Complemenary and Alternative Medicine in Urology

by Moyad, Mark, A., M.D.

• ISBN13: 9781455711611
• ISBN10: 1455711616
• Edition: 1st
• Format: Hardcover
• Copyright: 2011-08-01
• Publisher: SAUNDERS W B CO

Summary

This issue of the Urologic Clinics focuses on Complementary and Alternative Medicine in Urology. Topics covered include chronic pelvic pain, male and female sexual dysfunction, kidney stones, and prostate cancer, as well as the use of dietary supplements to assist in the treatment of these conditions.

Table of Contents

Preface	p. xi
The Complex Interplay Between Cholesterol and Prostate Malignancy	p. 243
Research into the role of cholesterol and prostate disease has been ongoing for many years, but our mechanistic and translational understanding is still poor. Recent evidence indicates that cholesterol-lowering drugs reduce the risk of aggressive prostate cancer. This article reviews the literature on the relationship between circulating cholesterol and prostate cancer. The data strongly point to hypercholesterolemia as a risk factor for prostate cancer progression and suggest clinical opportunities for the use of cholesterol-lowering therapies of alter disease course.
What Do I Tell Patients About Saw Palmetto for Benign Prostatic Hyperplasia?	p. 261
Saw palmetto is widely used to treat lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). Although there is passiionate support for herbal and complementary therapies for LUTS, clinical evidence is mixed. Because there is a well-recognized, profound placebo effect in tests of efficacy for agents treating LUTS, it is imperative that all therapies be tested in placebo-controlled trials. This article reviews evidence of the efficacy and safety of saw palmetto for men with LUTS caused by BPH, with particular emphasis on published randomized clinical trials and the upcoming Complementary and Alternative Medicine for Urologic Symptoms (CAMUS) trial.
Quercetin for Chronic Prostatitis/Chronic Pelvic Pain Syndrome	p. 279
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition with a heterogeneous origin that responds best to multimodal therapy. The bioflavonoid quercetin has antioxidant and antiinflammatory effects that have proven useful for treating this condition. Using the clinical phenotype system UPOINT, quercetin can be helpful for those with organ-specific complaints (bladder or prostate) and pelvic floor spasm. This article discusses the current understanding of CP/CPPS and how treatment with quercetin can be used alone or as part of multimodal therapy.
Pollen Extract for Chronic Prostatitis-Chronic Pelvic Pan Syndrome	p. 285
Prostatitis syndrome is a frequent condition in men. It is not known in most patients if the prostate is the only organ involved. Therefore, the disease is characterized as chronic prostatitis-chronic pelvic pain syndrome (CP-CPPS). Although many studies have been performed in patients with CP-CPPS, current trial evidence is conflicting and therapeutic options are controversial. Given the need for long-term treatment in CP-CPPS patients, phytotherapeutics, such as pollen extract, are an option due to few side effects. Preclinical studies on pollen extract have shown effects on smooth muscles of the bladder and urethra, strong antiinflammatory effects, and antiproliferative effects.
Lifestyle/Dietary Recommendations for Erectile Dysfunction and Female Sexual Dysfunction	p. 293
Sexual problems are diffuse in both genders. Although epidemiologic evidence seems to support a role for lifestyle factors in erectile dysfunction, limited data are available suggesting the treatment of underlying risk factors may improve erectile dysfunction. The results are sparse regarding associations between lifestyle factors and female sexual dysfunction, and conclusions regarding influence of healthy between performed. Beyond the specific on sexual dysfunctions in men and women, adoption of these measures promotes a healthier life and increased well-being, which may help reduce the burden of sexual dysfunction.
Promoting Welness for Patients on Androgen Deprivation Therapy: Why Using Numerous Drugs for Drug Side Effects Should Not Be First-Line Treatment	p. 303
The controversy over androgen deprivation therapy (ADT) for prostate cancer seems to have shifted over the past decade. The issue of adverse events or side effects now seems to dominate over that of clinical efficacy. However, this article provides evidence that questions the treatment of these side effects with numerous prescription medications that have their own unique toxicity profile in patients with nonmetastatic disease. The hope is that patients will no longer be considered passive participants in the prevention and treatment of ADT side effects, now that information is available to help mitigate many of these effects.
