Prostate Cancer Digest

The prostate is a walnut-sized gland found only in males that is located almost in between the urethra and the rectal cavity. It is surrounded by nerves and blood vessels which lead to the penis and the bladder. The purpose of the prostate is to secrete the prostate specific antigen (PSA) protein that liquefies the semen to enable the sperm cells to launch their journey. In simplest terms, it is the prostate that makes ejaculation possible. Prostate cancer is the growth of tumor cells in the prostate gland which can also invade the bladder, lymph nodes and bones. Once it had spread to the bones, it becomes incurable and extremely agonizing. “Everybody talks about the painful last year of life for prostate cancer,” observes urologist Dr. Peter Albertsen of the University of Connecticut. “It is a horrendous death.” It is the second most common form of cancer in men after skin cancer; and the second most common form of cancer death after lung cancer, according to the American Cancer Society. The leading risk factor is aging, and men between 40 and 75 are well advised to get regular medical examinations. The standard procedure in diagnosis is by testing the PSA level in the blood. The rule of thumb is that a PSA reading of above 4 is cause for concern. But “Although the PSA is the best test for prostate cancer, it’s far from perfect,” wrote Dr. Harvey Simon in The Harvard Medical School Guide to Men’s Health “In round numbers, about 20 percent of men with prostate cancer have normal PSA levels. At least two out of three men with high PSA levels do not have cancer: instead, their results have been elevated by some other condition such as benign prostatic hyperplasia (BPH), prostatic inflammation, or a urinary tract infection.” If a second PSA test confirms the initial finding, the next order of battle is getting a biopsy. The aggressiveness of the tumor cells are rated on the Gleason scale from 1 to 10. At this point, the patient and his physician will have to decide on the best of treatment. Informed choices are crucial, and here are the 5 approaches in combating this disease. Radical prostatectomy Radical prostatectomy is the complete removal of the prostate gland from the body via open surgery. Although this will affect sexual- and urinary functions, “There’s no better way to eliminate a cancer that’s confined to the prostate than total removal,” says Dr. Patrick Walsh, urologist at Johns Hopkins and Sen. John Kerry’s surgeon. Laparoscopic surgery Laparoscopic surgery is the operation on the prostate where surgeons create only a small incision on the patient and use x-rays videos to guide their instruments. There is minimal scarring and blood-loss, and the recovery time is just a matter of days. Common side effects are impotence, incontinence and bowel complications. This technique is relatively new so there is “a steep learning curve” for doctors, according to Simon. “When you’re first learning the procedure, it takes longer and has more complications, particularly rectal injury.” Radiation therapy Radiation therapy is the administration of a radioactive isotope to eliminate the tumor cells in the prostate. This can be done externally by using a focused beam; or internally by inserting the isotope seeds directly into the prostate. The isotope can either be iodine or palladium. An isotope seed is about the size of a rice grain. It is easier and cheaper than surgery, and the patient can return to his work the next day. The downside is the damage to tissues which renders future surgery dangerous, and the possibility that some tumor cells have survived. Hormone therapy Hormone therapy is the administration of drugs that block testosterone, the hormone that boosts bone density, muscle mass and red-blood cell count – but also fuels tumor growth. But it is not a cure for cancer, per se, and there’s always a risk that malignant tumors may recur in 15 years. The side effects are the classic symptoms of menopause: headaches, irritability and hot sweats. Diet and lifestyle change Diet and lifestyle change essentially means eating a balanced diet, engaging in exercise and avoiding stress and negative attitudes. This is the best way to prevent cancer but there’s no guarantee it will cure it. One of the most famous spokesmen for this personal paradigm shift is Dr. Dean Ornish, the advocate of low-fat diets as a way to reverse heart disease. Using the Ornish method, a study found that the subjects reported a 6.5% decrease in their PSA levels within 3 months. The regimen demands 1) limiting fat intake to 10% of total calories; 2) three hours of exercise a week and 3) meditation and support-group study sessions.