Prostate Cancer



Prostate cancer:

is a form of cancer that develops in the prostate gland in men.

Most prostate cancers are slow growing; however, there are faster moving ones which may spread from the prostate to other areas of the body like the lymph nodes, the bones like the vertebrae, ribs, pelvis, and femur.

As mentioned in the previous paper regarding BPH ( Benign prostatic hypertrophy hyperplasia) there are symptoms which can precede prostate cancer such as pain, difficulty in passing urine, nocturia, sexual intercourse pain, failure to get an erection Other symptoms can potentially develop during later stages of the disease. But sometimes no symptoms exist for men at all with prostate cancer and as a consequence they never have treatment and many times die of unrelated causes.

It has been shown prostate cancer tends to develop in men over the age of fifty and it is rare in men under 45.

It is one of the top 6 cancers causing death for men in the developed world and is higher in the US. Notwithstanding this over 80% of men will develop prostate cancer by the age of 80.

In the majority of cases prostate cancer will be slow-growing and benign. In such men, diagnosing prostate cancer is often viewed as “over diagnosis”

There has been debate about regular PSA testing by men over 50 of the benefit of having such a blood test because of its reliability, but most GPs conclude the benefit of the test outweighs the choice of not having a test.

The U.S Preventative Tasks Force concluded the following:

“Expected harms include anxiety for 100 – 120 receiving false positives, biopsy pain, and other complications from biopsy for false positive tests. Of those found to have prostate cancer, frequent over diagnosis is common because most cases of prostate cancer are not expected to cause any symptoms

If a PSA (Prostate-specific antigen) blood test may help 1 in 1000 avoid death due to prostate cancer, 4 to 5 in 1000 would die from prostate cancer after 10 years even with screening.”

In other words if PSA testing is inconclusive as to the diagnosis of prostate cancer -why do it in the first place?

A biopsy however can confirm the presence of prostate cancer. It involves inserting a special biopsy gun like instrument into the rectum and removing via special hollow-core needles tiny pieces of prostate for testing. It’s quite quick in the process but can be a little painful to some not all.

The one other test which has proved reliable and twice as good finding prostate cancer as the standard PSA test is a noninvasive test looking for the presence of the protein EN2( Engrailed-2)in the urine.

The University of Surrey’s Post Graduate Medical School maintained that ;”only rarely did we find EN2 in the urine of men who were cancer free, soif we find EN2 we can be reasonably sure that a man has prostate cancer.EN2 was not detected in men with non-cancer disorders of the prostate such as prostatitis or benign enlargement. These conditions often cause a high PSA result, causing considerable stress for the patient and sometimes also unnecessary further tests such as prostate biopsies."

There are also several other tests that can be used to gather more information about the prostate and the urinary tract:

1. An internal rectal examination to detect any prostate abnormalities.

2. A thin camera is inserted into the urethra which looks from the inside of the bladder.

3. An ultra sound and or Magnetic Resonance Imaging (MRI) is the two main imaging methods used for prostate cancer detection. An MRI provides a good image of the area for the doctor to see.

4. And finally there are the Trans rectal ultra –sonography which uses sound waves to create a picture of the prostate with a small probe inserted into the rectum.


Causes

There are a range of symptoms which while helpful are non-specific in their nature. However if any of these relate to the reader keeping a surveillance on his own prostate gland, the use of an accurate diagnosis regularly is definitely worth having done.

The primary risk factors are obesity, age and family history, but there are several related causes to consider:

  • Men with brothers appear to have a higher risk than men with fathers who have had it.
  • Blood pressure that is high appears more likely to develop prostate cancer.
  • Lack of exercise has been counted in as a contributing factor
  • African Americans are more affected by prostate cancer than white or Hispanic men, and are also more deadly in black men.
  • There is no evidence to suggest alcohol contributes or the eating of more fruit or vegetables or red and processed meat appear to have little effect.
  • Lower blood levels of Vitamin D may increase the risk of developing prostate cancer.
  • There are also some links between prostate cancer and medications, medical procedures, and medical conditions.
  • Use of cholesterol lowering drugs may decrease prostate cancer risk.
  • Contracting sexually transmitted diseases may contribute to an increased risk.
  • Obesity and higher than normal blood levels of testosterone may increase the risk for prostate cancer.
  • Vietnam War Vets exposed to Agent Orange had nearly a 50% increased risk of prostate cancer recurrence following surgery.
  • Men who ejaculate more frequently may decrease a man's risk of prostate cancer. One study showed that men who ejaculated 3-5 times a week at the age of 15-19 had a decreased rate of prostate cancer when they are old, though other studies have shown no benefit.

Treatment

Prostate cancer, especially the most common, low-grade forms found in the typical elderly patient, often grows so slowly that no treatment is required at all.


Aggressive prostate cancer

Treatment for aggressive prostate cancers involves surgery

It may involve :radiatation therapy, external beam radiation therapy, high focused ultra-sound, chemotherapy, oral chemotherapy,hormonal therapy, cryosurgery or a combination of these treatments.

All of these involve serious and detailed discussion and advice from your GP or Specialist and Repair Incontinence strongly recommends if your diagnosis is you have an aggressive prostate cancer to attend to this as soon as is practically possible.

It is not our intention on this website to go into or discuss the range of treatments available given the wide variety of choices available to your clinician who will discuss these in detail with you.


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