Prostate Cancer

Prostate warped around the around a tube (the urethra) is a gland of the male reproductive system found in front of the rectum and just below the bladder and responsible for making some of semen that carries sperm.

Prostate cancer is defined as a condition in which the cells of prostate has become cancerous, causing abnormal cell growth which spread to the distant parts of the body. Most prostate cancers are slow growing and enlarged prostate and prostate cancer may be detected during the Physical (rectum) exams.

Causes and risk factors
1. Age
The risk of developing prostate cancer increases with age of over 45

2. Family history
Statistic showed that if one of your directed family member has prostate cancer, your are twice at risk to develop it as well.

3. Race
Prostate cancer are more likely to strike black and white or Hispanic men in the US.

4. Heredity
Certain genes mutation are associated in promoting the growth of prostate cancer, including Hereditary Prostate cancer gene 1 (HPC1), transmembrane protease, serine 2-ERG or Transmembrane protease, serine 2-ETV1/4, etc.
Researcher found that up to 70 percent of men with prostate cancer have lost one copy of the Phosphatase and tensin homolog (PTEN) gene at the time of diagnosis. The tumor protein 53
(p53) mutations are late event in pathology of prostate cancer.

5. Low levels of vitamin D in blood

Researcher found that men with deficiency of level of vitamin D in the blood are at higher risk to develop prostate cancer.

6. Excessive drinking
Excessive drink not only increases the risk of liver cancer but also associated with higher risk of prostate cancer as it interfere with folate metabolism. Risk of prostate cancer is much high for men with excessive drinking habit and folate deficiency.

7. Enlarged prostate
Men with enlarged prostate are at high risk in developing prostate cancer.

8. Sexual transmitting diseases
Infected diseases such as chlamydia, gonorrhea, or syphilis are associated with higher risk of the diseases.

9. Obesity
In a study of Obesity May Raise Risk of Prostate Cancer Spread, Christopher J. Keto, MD, a urological oncology postdoctoral associate at Duke University Medical Center, Durham, N.C. found that overweight men were three times more likely to have their cancer spread.

10. Etc.

Symptoms
1. Frequent urination

Need to urinate many time than usual for over periods of 1 year or 2, as a result of enlarged tumors that press against the bladder.

2. Urgency
A desire to pass urinate more urgency as a result of enlarged tumor pressing against the bladder.

3. Dribbling

After finished passing urine, urine continues to dribbles as a result of the enlarged prostate tumor.

4. Hesitancy

Have to wait a long time for the urine stream to start as a result of cancer has narrowing the urethra.

5. Blood in the urine
Prostate cancer may have damaged any part of the urinary track.

6. Painful urination and ejaculation
As the cancer has grown large enough to interfere with the function of the urethra

7. Blood in the semen
As the cancer has grow large enough to damage inside the walls of urethra.

8. Lower back pain
As a result of the enlarged prostate tumor has pressed on spinal nerves.

9. New-onset erectile dysfunction (impotence)
Prostate cancer has interfered with blood vessels, responding to the erection.

10. Etc.

Diagnosis and tests
A. Blood tests

1. Digital Rectal Examination (DRE)

Digital rectal examination is included of physical exam, if you have some of the above symptoms or during an general exam. In DRE, your doctor inserts a lubricated, gloved finger into the rectum to feel the surface of the prostate gland to check for any abnormality of prostate.

2. Trans rectal Ultrasound (TRUS)
Ultrasound allows your doctor to visualize and assess the size of your prostate and to check for any abnormality and surrounding area with image taken from the test. In transcrectal ultrasound, a probe is inserted into the rectum to emit ultrasonic impulses against the prostate.

3. Prostate-specific antigen (PSA) test
The test is to measure the levels of rostate-specific antigen (PSA), a protein produced by the prostate. The high levels of PSA may be a indication of higher risk of the presence of prostate cancer.

4. Prostatic Acid Phosphatase (PAP) test
Prostatic acid phosphatase (PAP) is a test to measure the level of prostatic acid phosphatase, an enzyme produced by the prostate. The higher the levels of PAP is an indication of the disease progression.

B. Prostate biopsy

In prostate biopsy, samples of prostate are taken by a thin, tube-like instrument to examine under microscopy to review the stage of the cancer.

C. Bone scan
It is a nuclear scanning test, beside mostly used in identifying new areas of bone growth and damage to the bones breakdown, it can also evaluates the metastasis (spread) of cancer in the bone, if you doctor suspected that the prostate cancer has been spreading to the bone.

D. Etc.

Grades
The Grades of prostate cancer are depending to the tendency of spreading. Low grade cancers usually grow more slowly and are less likely to spread while high grade cancer indicates otherwise.

Stages
Prostate cancer is classified as 5 stages
1. Stage 0
If the cancerous cell have not penetrated in deeper tissue but in the surface of the prostate lining.

