Over the course of a lifetime, one man in six eventually will be diagnosed with prostate cancer… one in 35 will die from it. Despite how common the disease is, the treatment path for prostate cancer is seldom clear. Even conventional doctors who specialize in prostate cancer frequently disagree about the best course of action.

Surgery to remove the prostate gland and perhaps the nearby lymph nodes often is recommended, yet it can have onerous side effects — including incontinence that lasts for months or years and lifelong erectile dysfunction. What’s more, statistics show that surgery does not necessarily increase a man’s life span.

For these reasons, many doctors now recommend a “watch and wait” approach rather than surgery. Prostate cancer usually is slow-growing, and more than 70% of the men who develop it are over age 65. The older a man is, the more likely he is to die of some other condition before his prostate cancer becomes a real threat. The American Cancer Society (www.cancer.org) states, “At this time, watchful waiting is a reasonable option for some men with slow-growing cancers because it is not known whether active treatment, such as surgery, radiation therapy and hormone therapy, prolongs survival.”

The holistic view: For prostate cancer patients age 65 and older, as well as for some younger men whose cancer does not appear to be fast-growing, I support the decision to watch and wait before pursuing aggressive conventional treatment — with one important caveat. Instead of waiting passively and doing nothing, I recommend a proactive approach using natural therapies that may slow or halt cancer growth or even cause the cancer to diminish.

My regimen includes various nutritional supplements — including two new ones being researched at major university medical centers. Several of my patients with localized prostate cancer are using these natural therapies under my care — and now, up to 12 years after diagnosis, they continue to do well.

Unless noted otherwise, all supplements described below are available at health-food stores, generally are safe to take indefinitely and cause no significant side effects. Important: It is vital that men who have prostate cancer be monitored by an oncologist. Show your doctor this article, and discuss your desire to incorporate these natural therapies.

CUTTING-EDGE PROSTATE CARE

Aaron E. Katz, MD, associate professor of clinical urology and director of the Center of Holistic Urology at Columbia University Medical Center in New York City, is heading the research on two new supplements that are showing promise in the fight against prostate cancer. Studies are still in progress. Here is what we know so far…

Zyflamend. This unique formula from New Chapter (800-543-7279, www.newchapter.com, about $50 for 120 capsules) combines phytochemicals (beneficial plant chemicals) with herbal extracts from turmeric, ginger, green tea, rosemary, hu zhang (Japanese knotweed), Chinese goldthread, barberry, oregano, baikal skullcap and holy basil.

Dr. Katz’s laboratory study, published in 2005, found that Zyflamend reduced prostate cancer cell proliferation by up to 78% and may even have killed some existing prostate cancer cells. How it works: Chronic inflammation is linked to the formation of cancerous cells… and Zyflamend inhibits activity of two enzymes (COX-1 and COX-2) that promote inflammation.

Last year, researchers at The University of Texas MD Anderson Cancer Center published their own laboratory study showing that Zyflamend reduces activity of a family of proteins called NF-kappa B. When overactive, these proteins stimulate abnormal prostate cell growth.

Dr. Katz’s team is now analyzing results of a clinical trial of Zyflamend among men at high risk for prostate cancer. Preliminary findings are encouraging. The trial included 23 men, ages 46 to 75, who were diagnosed via biopsy with a type of precancerous cell proliferation called high-grade prostatic intraepithelial neoplasia (PIN) — a marker suggesting an 80% chance that cancer will develop within 10 years. The men also had elevated levels of prostate specific antigen (PSA) — a substance produced by prostate gland cells and often elevated when cancer exists. Participants took one Zyflamend pill three times a day for 18 months. Blood tests and biopsies then showed…

The PIN disappeared in 62% of patients.

Half of the men had decreases in PSA levels — some by more than 50% — indicating a return to more normal prostate cell activity.

For all of the nine patients who did develop cancer, the disease was the slow-growing type and confined to a small area.

If you are at risk: Based on the evidence that Zyflamend can reverse PIN and reduce PSA, I recommend taking three Zyflamend capsules daily (with meals to avoid gastric upset), continuing indefinitely, if you have any of the following…

An enlarged prostate (as detected during a doctor’s exam)

Any abnormal prostate PIN

PSA that is elevated for your age. PSA is considered elevated if it is at or above 2.5 nanograms per milliliter (ng/ml) in your 40s… 3.5 ng/ml in your 50s… 4.5 ng/ml in your 60s… or 6.5 ng/ml in your 70s.

