The prostrate enlarges as a man approaches middle age and will continue to enlarge for the rest of his life . the prostrate gland lies just below the bladder in front of the rectum and is found only in men . It surrounds the urethra which is the tube that leads from the bladder through the prostrate and penis and transports urine and semen . The main function of the prostrate gland is to produce semen which is the fluid that transports sperm during ejaculation .
The prostrate gland in an adult man is about the size of a walnut . the prostrate enlarges as men approach middle age and will continue to enlarge for the rest of their lives . This enlargement is made up of benign (non cancerous ) tissueand is known as benign prostatic hyperplasia (BPH) . BPH is not cancer nor does it lead to cancer , but it can interfere with the normal flow of urine and cause uncomfortable flow of urine and cause uncomfortable urinary out flow symptoms .
TIPS FOR A HEALTHY PROSTATE
Limit consumption of high fat foods , particularly red meat and diary products .
Eat a lot of fruits and vegetables , especially tomato and cruciferous vegetables like sprouts , cauliflower and others in the cabbage family . eat fish with a high omega-3 fatty acid content such as salmon , avoid alcohol , be physically active maintain a healthy weight
CANCER OF THE PROSTRATE
Prostate cancer is the second most common male cancer in the west . the death rates have doubled in the past 20 years and are predicted to overtake lung cancer as the first in the next few years . In India , though no specific statistics are available are available the national registry of cancer does show a steady increase in the incidence over the last few years , that too in relatively younger men , from an over view of the stastics from various cancer centers , prostrate cancer is roughly estimated to account for 1% of all cancers in the registers . The increasing incidence is not due to any sudden epidemic but largely due to better screening procedure using a reliable tumor marker called prostrate specific antigen(PSA), it is estimated that 30%of patients with prostrate cancer are in the early stage and hence are curable
Hither to prostatic malignancy was usually diagnosed in elderly patients and in the advanced stages , even in these men since the disease is quiet , many of them died along with the disease than due to the disease .
Prostrate cancer is rare before the age of 40 and the incidence increases with age , though the exact cause of prostrate cancer is not yet known , researchers suspect a high fat diet and genetics . However the greatest risk factor is age ;most men develop prostrate cancer if they live long enough . The likely hood of developing the cancer increases after the age of 60 . by age 65 most men have enlarged prostates . the first signs are night urination and difficult urination .
Literally 97% of all men will be affected with prostrate problems during their life time , early stage prostate cancer does not usually cause any symptoms and most such cancer are diagnosed by an ultrasound scan of the prostrate and ultra sound guided prostate biopsy . In particular early prostate cancer does not cause typical bladder out flow problems associated with BPH , this is because prostate cancer usually arises in the outer part of the gland . Cancer of the prostate is normally slow growing . A small proportion of prostate cancer can however be very aggressive , spreading quickly to other parts of the body especially the lymph nodes and the bones . Traditionally watchful waiting , palliative radiotherapy and hormonal manipulation are the main stay of treatment with advanced disease , with the advent of the tumor marker PSA and early screening of men through comprehensive medical check ups there is an increase in the number of younger men being diagnosed with the disease . Brachy therapy for prostate is the latest exciting armamentarium in curing the early disease . Early prostate cancer does not usually cause any symptoms and most such cases are diagnosed by an ultrasound scan PROSTATE CANCER DIAGNOSING
Be on the look out ; if prostate cancer can be detected early , proper treatment may result in cure , unfortunately except for occasional difficulty with urination , most men with prostate cancer are men with a family history of the disease . However every man aged 40 and older is at risk , all men aged 40 and older should get a digital rectal examination (DRE) as part of their regular annual physical check up
1)all men aged 50 and above should get a PSA test done as part of their annual physical , in addition to a DRE
2)if the DRE or PSA test is not conclusive enough , a trans rectal ultrasound should be performed
3)remember! prostate cancer often occurs with out any symptoms , regular testing can lead to life saving therapy
This is a blood test that measures the level of PSA, a protein found in the blood and produced by the prostate . It appears in high concentrations in the blood when the prostate cells are damaged (for instance in prostate cancer , infection benign prostatic hyperplasia ) although the test is not 100% accurate PSA test has become an important step in diagnosing prostate cancer and following the course of the disease . A level above 4mgs/dl is thought to be abnormal and will necessitate further investigation . when combined with DRE and trans rectal ultrasound prostate biopsy , it is highly reliable and currently the most effective means to diagnose prostate .
