Potential Therapeutic Effect of Ground Flaxseed on Begnin Prostatic Hyperplasia

Research Assignment Part One: The Potential Therapeutic Effect of Ground Flaxseed on Begin Prostatic Hyperplasia

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Question:

Is there a therapeutic effect of phytoestrogens, containing hydroxylated bicyclobenzylbutane diol, such as lignans, on begnin prostatic hyperplasia.

Target Population:

The target population of this therapeutic treatment would be for older males ranging from 40 years of age and older.  The optimal population would include males with begnin prostatic hyperplasia rather than metastatic prostatic hyperplasia, in which a more aggressive form of treatment might be needed.

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Intervention:

Administration of higher dosages of lignan extracts around 600 mg of lignin via flax seed extracts tablets.  It has been shown in a particular study that the higher dosage of 600 mg of lignin extract resulted in a greater impact on the reduction begnin prostatic hyperplasia, as well as its lower urinary tract symptoms (LUTS).

Comparative Treatment/Population:

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Ideally the study of interest should include a couple of study groups, with varying dosages of lignan extracts from flaxseed supplementation administered to the studies participants.  There should be one treatment group that will act as a placebo comparative group, to which the treatment groups can be compared against to find any significance.  There also needs to be a baseline to which all the groups need to be compared to, including the placebo group, to find if there is any significant difference from this baseline data, and to possible uncover if there is a placebo effect.

Defining Outcomes:

The resulting observational data will be quantified through clinical measurements which will hopefully include secondary measures such as prostate and bladder volumes, in which the residual volume would be calculated by the initial bladder volume minus the empty bladder volume ¹¹.  Secondary outcomes such as urine flow (Qmax) and changes in blood concentration of secoisolariciresinol (SECO), enterodiol (ED) and enterolactone (EL)  ¹¹.  Primary therapeutic measures, such as the overall quality of life and decrease in the overall Begnin Prostatic Hyperplasia symptoms could be measured through international Prostate Symptom Scale (IPSS), quality of life (QOL), survey scores as well as the ratings in the lower urinary tract symptom questionnaire ¹¹.  These LUTS measurements would be compared between groups with the placebo, and within each group for individual variation ¹¹.

Etiology, Prevalence, Justification:

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The most common agreed upon mechanism of how benign prostatic hyperplasia occurs, is due to an imbalance in the synthesis of dihydrotestosterone from the conversion of testosterone via a 5-alpha reductase enzyme ¹¹.  This increases dihydrotestosterone levels within circulation or within the prostate tissue, which then binds alpha-adrenergic receptors, resulting in an increase in prostate tissue ¹¹.   I was unable to find clear statistics for the proportion of males with benign prostatic hyperplasia within Canada, which could possibly be due to the idea that because it is not a metastatic cancer, and usually required minimally invasive treatments, especially if it is has small to medium LUTS, maybe the male population is not reporting it to the system.  However, multiple longitudinal and cross-sectional studies have been performed with a large range of males from different ethnicities and socioeconomic statuses and have found there to be an increase in the prostate size from 25g to 30g for males in their 40s, from 30g to 40g for males in their 50s and from 35g to 45g in males in their 60s ⁹.    Pharmaceutical prostatic reductive agents such as Finasteride have been seen to be very effect at reducing not only the symptoms of begnin prostatic hyperplasia but also effective at reducing the prostate mass and volume.  However they have been found to increase the rates of erectile dysfunction, decreased libido, depression and anxiety ¹⁰.  Lignan extracts from flaxseed supplementation could be used as a natural alternative with similar reductive effects as its pharmaceutical counterparts all the while lacking the same potential adverse side effects and also having positive synergistic cardiovascular health benefits due to potential anti-oxidant components of the flaxseed supplementation besides the lignan extracts.

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Searches:

Pubmed (Limitations, Species: humans, randomized, prostatic hyperplasia)

Cochrane Library (Limitations: none, benign prostatic hyperplasia)