Lifestyle Recommendations to Reduce the Risk of Kidney Stones	p. 313
Kidney stones are increasingly common in wealthy industrialized countries. The most frequent from (80%) is idiopathic calcium stone disease. Eating habits and lifestyle have a direct effect on the lithogenic urinary risk factors and the pathogenesis of this condition. A diet characterized by a high intake of fluids, fruits, and vegetables; a low consumption of salt and protein; and a balanced intake of calcium, fats, and carbohydrates constitutes an efficacious approach to the prevention and treatment of this illness. A correct body weight, regular exercise, and a reduction in stressful life events are also useful preventive actions.
Molecular Markers that Can Be Utilized in Diet and Dietary Supplement Research	p. 321
Prostate and other cancers have a multitude of potenetial markers that can be used in laboratory and clinical studies of diet and dietary supplement interventions. More overt clinical markers include imaging tests, biopsy samples, prostate-specific antigen kinetics, and urinary testing. Many molecular markers are currently available, including antiapoptotic and apoptotic proteins, cell adhesion molecules, cell cycle compounds, growth factors, angiogenic markers, and proliferative and inflammatory signals. Protein Kinases and transcription factors should also be considered for diversity. Testing of numerous molecular markers has become critical in gaining preliminary insight into the potential impact of a novel diet and supplemental agents.
Statin Clinical Trial (REALITY) for Prostate Cancer: an Over 15-Year Wait is Finally Over Thanks to a Dietary Supplement	p. 325
Support for a prescription statin clinical trial for the prevention or treatment of prostate cancer has been lacking, although recent data have provoked interest in such a study. The authors have initiated a pilot trial of red yeast rice (RYR) extract and prostate cancer. RYR significantly reduces low-density lipoprotein and is an option for statin-intolerant patients. RYR appears to be an adequate proxy for some statins as long as quality control is monitored. The REALITY (REduction in Active surveillance Lipid Indices Through Yeast or red rice) trial will be conducted in Toronto, Canada.
Prostate Cancer and Vitamin D: What Does the Evidence Really Suggest?	p. 333
The optimal approach to vitamin D supplementation for the average healthy person is debatable. In patients with cancer, the role of vitamin D supplementation, possibly in treatment, is even less clear. Vitamin D is shown to play a role in prostate cancer biology; however, the clinical data have not consistently demonstrated a link. Additional studies are needed to determine if higher doses of vitamin D supplements could benefit selected populations (ie, the elderly or patients with cancer) even if they may not be beneficial for the general population.
Prostate Imaging Modalities that Can Be Used for Complementary and Alternative Medicine Clinical Studies	p. 343
This article provides an overview of imaging modalities that aid in diagnosing, staging, and assessing therapeutic response in prostate cancer. Prostate cancer is the second most common type of cancer in American men and the second leading cause of cancer death among men. Prostate cancer is difficult to diagnose in early stages, and advanced disease often recurs after treatment. To localize sites of recurrence many imaging modalities have been used with varying success. This article presents case studies of PET scanning using carbon 11 acetate and discusses intravenously infused ascorbate, a complementary and alternative medicine therapy for prostate cancer.
Heart Health = Urologic Health and Heart Unhealthy = Urologic Unhealthy: Rapid Review of Lifestyle Changes and Dietary Supplements	p. 359
Almost all aspects of urology are affected positively and negatively by certain lifestyle changes and dietary supplements. Some of these interventions have potential profound impacts independently or in combination with conventional therapy, others have no impact, and some could negatively impact treatment and overall health. The heart-healthiest recommendations have consistently served as the safest and most potentially effective options in urology from benign prostatic hyperplasia, chronic nonbacterial prostatitis, interstitial cystitis, multiple urologic cancer, male infertility, male and female sexual dysfunction, kidney stones, and Peyronie disease.
Index	p. 369
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