Introduction

Max Gomez, Ph.D., Health Editor, WNBC

How's your prostate? What do you think it will be like in five years? In ten? In fact, as long as I'm asking -- how's your health in general? How is your cholesterol? Your blood pressure? Your PSA?

Sound a little nosy? Even rude? Sort of like asking what your bank balance is or whether you'll be able to afford to retire at age sixty-five or put your kids through college. I would never dream of asking about your private finances, but I'll bet you have at least a pretty good idea of how much you have in the bank. You may even read money magazines, newsletters, follow the stock market, or get financial advice from friends or professional advisors. But I'd be willing to bet just as much that you don't know your blood pressure, cholesterol, or, since this book is about prostate health, your PSA number.

Most men are serious about providing for the financial needs of themselves and their family. But when it comes to their personal health, their level of concern or interest is nowhere near the same. How many men subscribe to health newsletters or confer with nutritionists, never mind see their doctors regularly? Think about the financial straits your family would be left in should you develop a serious illness or, God forbid, die from a disease that could have been treated and even prevented! When you consider what you mean to your family, maybe you should be paying more attention to your health; at the very least, it should be as much as you pay to your finances.

In the United States -- a country with some of the best doctors, hospitals, and medicine in the world -- the majority of men never visit a doctor regularly. For many men, years can go by without their having their blood pressure taken, cholesterol checked, or urine analyzed. Men in America don't go to the doctor until they are sick, figuring that "if it ain't broke, don't fix it." The trouble is, this attitude is like closing the barn door after the horse is gone. By that I mean that, often, by the time you get sick enough to force you to go to the doctor, there may be precious little a doctor can do to help. The problem may have been treatable or even preventable had you gone sooner; but in a later stage, treatments may be painful, devastating, or may not be able to "fix" the problem.

Remember the old Geritol commercial slogan that proclaimed, "When you've got your health, you've got just about everything"? Sounds trite, but it's really true. When you're sick, nothing else matters; when you're healthy, everything else is possible. The fact is that the single most important thing a man can do to provide for the security of his family -- both financial and emotional -- is to take care of his health. Caring for your family means caring for your health, pure and simple.

But visiting a doctor is only one part of taking control of your health. An equally important part is learning everything you can about preserving your health with preventive care -- learning about the foods and nutrients that enhance your health as well as the substances that can harm it. The dirty little secret no one wants to talk about when it comes to health is that most of the diseases Western man dies of are largely self-inflicted. I know this sounds like blaming the victim, but we have to own up to the fact that the heart attack or cancer we suffer from at age sixty probably had its roots in the cheeseburgers we were eating (and other bad habits we were practicing) throughout our twenties, thirties, and beyond.

But let's get back to prostate cancer, which has been a topic of special interest to me for some time. It has long struck me that men just don't take prostate cancer as seriously as women take breast cancer. Men are certainly are not as vocal about it, yet prostate cancer is very similar in terms of the numbers affected, while treatments are nowhere near as advanced as they are for breast cancer. Far more research dollars flow into breast cancer research than into prostate cancer research primarily because women have mobilized and lobbied for it. This in no way means that we have conquered breast cancer or even that we have adequate means of treating, detecting, or preventing it -- just that the current state of knowledge on prostate cancer lags well behind what we know about breast cancer.

My opinion stems partly from my recent prostate cancer news segments, which have focused on such topics as:

• Mobile health units that spread the word to men on this silent but often deadly disease

• A recent study confirming that men who undergo vasectomies are no more likely to develop prostate cancer than men who do not

• The controversy over the effectiveness of PSA testing for finding prostate cancer

• How researchers at several institutions are currently testing vaccines that may save countless lives from prostate cancer

Of all the newsworthy topics relating to prostate cancer and health, arguably none is more important than the role of proper nutrition in preventing or controlling prostate cancer, yet it is the least well understood by the general public. Few men, for example, have ever heard that Asian men, who eat more soy, have a lower prostate cancer rate than other ethnic groups, another recent news segment I reported. That's a big reason why in this book you will find additional leading-edge information from America's top researchers on how to prevent various kinds of prostate problems -- from an enlarged prostate to prostate cancer. I would venture to guess that one of the most surprising yet important things you will discover in these pages is this: the same plan of prevention that helps stave off cancer in the first place should be continued and is still effective even after prostate cancer is diagnosed.

In the pages of this book you will get that crucial information from the Institute for Cancer Prevention's top researchers, including potentially life-saving information on treatment options after diagnosis. The Institute for Cancer Prevention (the new name of the American Health Foundation) is America's premier cancer prevention research organization. In fact, it is the only national research organization devoted specifically to the prevention of cancer and has been studying the nutritional factors in cancer prevention with multidisciplinary research since 1974.

In case the significance of the word "prevention" in the Institute's name hasn't quite registered, think about the following: It is estimated that fully 70 percent of cancers are preventable through lifestyle changes, primarily diet and the avoidance of tobacco. Seventy percent! That means that if we could just change a few bad habits and adopt a few preventive measures by modifying our diets, we could well see cancer become an unusual occurrence instead of the scourge it has become today.

More important, we're talking prevention, not treatment. As good and promising as some new cancer therapies are, any candid oncologist (cancer specialist) will admit that it is far better never to get cancer than to treat it. Even successful cancer treatment will likely be a damaging ordeal. How much better to prevent cancer in the first place than to go through disfiguring surgery, brutal chemotherapy, and energy-sapping radiation! That's the potential we present here.

