Argentyn 23, Sambuchol, Noni Concentrate, cucurmin and the Essential Oil of Oregano.

Dr. John Lee feels there is potent evidence that testosterone inhibits prostate cancer cell growth.[3] Progesterone is necessary to block the undesirable side effects of unopposed estrogen. The desired ratio of saliva progesterone should be between 200 and 300 times the saliva estradiol level.

What Is The Significance Of PSA Values?

Prostate Specific Antigen is actually produced by both prostate and breast tissue. The function of PSA appears to have been clarified. When there is excessive crowding of prostate cells these cells release PSA. This antigen blocks angiogenesis(new blood vessel formation) of adjacent tissues. This tends to stop cell growth as the rapidly growing cells can no longer get new blood vessels to allow them to continue uncontrolled growth. Thus stopping angiogenesis acts to curtail rapid tumor growth. Men early in the course of their prostate cancer have low testosterone levels and little or no elevation of PSA values.[4] When testosterone levels have been restored to normal in men with prostate cancer cellular energy production is increased and the healthier prostate cells are able to produce more PSA. This leads to a slight increase in PSA values that does not mean that the cancer is growing. It actually means the prostate cell is stronger and again producing PSA which should slow down the cancer by stopping new blood vessel formation.

Restoration of normal levels of progesterone, testosterone and estradiol heals prostate cancer as the hormone abnormalities which caused the cancer no longer exist. Progesterone is a vital part of therapy because it restores normal inhibition of 5-alpha-reductase the enzyme that permits testosterone to be converted into dihydrotestosterone (DHT). This initial undesirable creation of DHT permitted proliferation of prostate cells(benign prostatic hypertrophy BPH) and the subsequent appearance of prostate cancer under the cell growth influence of excess estrogen. Correct administration of progesterone and testosterone can lead to shrinkage of the prostate gland with disappearance of the cell stimulating effects of estrogen and the symptoms of prostatic enlargement.

Elevated PSA values can be found in patients who have enlargement of the prostate gland(Benign Prostatic Hypertrophy), prostatitis and prostate cancer. A surprisingly high percentage of patients have cancer with very low values of PSA (below 4) supporting the idea low values of PSA are indicative of poor cellular energy secondary to low testosterone levels.

High Insulin Values Lead To Increased Death In Prostate Cancer

A Swedish urologist, Dr. Jan Hammarsten, is an expert in the relationship between insulin and prostate cancer . He relates that there is no evidence that insulin causes prostate cancer.[5] What insulin does do is act as a stimulus for prostate and probably other cancers to grow and become more aggressive. Between the years 1995 and 2003 Dr. Hammarston's group studied 320 patients with biopsy proven prostate cancer. They also used ultrasound to measure the size of the prostate gland. They did blood tests for all the components of metabolic syndrome (insulin, cholesterol, triglycerides and uric acid). Excess insulin caused the cancers to grow more rapidly. The men who died had a faster rate of growth of prostate tissue and also had more aggressive scores on the cancer biopsy samples. Elevated fasting blood insulin levels were associated with the lethal cases of prostate cancer. The higher the insulin levels the greater the likelihood of death. The insulin values were more accurate than microscopic grading of stage of the tumor or PSA values in identifying persons at risk of rapid fatal cancer courses. This suggests that revising diets in cancer patients toward low insulin stimulating foods with fat restriction may be as worthwhile as what therapeutic agents are being administered.

What happens to cancer patients who lower their insulin values? Dr. Dean Ornish uses a plant based diet. The cancer markers for the men on this diet decreased[6] over a one year follow-up whereas the control patients on a standard diet saw their tumor markers get worse. This suggests that individuals on a low fat low carbohydrate diet will do well in avoiding and defeating cancer by keeping their insulin values low. This diet is exactly the same as the diet used in the initial stage of therapy for Type 2 diabetes[7] (see Chapter 5 topic How To Recover From Type 2 Diabetes).

Dr. Robert Rowen advises getting an 8 hour fasting insulin test annually which is a good idea because it identifies persons at risk of becoming diabetics when elevated values are discovered. This test may be even more important for patients with malignancies because elevated insulin results select out the cancer patients who may be at risk of early death because of rapid uncontrolled spread of cancer. Persons with or concerned about prostate cancer will probably fare better if they go on a low fat, high carbohydrate restricted, low glycemic carbohydrates diet. The fasting insulin value needs to be below 5 mU/L.[8] The nearer this value is to zero the better. On a vegetarian low fat low carbohydrate diet Dr. Rowen has been able to reduce his fasting insulin blood level to zero. Decreasing fat intake in the diet permits smaller quantities of insulin to control blood sugar values much better than when fat intake is uncontrolled. When there is no carbohydrate excess in the diet and the carbohydrates being eaten are low glycemic (do not cause prompt large increases in insulin output) the pancreas produces less or no insulin. High glycemic carbohydrates to be avoided include white potatoes, corn, rice, bananas and pasta.