DIGITAL RECTAL EXAMINATION (DRE)
In this test a gloved finger is inserted in the rectum . the urologist feels for the size , shape and texture of the prostrate , cancer feels hard . however more tests will be needed to make sure that cancer is present . It is one of the best methods to screen for malignancy
TRANS RECTAL ULTRASONOGRAPHY (TRUS)
With a probe inserted in the rectum , TRUS shows sound waves bouncing off the prostrate and other parts of the body . It is used along with PSA and DRE to diagnose prostate cancer . It is used to help specifically localize tumors for biopsy and give idea of the local extent of the disease . all men aged 50 and above should get a PSA test and DRE done as part of their annual check up . Many prostate cancer patients wo have been treated may never have problems with their cancer again
This is a surgical procedure in which a few cells are removed for microscopic examination . Biopsies are usually done using a local anaesthetic
The TRUS –guided biopsy allows for an accurate removal of representative tissue from the abnormal areas . once the diagnosis is made the next process is quantification of the disease and to see its reach and spread using a CT scan of the abdomen pelvis or an MRI scan or a whole body bone scan using TC99 diphosphonate .
THE IMPORTANCE OF EARLY DETECTION
Most cancers have a better chance of cure if found and treated at an early stage .Many prostate cancer patients who have been treated may never have problems with their cancer again , on the other hand some men with prostate cancer will not die of the disease even if it remains untreated . It is not possible to say whether early detection of prostate cancer will lower an individual’s chance of eventually dying from that cancer
STAGES OF CANCER
If cancer is found in the prostate , it is important to determine the extent (stage) of the cancer to decide on the best treatment option in addition to PSA and TSU the following may also be used to establish the extent of the disease ; CT and/or MRI or a bone scanning
The pathological staging of prostate cancer is typically divided into 5 stages
the tumor is located with in the prostate gland and is too small to be detected during a rectal examination , but it may be discovered through other diagnostic procedures such as PSA test . prostate cancer at this stage generally produces no symptoms
the tumor is still located with in the prostate gland but it has grown to a point where it can be felt during a rectal examination or imaged by ultrasound or other types of imaging study , there are often no symptoms
the tumor has spread beyond the prostate to other areas near the gland
the tumor has spread and become fixed to other adjacent parts of the body , such as the rectum or bladder
The tumor has spread to lymph nodes , bones or else where , symptoms such as bone pain , weight loss fatigue are common
GRADING PROSTATE CANCER
In addition to stages , prostate cancer is graded to determine how aggressive or fast growing the tumor is
The prostate biopsy specimen is graded according to the appearance under a microscope . there are several grading systems but the Gleason grading system is the most common . it ranges from a score of 2 (lowest)to 10(highest ) .lowest scores 2-4 mean they are usually less aggressive and slower to progress . a score of 5-7 is intermediate and a score of 8-10 means the cancer cells are more likely to be aggressive .
SYMPTOMS AND HOMOEOPATHIC MEDICINES
- Sabal serrulatha : this medicine has been recommended for various prostatic troubles , but its homoeopathic use seems confined to acute cases of enlarged and inflamed prostate , the gland is hot , swollen and painful , here also come in our regular inflammation polychreasts , such as “aconite “ and “belladonna “ and it will not be necessary to go outside of them . Sabal is not altogether useless in senile hypertrophy , the writer has seen a marked palliative action in several cases and avoidance of surgical interference .
- Lycopodium : pressure in the perinaeum near anus while urinating .
- Conium : this remedy is useful in chronic hypertrophy of the prostate with difficulty in voiding urine , it stops and starts and there is an accompanying catarrh of the bladder . The suitability of conium to the complaints of the aged should be considered .
- China philla : gives occasional good results in relieving the tenesmus frequent urination and general discomfort due to prostatic hypertrophy , spongia is also a remedy for this condition .
- Thuja : Frequent pressing to urinate with small discharge , patient strains much , stitches from rectum into bladder , discharge of prostatic juice in the morning on awaking .
- Ferrum picratum : is one of the best medicines for prostatic enlargements in the aged .
- Conium maculatum : is the stereotype of the elderly man who instead of growing wise , becomes obsessed with sex , he has problems with his prostate , which is enlarged and may even become cancerous .
Medicines shall be taken on the advise of the doctor
Tips For A Healthy Prostate :
- Limit consumption of high fat foods particularly red meat and diary products .
- Eat a lot of fruits and vegetables , especially tomato, and cruciferous vegetables like sprouts , cauliflower and others in the cabbage family
- Eat fish with a high omega-3 fatty acid content such as salmon
- Avoid alcohol
- Be physically active and maintain a healthy weight .
Diet and Bowel Preparation : The patient is given a bowel laxative to clear the bowels for the procedure , a little vaseline around the back passage will prevent soreness , the patient should commence a liquid diet after taking the bowel laxative .
The following clear liquids are allowed ; fruit juices , apple , cranberry , grape , strained orange juice , desserts jellies fruit ices beverages –coffee , tea , lemon/ orange drinks soups ; any strained soups , no alcohol strictly
Remember to drink as much fluid as possible prior to your examination , the nursing staff will administer an enema.