2. Stage I
In stage I, The cancerous cells are no longer in the surface but have invaded into deep the prostate lining, but still completely inside the prostate.

a. Stage IA1
The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1:The spreading is < 3mm(1/8 inch) deep and & less than 7mm (1/4 inch) wide.
a.2. Stage IA2: The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and & less than 7 mm (about 1/4 inch) wide.

b. Stage IB:
The cancer in this stage have invaded the connective tissue, & less than 5cm (2 inches).

b.1. Stage IB1: Cancer is 4 cm large (1 3/4 inches).

b.2. Stage IB2:Cancer is ≥ 4 cm (1 3/4 inches) but & less than 5cm (2 inches)

3. Stage II
In stage II, the cancerous cells have spread to distant tissues, but is still within the prostate.

4. Stage III
In this stage, cancerous cells has spread to the tissues immediately surrounding the prostate.

5. Stage IV
In this stage, cancerous cells has spread to the tissues immediately outside of the prostate, into other distant parts of the body

Preventions
A. How to avoid
1. Safe sexSexual transmitting diseases, such as are known to associated with higher risk of prostate cancer. Men have several sex partner should consider the use of condom.

2. Reduce drinking and take folate supplement
Risk of prostate cancer is much high for men with excessive drinking habit and folate deficiency.

3. Walking
Researchers found that walking at least three hours a week slow the progression of prostate cancer by a rate of 57 per cent or even prevent the development of prostate cancer.

4. Physical activity
Physical activity such as exercise, walking, swimming, etc. can reduce levels of the chemicals that stimulate cancer growth and metabolism of proteins released by fat cells.

5. Avoid Diet high in red meat
In the October 6th issue of the Journal of the National Cancer Institute, researchers found that Men who diet high in red meat are at higher risk of prostate cancer.

6. Drinking your milk
Milk contains high amount of vitamin D that can reduce the risk of prostate cancer caused by vitamin D deficiency in the blood.

7. Etc.


B. With diet
1. Soy
In laboratory studies, saponins have shown the ability to inhibit the reproduction of cancer cells and slow the growth of tumors in several different tissues.

2. Green Tea
In a study of examination of the effects of green tea extracts, researcher found that halts growth of oral cancer cells and breaks down and kills existing oral cancer.

3. Cruciferous vegetables
Cruciferous vegetables such as cauliflower, broccoli, cabbage, etc. beside contain high amount of antioxidants, but also phytonutrients that have been shown to help prevent the onset and halt the progression of certain cancers.

4. Tomato
Many studies showed that antioxidant lycopene in tomato inhibits cancer cell growth and exhibit apoptosis, causing cell death.

5. Carrot
Carrot contains high amount of beta carotene which has shown to induce appotosis of cancer cells. In study of Cell Cycle Regulation and Induction of Apoptosis by β-carotene, researchers found that in vivo study warrants further confirmation that β-carotene acts as apoptosis agent in cancer cells particularly leukemia cells but not normal cells.

6. Etc.

C. With nutritional supplements
1. Antioxidants
Antioxidants such free radical scavengers vitamin A, C, E enhance the immune system against the forming of free radicals and prevent the alternation of cell DNA cause of abnormal cell growth.

2.. Vitamin DIn a study published in the journal BJU International, vitamin D supplements may slow the progress of prostate cancer.

3. Lycopene
Studies have shown that men who consume large doses of lycopene have a much lower incidence of prostate cancer.

4. Beta -carotene
In some laboratory, animal, and human studies, researchers found that vitamin A, certain retinoids may also inhibit cancer development.

5. linoleic acid
In the October 6th issue of the Journal of the National Cancer Institute, researchers found that linoleic acid reduces the risk of prostate cancer-progression by 40 percent.

6. Flavonoids
In a study of flavonoids intake in human, The researchers found that flavonoids’ anticancer property has been proposed to exist via prevention of the formation of cancer-causing metabolites, inhibition of tumor cell proliferation, and stimulation of programmed tumor cell self-destruction (apoptosis).

7. Etc.

Treatments
A. In conventional medicine
Treatment of prostate cancer is depended on the diagnosis of grade, stage and the speed of the growth of the cancer
A.1. Treatments for Non-invasive prostate cancer
1. Observation
Due to prostate cancer slow-growth nature and if surgery and radiotherapy might post too higher of a risk, your doctor might take a wait and see status but only recommend in the first instance when it is necessary.

2. Surgery
a. In surgery, after determine the grade, stage and speed of slow growth, the surgeon will try to remove as much as cancer infected area as possible. in prostate cancer, most comone surgery is to remove the entire prostate grand with the incision in the perineum or a prostatetomy with incision just above public area.
b. Risks and side effects
Surgical and anesthesia risks
c. Things you must know before surgery
c.1. No semen fluid when you have sex
c.2. Impotent
It is happen to over 50% of all cases
c.3. There will be catheter attached to your bladder for fluid draining.

3. Radio therapy
a. Radiation may be used to treat non-invasion prostate cancer due to certain concerns such as important or general medical conditions of a patient. Radio therapy used high-energy x-rays or other types of radiation, radiation therapy kills the cancer cells and keep them from growing or regrowing. In prostate cancer, brachytherapy, similar to general radiotherapy with a implant of of a small radioactive seed into the tumor
c. Side effects
c.1. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation.
c.6. Etc.

