Prostate Cancer

Cancer and Neoplasms, Renal and Urogenital

Prostate cancer occurs when cells in the prostate gland grow out of control. To understand prostate cancer, it is first important to understand the prostate gland. The prostate gland is located in the male reproductive tract near the bladder and rectum. Its primary job is to create a fluid that gives sperm nourishment and keeps the semen in a liquid form. The prostate sits in the middle of the urethra and can become enlarged and grow abnormal cells. This can begin with a condition known as prostatic intraepithelial neoplasia (PIN). This usually starts in young men between the ages of 20 to 40 years old, and 50 percent of men have these abnormal cells. Another type of condition that causes abnormal cells is called proliferative inflammatory atrophy (PIA). This is a sign of inflammation to the prostate gland and may turn into cancer cells. Doctors will usually do a biopsy and keep a close eye on the cells to watch for changes. Prostate cancer affects 1 in 5 men in the United States. Prevention is key in this type of cancer and early detection and treatment can increase the lifespan of men at risk for this disease.

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Symptoms

The symptoms of prostate cancer may not appear until the disease is advanced. 85 percent of prostate cancers are caught because of early screening tests before any symptoms develop. Early warning signs of the disease are rare. When the tumor grows, the symptoms may include:

  • Frequent urination, especially at night
  • Reduced urine flow
  • Trouble starting a urine stream
  • Weak or interrupted urine flow
  • Burning or painful urination
  • Painful ejaculation
  • Trouble getting an erection
  • Blood-tinged semen
  • Decreased volume of ejaculation
  • Pelvic discomfort and pain
  • Pain in the bones, especially lower back, hip, or upper thighs
  • Swelling in the lower extremities

There is another prostate condition known as benign prostatic hyperplasia (BPH) which causes the prostate to become enlarged and cut off the urethra preventing urine from flowing properly. Studies show this is not a cancerous condition and does not cause prostate cancer, but it is serious and needs treatment. Symptoms can also mimic those of BPH, so it is important to see your doctor if you have the above symptoms. There are a few simple tests that can help the doctor decide whether your condition is BPH or cancerous.

Risk Factors

  • Age (between 65-80 years)
  • Family history of prostate cancer
  • Genetic susceptibility
  • Serum sex hormones (androgens)
  • Diet (excessive red meat, fats, and dairy)
  • Excessive alcohol use
  • Vasectomy
  • Obesity
  • Low physical activity

Diagnosis

A special mention should be made about screening for prostate cancer. Various screening methods include a digital exam (inserting a physician’s finger into the rectum to feel the prostate), and a blood test to measure the level of prostate-specific antigen (PSA). A high level of PSA may indicate cancer, among other possibilities. Various governing bodies have concluded that the benefits of screening do not always outweigh the risks. A high level of PSA does not always mean cancer but would subject the otherwise normal individual to invasive, painful, or costly tests. It is important to discuss with your doctor if you are a candidate for screening. See your doctor yearly for prostate screening exams. Prostate screening exams should be done after the age of 40 for any man that has risk factors and yearly after the age of 50. It may be uncomfortable but may save your life. If you develop symptoms, see your doctor right away. Yearly prostate screening tests include:

Digital rectal exam (DRE). The doctor will place a finger into the rectum so the prostate gland can be checked for enlargement. They also feel the shape and texture of the gland. Based on this test, it may be decided to run further testing.

Prostate-specific antigen (PSA). This is a blood test that checks for high levels of this antigen. It can be elevated in several different prostate diseases including BPH, infection, or cancer.

If the doctor suspects cancer, the following tests may be ordered:

Ultrasound examination. A very small doppler is placed into the rectum to look at the prostate gland. They can more clearly see the shape and size of the gland.

Biopsy. If your gland looks abnormal, the doctor can take a small sample of cells from the gland with a needle. This will be looked at by a laboratory for abnormal cells.

If you are diagnosed with prostate cancer, the doctor will run more tests to stage cancer and see how far it has spread. This will help determine the level of treatment you will need. This will include bone scans, computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans.

Stages

Based on the results of these tests, cancer will be assigned one of the following stages:

Stage I. The cancer is still in the prostate and has not spread to any other areas of the body. The cancer isn’t considered aggressive at this stage.

Stage II. The cancer is still confined to the prostate, but the cells are becoming aggressive and growing throughout the gland.

Stage III. Cancer has spread to tissues around the prostate and seminal vesicles.

Stage IV. Cancer has spread to other organs, lymph nodes, and the bones.

Treatments

If your prostate cancer is caught in the early stages, your doctor may opt to “watch and wait.” This means your doctor will follow you closely and monitor blood tests and additional biopsies. The first stage of prostate cancertends to be slower growing. If cancer is found to be at Stage II or beyond your oncologist may order radiation, chemotherapy, biological, and/or hormone treatments. If none of these treatments work, then surgery is recommended. The treatments are as follows:

Radiation treatments. They will use high powered radiation either directed at the outside of your body, or on the inside. Radiation has side effects that include pain with urination, diarrhea, pain with bowel movements, trouble having an erection, and increased urination.

External radiation. A beam of radiation will be directed at the prostate area. This usually lasts 5 days a week for around six to eight weeks.

Internal radiation. They will place rice size grains of radiation into your body and they will release the radiation over time. The seeds can be placed directly in the area of the prostate and are not removed once they are done.

Chemotherapy. When prostate cancer spreads throughout the body and there is no response to other treatments, doctors may suggest chemotherapy. This sends a medication into the body that can kill off cancer cells anywhere they spread. It can be given either intravenously or orally.
Sideeffects include; hair loss, weight loss, nausea, vomiting, and fatigue.

