Monday, June 23, 2014

Prostate Cancer: Alternatives For Prevention And Treatment

Prostate Cancer is the most common cancer among men, and more specifically, it is the second type of cancer that is most deadly among U.S. men. Despondently, aside from the lack of a cure, there is not a sure guide to follow in order to prevent it beyond any doubts, but there are some actions that can be incorporated to daily life that may aid in this prevention. Generally, the best initial approach is for men to learn about the risk factors; men who find themselves with a near-average risk of developing prostate cancer - be it due to advanced age, racial background, diet, and/or family history - must consider making choices in daily life, that is, exercising, having healthier meals, among many other life-changing selections.
Although there is not much substantial evidence to support them, some studies have pointed out that the choice of a diet that is low in saturated fat and high in fruits and vegetables is ideal for maintaining a healthy prostate. From a nutritional point of view, this is no surprise, for this type of diet is healthy for the human body in general, and has repeatedly proven to assist men in controlling their weight, and consequently the heart and the cardiovascular system. In studies that considered fat association with the risk of having prostate cancer, animal fats were found to be more associated to prostate cancer cases than plant-derived fats. Furthermore, some fish are also associated with a reduced risk of prostate cancer, more specifically those that have fatty acids (such as the omega-3) that healthily replace saturated fat in any diet. Other studies showed that diets containing olive oil, green tea and many vegetables, such as (cooked) tomatoes, soybeans and other legumes, might be linked to a lower risk of prostate cancer, particularly in advanced cases.
Moreover, a physician must always accompany any supplementation to the diet; for example, calcium in excess has been linked to a higher risk of prostate cancer. Men in general must watch out to not exaggerate on their calcium consumption; either in daily meals, or in vitamin supplementation itself, the daily intake should not exceed 1500 mg. Also, consumption of any multivitamin is not recommended, since a man on a diet full of vegetables and fruits most likely will never need vitamin supplementation. Tomatoes have also been studied since they are well known to contain lycopenes, which are powerful antioxidants that may help diminishing or extinguishing cell damage, and such studies have shown a decrease in prostate cancer. Other antioxidant vitamins, such as selenium and vitamin E have also been the target of many studies, but with no real success or closure to the topic. However, eating all the vegetables and fruits in the world will not even come close to removing completely a man's risk of having cancer in his prostate. Therefore, men who are currently in one of the risk groups should consider not only these improvements in daily life, but also - and most importantly - should consult a specialized doctor to discuss whether having yearly digital rectal examinations, prostate biopsies, ultrasounds and/or prostate specific antigen (PSA) blood tests are the recommended choices for each individual case. Furthermore, a doctor must also be consulted in cases of stress, high blood pressure and cholesterol, and depression, since treating these conditions is of utmost importance for improving survival rates of prostate cancer patients.
A doctor for those cases in which risk reduction is needed may also prescribe medications, depending on the case. The two drugs that are currently under study are the hormone drugs named Finasteride and Dutasteride, because of their use in treating Benign Prostatic Hyperplasia, which is not a cancerous condition, but also causes enlargement of the prostate. They are both 5-alpha reductase inhibitors. The 5-alpha reductase is the enzyme in the human body that converts testosterone into dihydrotestosterone (DHT), which is the key hormone that induces the prostate to grow. These inhibitors block the enzyme and prevent the formation of DHT, and consequently prevent prostate growth. Several studies of both these drugs have been performed in order to assess whether or not they can be useful in decreasing prostate cancer risk. In those studies, it was found that a group of men taking these drugs was less susceptible to develop prostate cancer after several years, when compared to the placebo-consuming control group; this did not interfere with death rates, on the other hand, as both groups had similar survival rates. Other drugs are currently being tested for their properties of lowering the risk of having this condition, but none have been proven yet to be helpful enough to allow doctors to recommend them to men in need.
Researchers worldwide are searching for genes that may be linked in any way with prostate cancer. Some of these genes have been identified and seem to increase the risk of the carrier of having cancer. British scientists discovered the PTEN gene, which is involved with prostate cancer, and is currently under study to reveal how it works and affects cancer. Other scientists from the UK unmasked another gene, called E2F3, which seems to be overactive in advanced prostate cancer cases. This could help doctors to determine which men really need treatment, while others may only need active screening. Yet another gene, the MSR1, was discovered in the USA and is found in some families that have an ongoing history of prostate cancer, and may be important in increasing the risk of the carriers having the same condition. Hopefully in the future these studies may make it possible for doctors to perform genetic tests for prostate cancer risk as it is being done nowadays with breast cancer.
While preventing and diagnosing are the first steps for dealing with prostate cancer, once it is found and confirmed, treatment is the only option. Each individual case will require different measures of treatment, depending on age and the degree to which the cancer has spread or not. Some men have tumors that grow very slowly and may never even need to be treated; in such cases, the tumor grows extremely slowly and because of this has little to no symptoms, therefore it is better to wait and monitor the patient than to give him drugs that may cause unwanted side effects. However, when the cancer is found to be aggressive, it will probably spread and, before it does, surgery is the best option. A surgical procedure to remove the entire prostate is called a radical prostatectomy, and may be done either by cutting into the patient's abdomen and removing the prostate, or by making small cuts and using special equipment, sometimes even a robot, to remove the gland. Furthermore, if the cancer is causing discomfort by pressing on the urethra, a transurethral resection of the prostate may also be performed to relieve the symptoms. In the past, some men even went the distance by removing their testicles, in order to halt testosterone production, aiming to control and even reduce the tumor. Nowadays this treatment is not recommended in most cases, since hormone therapy can have the same effect without the need for surgery, stopping the action of the male hormone. This hormonal treatment is generally used to reduce the chances of prostate cancer returning after other treatments have been performed.
Radiotherapy can be utilized to treat prostate cancer that has not spread outside of the gland, but is also effective in treating cancer that has spread and in controlling pain. In this type of treatment, a controlled beam of radiation is used to kill the cancerous cells, which in turn reduces the tumor. Radiation can also be delivered directly on the gland, by placing radioactive wires into the prostate. Some doctors use chemotherapy as well, using drugs to destroy the cancer cells, usually as a last resort if hormone therapy is not successful. Generally, a combination of these treatments is not recommended, for each individual type of treatment has its own side effects and all of them have a huge downside for those that undergo them. The best thing to do is try to prevent and know the risk factors by heart, so that one does not have to put himself through these treatments, that are uncomfortable and, in their majority, tamper with the proper functioning of the human body.By Manoel Figueiredo Neto
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