NOT LONG AGO, the Journal of the American Medical Association, the heavily vetted publication of the world’s most conservative organization of doctors, published a study of men who had taken an extract of saw palmetto, a plant that grows largely in Florida, every day for six months. Use of the herb, the study of 3,000 men concluded, had a beneficial effect on the men’s benign prostatic hyperplasia (BPH), an enlarged prostate condition that results in urinary difficulties, particularly for men over 50.

Both before and since then, several studies have reached similar conclusions. The herb is as effective as finasteride, the prescription medicine used to treat BPH, all investigations found.

But publication of the study in JAMA was especially significant. Reports in the journal of this and other herbal treatments signal that alternative therapies have entered into mainstream medicine.

BEYOND THE PLACEBO EFFECT

Since prescription drugs already effectively treat BPH, what’s the big deal? Why do we need an alternative?

“One reason is that herbal medications are less expensive and less toxic,” says Dr. William Fair, emeritus chairman of urology at the Memorial Sloan-Kettering Cancer Center in New York. “As with herbal supplements in general, there is still the problem of standardization. But the fact that there’s evidence that these substances provide something more than a placebo effect means the industry should work toward it.”

Fair, who has written extensively on the use of herbal supplements to complement conventional, or allopathic, medicine, notes that another herb, phygeum africana, has shown similar benefits to men with BPH.

Both substances, he says, have a significant effect on urinary flow rates. They have the added benefit of producing none of the side effects of finasteride.

NATURE’S PHARMACY?

Phygeum, however, may never see widespread use as a preventive treatment for BPH.

So far it’s been found only in Columbia, and appears to be on the edge of extinction. Its plight illustrates much about the future of potential natural treatments for disease: Only about 1.5 percent of the world’s plants have been identified. Who knows what other plants yet to be identified but on the verge of extinction might contain cures for deadly diseases?

What other natural treatments might benefit men with prostate problems? Perhaps the most exciting new agent introduced in the last year has been the herbal tea mixture PC-SPES, which has been shown to inhibit prostate cancer that is resistant to hormone therapy.

When prostate cancer spreads beyond the gland, doctors frequently attempt to block testosterone, which “feeds” the tumor. When hormones fail to do the job, the cancer spreads quickly. PC-SPES has been shown to have a phytoestrogenic effect — that is, it blocks testosterone.

Although it has not been subjected to the same randomized control studies as chemotherapy, it has been used by Chinese and other Asian cultures for more than 3,000 years.