WORLD CANCER DAY: PROSTATE CANCER

 

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Nelson is a 57 year-old married father of seven children, from Rwanda. He had complained to his wife about the onset of difficulty in urinating, and later on, dark-colored urine. He had a male cousin who died from prostate cancer. During medical examinations, his PSA levels were high, and after a biopsy was diagnosed of prostate cancer.

Prostate cancer is cancer that occurs in the prostate, a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer in men. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

Prostate cancer is a male only disease and is the second most common male cancer in the United States, after skin cancer. However, if Prostate cancer is detected early when it’s still confined to the prostate gland it has a better chance of successful treatment.

INCIDENCE RATE

It is the most commonly diagnosed cancer among Nigerian men. An estimated hospital prevalence of 127 per 100,000 in Lagos, Nigeria was reported in 1997. A recently published data from southwestern Nigeria also reported a hospital prevalence rate of 182.5 per 100,000 male admission in the hospital Aug 10, 2013.

CAUSES

It is not clear what really causes prostate cancer, but it is said by researchers that prostate cancer begins when some cells in your prostate becomes abnormal. Mutations in the abnormal cells’ DNA cause the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can also break off and spread (metastasize) to other parts of the body.

RISK FACTORS

The exact cause of prostate cancer is unknown. However, the understanding of certain genetic causes continues to increase. The following factors can increase one’s risk of prostate cancer.

  • Older Age: The risk of prostate cancer increases as you age.
  • Family history: If there is history of prostate cancer in a family, the risk may be increased. Also, if there is a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, the risk of prostate cancer may be higher.
  • Obesity: Obese men diagnosed with prostate cancer may be more likely to have advanced disease that’s more difficult to treat.

SIGNS AND SYMPTOMS

Prostate cancer may cause no signs or symptoms in its early stages. Prostate cancer that’s more advanced may cause signs and symptoms such as:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in semen
  • Discomfort in the pelvic area
  • Bone pain
  • Erectile dysfunction
  • Blood in urine

 

DIAGNOSIS

A digital rectal examination, done by either self (Self Prostate Examination) or a health provider, or Prostate Specific Antigen test can detect an abnormality. Further tests to determine whether it is prostate cancer include:

  • Ultrasound: If other tests raise concerns, trans rectal ultrasound can be done to further evaluate the prostate. A small probe, about the size and shape of a cigar, is inserted into the rectum. The probe uses sound waves to create a picture of the prostate gland.
  • Collecting a sample of prostate tissue: If initial test results suggest prostate cancer, a procedure to collect a sample of cells from your prostate (prostate biopsy). Prostate biopsy is often done using a thin needle that’s inserted into the prostate to collect tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present.
  • MRI fusion: While still being developed worldwide, MRI fusion to assist in prostate biopsy and diagnosis is being used more and more.

PREVENTION

  • Good Sleep:Good quality sleep is essential for the health of the reproductive system and the production of sex hormones. Less than optimal sleeping habits will cause a decrease in testosterone levels and elevated stress hormone production, with an increase in prostatic growth.

 

  • Increase Antioxidant Consumption: Phytochemicals act as antioxidants supporting detoxification pathways essential for a healthy prostate. Drink antioxidant-rich beverages such as green tea, and ginger tea for an extra antioxidant boost.

 

  • Maximize Your Vitamin D Levels:Vitamin D levels of less than 60 ng/ml is associated with vitamin D deficiency. A deficiency of vitamin D impacts testosterone production and also increases prostatic growth. Regular sun exposure no less than three days a week without sunblock can significantly raise your vitamin D levels. Consume a high quality vitamin D3 supplement when you are unable to receive adequate sun exposure.

 

  • Use Natural Cleaning Products:Whether the product is for hygiene care or house cleaning, choose natural products that do not contain health hazards. Always avoid xenoestrogen containing substances found in plastics, deodorants, shampoos, and household cleaning agents.

 

  • Anti-Inflammatory Diet:Consume a diet rich in clean proteins, healthy fats, and antioxidants. High quality fats such as avocados, grass-fed butter, olives, olive oil, fish, and coconut oil contain essential fatty acids required for optimal testosterone production and prostatic health.