An ultrasound or other imaging test showing prostate lesions

One or more immediate family members with a history of prostate cancer, if you are over age 50.

If you have high-grade PIN or prostate cancer: In addition to taking Zyflamend, consider taking a second new supplement, Prostabel, described below…

Prostabel. Available on-line from Natural Source International (888-308-7066, www.natural-source.com, $145 for 100 capsules), Prostabel combines extracts from the barks of the Amazonian Pao pereira tree and the sub-Saharan plant Rauwolfia vomitoria. In 1980, scientists from the Pasteur Institute in France identified the cancer-fighting properties of these substances.

Dr. Katz’s team at Columbia is now conducting a clinical trial on Prostabel. The study currently has 25 men, ages 40 to 75, with negative biopsy reports but elevated PSA levels. Participants were assigned to take from two to eight capsules of Prostabel daily for 12 months.

Findings are preliminary — eight men have completed the 12-month course of treatment to date. Prostabel significantly lowered PSA in five of the eight men. While four of the men have developed cancer, their cancers are small and slow-growing. Researchers are waiting to see if Prostabel suppresses cancer cell growth in the remaining 17 participants. Just one patient, who was on the highest dosage, developed liver enzyme problems as a side effect. Surprising: Patients experienced significant improvements in urination problems common among older men, such as frequent need to urinate and slowed stream.

To inquire about the clinical trial, call 212-305-3790.

Recommended dosage: Three Prostabel capsules daily. Take on an empty stomach to maximize absorption — if it causes digestive upset, take with meals instead.

MORE CANCER FIGHTERS

In addition to taking Zyflamend and/or Prostabel, I recommend that men who have had a diagnosis of prostate cancer take all of the following, continuing indefinitely…

Zinc. The prostate gland is extremely sensitive to hormones, especially estrogen. Although estrogen is primarily a female hormone, as men age and their testosterone levels decrease, an enzyme called aromatase converts some of the remaining testosterone to estrogen, thereby increasing risk for prostate cancer. Zinc helps to slow the activity of aromatase.

Dosage: 50 mg daily. Caution: Check with your doctor before taking zinc if you are undergoing chemotherapy — zinc may not be compatible with some chemotherapy drugs.

Copper. Long-term zinc supplementation can lead to a copper deficiency, so also take 2 mg of copper daily.

Selenium. This mineral appears to protect against prostate cancer, perhaps by providing antioxidants (chemical compounds that protect cells from free radicals that can damage cell DNA).

Dosage: 200 micrograms (mcg) daily. Note: Although evidence is not conclusive, selenium has been linked to increased risk for diabetes — so have your blood sugar monitored regularly.

Vitamin E. This provides antioxidants that guard against cell damage.

Dosage: 200 international units (IU) daily of “mixed” vitamin E (as indicated on label).

Calcium limit. Take no more than 500 mg of supplemental calcium daily. Some evidence links high doses to increased prostate cancer risk.

Men who have been diagnosed with prostate cancer and who want a more aggressive approach can add the following and continue taking them indefinitely…

Indole 3-carbinol. Supplementing with this plant chemical found in cruciferous vegetables helps the liver metabolize and excrete estrogen.

Dosage: 400 mg daily.

Maitake mushroom extract. This enhances immune function. Use capsules or tincture labeled “standardized MD-fraction.”

Dosage:1 mg per day for every 2.2 pounds of body weight (for instance, a 165-pound man would take 75 mg daily… a 200-pound man would take 90 mg daily). Take in two divided doses on an empty stomach.

Beta glucan. Beta glucan is a complex sugar. The most beneficial form is derived from baker’s yeast and sold under the brand name WPG 3-6. It boosts the immune system’s effectiveness against cancer and other diseases.

Dosage: 500 mg twice daily. The brand I recommend is ImmunotiX 3-6, the potent and purified WGP 3-6 product from Xymogen (800-647-6100, www.xymogen.com).