3. Etc.

A.2. Treatments for invasive prostate cancer
If all diagnosis indicated that the cancer has spread to distant parts of the body
1. Hormone therapy
In most case, prostate cancer is required testosterone to feed its growth. hormone therapy works by blocking the testosterone in your body, leading to either die or slow down and stop growing. Drugs used include leuprolide, goserelin, cyproterone, etc.

2. Surgical castration
a. It is a surgery to the production of testosterone by removing the testes. There are many thing you should consider such as castration will make you infertile, and this effect is absolutely irreversible, drastic decrease in your sex drive, etc.
b. Side effects
Surgical and anesthesia risks

3. Radiotherapy
a. Radiation may be used for stages II, III, and IV to kill any cancer cells remaining in the body. By using high-energy x-rays or other types of radiation, radiation therapy kills the cancer cells and keep them from growing or regrowing.
c. Side effects
c.1. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation.
c.6. Etc.

3. Chemotherapy
Chemotherapy is most use to treat with advance stage of cancer combined with radio therapy, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells. Ovarian cancer is often respond well to chemotherapy. In prostate cancer, chemo is recommended if other treatments has been tried without success, because of prostate arduous nature.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.

B. In Herbal medicine
1. Zyflamend
Zyflamend is a formulation containing ten different herbs, including Holy basil, turmeric, ginger, green tea, rosemary, hu zhang, Chinese goldthread, barberry, etc. 18 month study was conducted at Columbia University and New York Presbyterian hospital indicated that 48% of the participants demonstrated a 25%-50% reduction in PSA levels by the 18 month mark and 60% of the volunteers showed completely benign prostate biopsies at the end of the study.

2. Fenugreek is used both as a herb (the leaves) and as a spice (the seed), genus Trigonella, belonging to family Fabaceae. Vitro studies have shown that fenugreek exhibits chemopreventive properties against certain cancers.

3. Pygeum Africanum Extract
In a sudy of isolated from Pygeum africanum bark exhibits androgen antagonistic activity, inhibits AR nuclear translocation and prostate cancer cell growth. Invest New Drugs. 2010 Dec;28(6):729-43. researchers found that pygeum components inhibit the nuclear transport of AR and inhibit prostate specific antigen (PSA) expression and efficiently represses the growth of both the androgen-dependent and some types of androgen-independent protate cancer cells.

4. Turmeric
In a study conducted by S. Uddin and colleagues at the Department of Human Cancer Genomic Research at King Faisal Specialist Hospital and Research Center in Saudi Arabia, researchers found that Curcumin in turmeric may inhibit the proliferation of lymphoma cancer by modulating cell cycling and inducing apoptosis.

5. Absinthe
Absinthe is also known as Wormwood, a distilled, highly alcoholic beverage flowers extracted from leaves of the herb Artemisia absinthium. In a study, researcher at the University of Washington found that wormwood can be used as a promising potential treatment for cancer.

6. Etc.

C. In traditional Chinese medicine
1. Ling Zhi
In a study of Ling Zhi extracts tested them on three different types of cells: drug-sensitive small-cell lung cancer, drug-resistant small-cell lung cancer, and normal lung cells, researchers found that Ling Zhi killed lung cancer cells. Cancer cells responded to the herb much in the same way as they would react to chemotherapy drugs. Yet unlike chemotherapy drugs, which can also be toxic to healthy cells, herbal extracts were more deadly to cancer cells than to normal cells, indicating that they have some ability to specifically target cancer.
2. Bai Hua She She Cao
The Sanjiv Kumar YADAV, Shao Chin LEE(Yong Loo Lin School of Medicine, National University of Singapore researcher results showed that the ethanol extract from Bai Hua She She Cao effectively evokes cancer cell apoptosis, possibly through burst-mediated caspase activation.

3. Ban Zhi Lian
Ban Zhi Lian is also known as scutellaria. The bitter and cool herb has been used in TCM as diuretic and to treat tumors and cancer as it clears heat, expels toxins, eliminates stagnation, stops bleeding and calms pain by enhancing the functions of lung, liver, spleen, stomach and large intestine channels. In a recent study results suggest that ginger, tea, and a Chinese herb called Scutellaria barbata or Ban Zhi Lian could all help to prevent cancer.

4. Wu bei zi (Chinese Galls)
In a study of melanogenesis inhibition by gallotannins from Chinese galls in B16 mouse melanoma cells, researchers indicated that Chinese galls inhibit melanin biosynthesis, associated with hyperpigmentation and can be used as skin-whitening cosmetics for skin care.

5. Huang Qi
In study of Astragalus-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials, researchers found that astragalus may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.
According to the American Cancer Society, the substances, licochalcone-A, licocoumarone and glabridin, which are present in licorice root, may prevent mutations in the DNA and kill existing cancer.

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