To the best of my knowledge no other cancers have yet been studied to see if this relationship between high carbohydrate diet with corresponding high insulin levels causes increasing cancer deaths holds up for other cancers as well. My guess is this is likely to turn out to be just as dangerous for these cancers as it is for prostate cancer.

The fasting insulin blood test is probably the most important blood test that is rarely utilized by US health care providers. Insist on obtaining this test at least once a year. Early discovery of high insulin values enables the pre Type 2 diabetic to institute restriction of sugar and fat along with ingestion of essential omega 3 fatty acids which will reverse the impending diabetic state in 90 % of persons. This will permit these individuals to avoid the ravages of long term hyperinsulinemia (premature aging, rampant arteriosclerosis and death). This same dietary approach will improve survival in prostate cancer and possibly other malignancies.

How To Restore Hormone Balance

The best way to determine the quantity of free testosterone, progesterone and estradiol is by use of saliva testing. (performed well by ZRT Laboratory Beaverton, Or. Phone 503-456-2445). Absolute values are less important guides to the therapy than ratios of one hormone to another. Correction of abnormal values for these hormones by proper topical skin hormone administration allows recovery from prostate cancer to occur.

All therapy must be carried out with bio-identical natural human hormones not patented pharmaceutical products which have proven to be a disaster in women by causing many cases of breast cancer. There is no way to correctly calculate dosage without using salivary hormone testing.

Progesterone therapy inhibits 5 alpha reductase which converts testosterone into dihydrotestosterone which is believed to be responsible for enlargement of the prostate gland. This helps preserve normal amounts of testosterone. Progesterone also has energy producing effects (anabolic).

Testosterone is the most potent anabolic(energy creating) hormone. It has been shown to be vital in creating good cardiac performance and muscle strength throughout the body. Testosterone is a direct antagonist of estradiol.

Both progesterone and testosterone promote the p53 gene that leads to normal healthy cell apoptosis (cell death) and helps prevent cancer. Estradiol promotes the Bel-2 gene which is a cancer causing gene that stops apoptosis thus encouraging the development of cancer. The proper relationship of these three hormones is important in preventing and treating cancer.

Bio-identical (natural, human) hormones must be used rather than synthetic patented pharmaceutical drugs that have caused so much cancer in females. Dosages should be chosen so that progesterone, testosterone and estradiol are returned to normal values. This can only be accomplished by using saliva specimens for evaluating hormone levels.

In males over 60 typical salivary values are:

Estradiol 2.0 to 2.7 pg/ml.
Progesterone 20 to 30 pg/ml
Testosterone 20 to 30 pg/ml.

To restore hormone balance:

Saliva progesterone levels need to be between 200 and 300 times that of estradiol.
The ratio of saliva testosterone to estradiol should be between 200 and 300 times that of estradiol..

General dosages for men deficient in progesterone and/or testosterone

Transdermal progesterone 5 to 8 mg daily
Transdermal testosterone 1 to 2 mg daily

Summary

Prostate cancer appears to be caused by excessive exposure to environmental estrogens. The poorly understood condition (chronic prostatitis) may be a sexually transmitted disease which does not improve with antibiotic therapy suggesting it could be a viral illness. Using skin formulations of bio-identical progesterone and testosterone can heal and prevent recurrence of prostate cancer by maintaining testosterone, progesterone and estradiol values in a normal range. For part 1 click below.

Footnotes:
1. Douglass, W. C. Real Health September 2003 Volume 3 No. 4 page 3
2. Lancet June 2, 2001
3. Lee, John M.D. Hormone Balance for Men pg 18
4. Ibid pg 20
5. Hyperinsulinemia: a prospective Risk Factor for Lethal Clinical Prostate Cancer Eur J. Cancer, 2005 Dec; 41(18):2887-95 EPub 2005,October 20.44412 (5/2006);
6. Ornish, Dean et al J. Urol.. 2005; 174(3) 1065-9
7. Howenstine, James A. A Physicians Guide To Natural Health Products That Work 2002 pg. 100-04 Penhurst Books Miami, Fl. 8. Rowen, Robert MD Second Opinion Vol XVI No. 11 November pg 1-3.