Biological therapies. These medications increase your immune system to fight off cancer. The lab will engineer some of your immune cells to make them able to fight off and kill prostate cancer cells and then places them back into your body.

Hormone treatments. Testosterone directly affects prostate cancer cells and increases their growth. Hormone treatments block the production of testosterone. Some medication scan block the effects of testosterone on cancer cells. The doctor can also surgically remove the testicles to stop them from producing testosterone. This type of treatment only slows cancer growth and is most often used with other cancer treatments as a combination therapy. Side effects include trouble getting an erection, weight gain, reduced bone mass, and low libido (sex drive).

Prostate surgery. The doctor removes the prostate, any tissue that may be affected around the prostate gland, and lymph nodes in the area. This can either be done with open surgery or laparoscopically. Side effects may includeerectile dysfunction and trouble urinating.

Cryosurgery. This is a minor surgery where the doctor places thin needles into the prostate gland. Then cold gases are sent through the needles to freeze any cancerous tissue. This is usually done only when radiation treatments do not work.

Alternative Treatments and Home Remedies

While alternative medicine has not been shown to cure cancer, some people may use alternative medicine as a complementary therapy to medical treatments. This may help with the side effects of treatment and reducing cancer symptoms. Always speak with your doctor about using alternative medicine. Some herbal therapies have side-effects and drug interactions that can interfere with medical treatment. A few alternative medicine therapies for prostate cancer include:

Increase antioxidants. Antioxidants help to cleanse cancer-causing free radicals from the body. Eat more plant-based foods like fresh vegetables, fresh fruits, and get enough vitamin E, vitamin C, and Co-Q10.

Lycopene. This carotenoid is found in considerable amounts in tomatoes. Lycopene is a strong antioxidant that may reduce the risk of prostate cancer.

Allium vegetables. These include garlic, onions, chives, leeks, and scallions. Allium vegetables have been shown to have antitumor effects. A recent population-based study involving Chinese men with prostate cancer and healthy controls showed a reduced risk for prostate cancer in those with a diet rich in these vegetables.

Lower inflammation levels. Having high levels of inflammation in the body encourages the growth of damaged cells and cancer. Reduce foods in the diet that encourage inflammation like dairy, red meats, processed foods, and wheat.

Curcumin. This comes from turmeric and may have cancer stalling properties.

Maitake mushrooms. These Asian mushrooms may inhibit the growth of cancer cells.

Cleanse the body. Getting toxins out of the body can increase our healing potential. Try a sauna bath or do exercises that make you sweat. Make sure your bowels are moving properly. and try the following cleansing herbs with your doctor’s approval:artichoke leaf, milk thistle, and dandelion. These can help the liver work better to remove toxins.

Lifestyle Changes

The very good news for prostate cancer is that research shows lifestyle changes can slow the progression of cancer. While diet and lifestyle changes are not a cure for cancer, there are definite changes in the results of the PSA and biopsies one year from diagnosis. If you have Stage I prostate cancer, lifestyle changes may be the only treatment needed and in later stages can increase positive outcomes when used with cancer treatment. Lifestyle changes include:

Dietary changes. Dietary changes to help fight off prostate cancer includessoy proteins in place of meats, fresh fruits and vegetables, legumes, and whole grains.

Exercise. 30 minutes of exercise at least six days of the week. This needs to be a moderate level of aerobic exercise such as walking briskly, jogging, rowing, or riding a bicycle.

Reducing stress. Lowering stress levels can help the body fight cancer. Try meditation, relaxation techniques or incorporate yoga as a form of exercise to increase deep breathing.

Find support. Studies show that 95% of men who do lifestyle changes plus add a weekly cancer support group show a steeper drop in the PSA after one year. Support groups help relieve stress by giving you others to talk to that understand your diagnosis. Support groups can be found through your local community health department, church, or local hospital. For those who have not yet been diagnosed with prostate cancer, lifestyle changes can reduce the risk of getting prostate cancer. This is especially important if you have a family history of the disease.

References

American Cancer Society.(2019, August 19). What causes prostate cancer? Retrieved fromAmerican Cancer Society:https://www.cancer.org/cancer/prostate-cancer/causes-risks-prevention/what-causes.html

American Cancer Society. (2015, August 13). Prostate cancer prevention and early detection. Retrieved from American Cancer Society:https://www.cancer.org/content/dam/CRC/PDF/Public/8793.00.pdf

Geo Espinosa, M. L. (2015, August 13). Six naturopathic methods to combat prostate cancer. Retrieved from Naturopathic.org: www.naturopathic.org/content.asp?contentid=505

John Hopkins Medicine. (2021). Prostate cancer symptoms. Retrieved from:https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-symptoms

Mayo Clinic. (2015, March 3). Causes of prostate cancer. Retrieved from Mayo Clinic: www.mayoclinic.org/diseases-conditions/prostate-cancer/basics/causes/con-20029597

National Institute of Health. (2015, July 31). Prostate cancer. Retrieved from National Cancer Institute: www.cancer.gov/types/prostate

National Library of Medicine. (2005, September 17). Intensive lifestyle changes may affect the progression of prostate cancer. Retrieved from National Institute of Health: www.ncbi.nlm.nih.gov/pubmed/16094059

Shaw, S. I. A. (2016) An update on the risk factors for prostate cancer. World Cancer Research Journal, 3(2), e711. Retrieved from:https://www.wcrj.net/wp-content/uploads/sites/5/2016/06/An-update-on-the-risk-factors-for-prostate-cancer-e711.pdf

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