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Middle-Aged Man Doing Yoga

Movember,” the annual moustache-growing month to draw awareness to prostate cancer, is drawing to an end, and once again I forgot to not shave. It’s not that I have an aversion to facial hair or an active intolerance to benign public-health campaigns; I just tend to pay less attention to popular trends than to stuff that might help me make healthier choices as I get older.

And it turns out that there was plenty of good news released this week on the prostate cancer front — depending on your point of view.

As some of you may know, I’m not a fan of prostate-specific antigen (PSA) screening. Studies showing the downsides of the procedure (primarily false-positive results leading to unnecessary treatment and nasty side effects) have been piling up in recent years, leading to the U.S. Preventive Services Task Force recommending in 2012 that doctors stop using the test. So I was happy to see a study from Brigham and Women’s Hospital in Boston and the Henry Ford Health System in Detroit showing that middle-aged men have begun to heed the warnings.

Researchers reviewed data from four National Health Interview Surveys involving more than 20,000 men and found a dramatic decline in the percentage of men choosing to undergo PSA screenings — 21.7 percent among guys 50 to 54 years old and 22.2 percent among men my age (60 to 64).

“It appears middle-aged men are hearing the message,” said lead study author Jesse Sammon, DO, who is less sanguine about the choices these guys are making than I am. “The problem is they’re controversial recommendations and very high-quality evidence supports the consideration of PSA screening for many men.”

Most prostate cancers are not life-threatening, but public health officials are concerned that without PSA screening more men will show up in their doctor’s office with advanced metastatic prostate cancer, which is often fatal. The side effects of radiation treatment in these cases — fatigue, impotence, incontinence — can be severe. Unless you’re doing yoga.

That’s what researchers at the University of Pennsylvania found when they surveyed 27 prostate cancer patients after they practiced Eischens yoga for 75 minutes twice a week for a year. The patients reported that the side effects of the radiation therapy gradually improved during the course of treatment.

Though it’s a tiny sample size, Neha Vapiwala, MD, an associate professor in the Department of Radiation Oncology, was encouraged by the results. She noted that regular yoga practice can strengthen the pelvic floor muscles and increase blood flow, helping to improve erectile dysfunction and urinary incontinence. And the social aspect of a yoga class probably can’t hurt, either.

“There may also be a psychosocial benefit that derives from participation in a group fitness activity that incorporates meditation and promotes overall healthiness,” Vapiwala said. “And all of this ultimately improves general quality of life.”

Good News

The last bit of good news comes from the University of California, San Francisco, which last week released a study showing that working up a sweat on a regular basis — combined with certain dietary choices — can help prevent a guy’s prostate from acting up in the first place.

UCSF researchers analyzed data from two major health studies tracking more than 62,000 middle-aged men from 1982 to 2010 and discovered a few key lifestyle patterns that tended to sustain a healthy prostate: regular exercise and a diet that included fatty fish and tomatoes while avoiding processed meats.

“It’s interesting that vigorous activity had the highest potential impact on prevention of lethal prostate cancer,” noted lead study author Stacey Kenfield, ScD, an assistant professor in the UCSF Department of Urology. “We calculated the population-attributable risk for American men over 60 and estimated that 34 percent of lethal prostate cancer would be reduced if all men exercised to the point of sweating for at least three hours a week.”

I don’t like to get too caught up in the specifics of these kinds of studies, but I do take heart in the knowledge that a basic healthy lifestyle will generally trump conventional approaches to many of the maladies guys my age face. That’s not to say I don’t appreciate everyone who sprouted a ‘stache this month; I just figure clean living — and a clean upper lip — is good enough for me.

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