In the course of this book, we present the Transition Diet. It is a program based on the pioneering effort made over many years by my coauthor, Dr. Daniel Nixon, President of the Institute for Cancer Prevention. Dr. Nixon explains that the changes that we need to make in our diet should be undertaken gradually and systematically -- that we should dismantle our old, unhealthy eating habits one nasty habit at a time and introduce healthy substitutions in the same systematic way.

This may well be the most sensible diet plan you'll ever see, and it offers not only the best hope of preventing prostate cancer but also of treating the disease in its early stages.

Let me take a more personal perspective, if I may, that I hope will drive home my reasons for believing in cancer prevention as a better way. I was born in Cuba and grew up with the Caribbean equivalent of "bicoastal"; that is, for all intents and purposes, my immediate family lived both in Miami and Havana until Fidel Castro came to power. Then virtually all of my extended family -- aunts, uncles, cousins, grandparents -- were trapped in Cuba, prohibited from emigrating for years. It was shortly thereafter that my grandfather, after whom my father and I were named, developed prostate cancer. Prevented from coming to America for treatment, he died never again having seen his son or grandchildren.

Recently my father and I returned to Cuba for the first time in nearly forty years. I did a bittersweet story on how my father was able to, after all these years, visit his father's grave and finally bid him rest in peace. But as the senior health correspondent for the flagship NBC television station, I was also particularly interested in the Cuban health system. While the standard of living in Cuba is poor by Western standards, Cuba has achieved remarkable success in health care despite the fact that its medical system lags behind ours in many respects. Cubans living on the island have nearly the same life expectancy as people living in the United States, their infant mortality rates are actually better than in many cities in this country, and they die of the same degenerative diseases of the Western world: cancer, heart disease, and stroke.

Yet when I visited a hospital or clinic in Cuba, I was struck by the lack of medical supplies -- many clinics hardly had two aspirins to rub together. So how had Cuban medicine managed to achieve many of the same health milestones we have in this country?

There are many answers to this question. In Cuba's version of socialized medicine, doctors work for the government public health system. Every school, factory, farm, workplace, apartment complex, and neighborhood is assigned a physician; Cuba has more than twice as many doctors per capita as we do in the States. Not only do these doctors work in the neighborhoods they serve, they actually live in their practice area. A common arrangement is for a doctor to live above his office, often with his nurse living in the same apartment complex or the same small stand-alone clinic.

Because these doctors are neighbors of the people they treat, they see whether Señor Rodríguez is smoking again, whether Señora González has been coming in for prenatal care, and that Señorita López may be getting too heavy. The doctor can then help his or her patients before they get really sick. In other words, they may not have high-tech medicine, but they practice good old-fashioned hands-on preventive medicine! Granted that much of this is born out of necessity, but there are lessons here for all of us.

One area that Cuban doctors have developed -- again, partly out of necessity but partly out of a long tradition of herbal medicine and healing -- is medicina verde, literally "green medicine." (I still remember my grandmother brewing up a cup of manzanilla tea -- chamomile in America -- to ease my upset stomach.) Because they have a tremendous shortage of modern drugs and medications, Cuban doctors use herbal medicine for a wide range of ailments. In fact, the government publishes a pamphlet detailing the uses of herbal preparations, and every pharmacy has an entire section devoted to medicina verde.

Perhaps as a consequence of our scientific achievement in America, we have forgotten the ancient lessons learned by less technologically advanced cultures when it comes to the value of good nutrition and the appropriate use of herbal medicine. In recent years, we have discovered more and more about the science behind Chinese herbal medicine and Indian Ayurvedic medicine, both of which utilize food and herbs for good health. But we still tend to treat people after they get sick rather than work at keeping them healthy.

Not only is it often too late to really help people after disease has taken hold, but our propensity to look to science to fix a problem has become counterproductive when it comes to our health. America still has the space-age attitude that to every problem there's a technological answer. We expect to be able to eat a lousy diet, never exercise, smoke, drink to excess, and fry in the sun, and that modern medicine will give us a pill or an operation to make us all better when we suffer a heart attack or stroke -- or develop skin, lung, breast, colon, or prostate cancer. Well, I'm here to tell you that modern medicine often won't be able to help you. You have to acknowledge some responsibility for your own health; not only are a lot of the diseases we suffer from partly due to our lifestyles, but we can do something about them!!

Eating foods today that will protect you tomorrow is really as simple and logical as planning the finances today that will help you live better when you retire -- or changing the oil in your automobile now so that it won't need a complete engine overhaul later. When it comes to both your car and your health, the mechanic in the commercial had it right -- you can pay me now or you can pay me later -- and later it's going to be a lot more painful.

Recently I learned something that made preventive medicine even more compelling. I started studying prostate cancer rates around the world. Autopsies show that even young men -- as young as their early thirties -- have signs of prostate cancer. If even thirty-year-olds have the seeds of prostate cancer but live out their whole lives and die in their eighties and nineties of something else, what is going on?

It could be genetic, of course. But Dr. Nixon and the researchers at the Institute for Cancer Prevention and others found otherwise. The difference is diet and nutrition. When Asian men move from Japan or China to Hawaii and begin consuming our Western diet, their rate of prostate cancer rises to meet that of men in the United States. And not only is the incidence of prostate cancer lower among Asian men (in Asia), their death rate from the disease is also far lower. The lesson here is that we in America can do a lot to protect ourselves against the number two cancer-killer of men.

Both as a health reporter and as a man, I know that the information in this book is crucial to all men of all ages and to their families. It is far more important than almost any of the other things you spend time and energy worrying about. You must play a part in protecting your most precious possessions, your own body and health. After all, there will always be another stock and another car. But you only have one body and your family has only one you. The time to care for your health is now.

Copyright © 2004 The Institute for Cancer Prevention, Max Gomez, and The Reference Works, Inc.