Prevention and treatment of Prostate Cancer

PSA blood test may allow treatment

Prostate cancer. Malignant neoplasm, usually adenocarcinoma, is the second major cause of cancer deaths in males in the U.S.. Occurrence under age 50 is unusual; but a large percentage of men will develop cancer of the prostate as they grow older.

What causes prostate cancer is not known; and there is no evidence that benign prostatic hypertrophy (BPH) develops into it. What we do know is that, after growing inside the prostate gland, cancer cells can grow through the wall of the prostate (the capsule) and spread to other areas.

With time, the cancer can spread to lymph nodes, and on to other organs, producing fatal results. There may be no symptoms at the onset; but as the disease progresses, signs of urinary outflow obstruction or bone pain may appear.

Prostate cancer is described by one of four stages: A or B when the cancer is believed confined to the prostate gland; C meaning it has spread into the area immediately outside the prostate gland; and D when it is spread to areas outside the prostate region. Stage D is incurable.

Prevention of Prostate Cancer. A diet low in fats is recommended. A large study at Loma Linda University in California involving over 6,500 men showed a 3.6 greater incidence of prostate cancer in men who ate large amounts of meat and dairy products to those who ate those foods sparingly or not at all. Studies in Asia and South Africa also showed a lower risk in men who maintained a very low-fat diet.

Early detection of tumors by a routine rectal exam and prostate specific antigen (PSA) blood test may allow treatment while the tumor is localized to the prostate. Rectal exam and a PSA test are recommended to be performed annually for all men over 50. By inserting a gloved finger into the rectum, a physician can feel any nodules or areas of questionable firmness or hardness in the prostate.

If either abnormality is detected or if the PSA is significantly elevated, a biopsy is done. Ultrasound study can also be used to visualize and measure nodules in the prostate.

Radical prostatectomy

Radical prostatectomy, a major surgical procedure consisting of removal of the prostate gland and adjacent seminal vesicles, is the primary recommendation of urologists but is associated with potential complications that must be considered.

First, the surgery is not a guaranteed cure and men may not live longer because they had the surgery. Second, many men develop urinary incontinence following surgery and some have to wear pads. Finally, even with the nerve-sparing radical prostatectomy, at least 70% of patients lose their ability to have an erection.

Radiation theraphy. Combined precision irradiation (CPI) combines the use of two types of radiation theraphy that are less effective alone for purported good results. This technique uses ultrasound to guide placement of radioactive iodine seeds through the perineum into the prostate and seminal vesicles.

The simple operation takes 30 - 40 minutes and the patient may go home the same afternoon or the next day. Post implant accelerator irradiation to the prostate begins three weeks after the implant and is given five days a week for six weeks. An alternative to this procedure is to make an incision to place the seeds which also allows removal of suspicious lymph nodes.

Hormonal manipulative theraphy. Either castration or use of medication (LH-RH agonists or estrogens) can be used. By markedly lowering male hormone (testosterone), the tumor will shrink and symptoms caused by the cancer will diminish or disappear. This form of treatment is used only when the cancer is incurable by either surgery or irradiation or when the patient is not a suitable candidate for curative treatment.