 

  • Improve Your Gut Motility:One way to promote optimal detoxification in your body is to improve the frequency of bowel movements. You can improve your bowel motility by eating a diet rich in anti-inflammatory foods that are rich in fiber. Consider adding foods like chia seeds, flax seeds, fermented foods, and probiotics into your diet for optimal gut health.

 

  • Low Intensity Movement:A sedentary lifestyle will reduce testosterone levels and cause prostatic inflammation. Move throughout the day receiving low-intensity exercise like playing, walking, or light cycling. Regular movement will limit inflammation in the body and improve prostate health.

 

  • Practice Deep Breathing:Practicing stress relaxation exercises is as easy as deep breathing. Deep breathing calms the heightened sympathetic nervous system responsible for fight or flight, and relaxes the body. This practice reduces stress hormones and lowers inflammation and cancerous cell growth in the body.

 

  • Zinc and Magnesium:Optimize your zinc and magnesium levels to promote healthy detoxification and provide immune support. Both of these super nutrients stimulate testosterone production and the detoxification of contaminants like xenoestrogens. Pumpkin seeds are one of the best sources of both of these key nutrients. You may also choose to eat fresh tomatoes, prepare green drinks or use super green powders and consume healthy organic meat products.

 

  • Use a High Quality Omega-3 Supplement:Consuming 2 to 5 grams of omega-3 fatty acids can help limit inflammation in the prostate and improve testosterone production. Researchers have shown that high dose omega-3 fatty acids are powerful agents to reducing prostatic growth.

 

  • Consider Other Supportive Supplements:Adding supplements into your diet can help reverse prostate health complications. Optimize your nutrient intake by adding a combination of high quality supplements, including Vitamin D3, K2, probiotics, and anti-inflammatory compounds such as curcumin (such as turmeric powder), sulforaphane, resveratrol, and pterostilbene (also found in blueberries) and green tea extract (EGCG). These unique compounds synergize to boost up the anti-oxidant pathways.

 

MEDICAL TREATMENT

  1. Surgical Treatment

Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes.

  1. Radiation Therapy

Radiation therapy uses high-powered energy (radiation), to kill cancer cells. Side effects of radiation therapy can include painful, frequent or urgent urination, as well as rectal symptoms such as loose stools or pain when passing stools. Erectile dysfunction can also occur.

  1. Hormone Therapy

Hormone therapy is treatment to stop the body from producing the male hormone testosterone. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of testosterone may cause cancer cells to die or to grow more slowly.

Hormone therapy options include:

  • Medications that stop your body from producing testosterone. Medications known as luteinizing hormone-releasing hormone (LH-RH) agonists prevent the testicles from receiving messages to make testosterone. Drugs typically used in this type of hormone therapy include leuprolide (Lupron, Eligard), goserelin (Zoladex), triptorelin (Trelstar) and histrelin (Vantas). Other drugs sometimes used include ketoconazole and abiraterone (Zytiga).
  • Medications that block testosterone from reaching cancer cells. Medications known as anti-androgens prevent testosterone from reaching your cancer cells. Examples include bicalutamide (Casodex), nilutamide (Nilandron) and flutamide. The drug enzalutamide (Xtandi) may be an option when other hormone therapies are no longer effective.
  • Surgery to remove the testicles (orchidectomy). Removing your testicles reduces testosterone levels in your body.

Hormone therapy is used in men with advanced prostate cancer to shrink the cancer and slow the growth of tumors. In men with early-stage prostate cancer, hormone therapy may be used to shrink tumors before radiation therapy, which can increase the likelihood that radiation therapy will be successful.

Side effects of hormone therapy may include erectile dysfunction, hot flashes, loss of bone mass, reduced sex drive and weight gain.

  1. Chemotherapy

Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both.

Chemotherapy may be a treatment option for men with prostate cancer that has spread to remote body locations. Chemotherapy may also be an option for cancers that don’t respond to hormone therapy.

  1. Biological Therapy

Biological therapy (immunotherapy) uses your body’s immune system to fight cancer cells. One type of biological therapy called sipuleucel-T (Provenge) has been developed to treat advanced, recurrent prostate cancer. This treatment involves taking some of your own immune cells, genetically engineering them in a laboratory to fight prostate cancer, then injecting the cells back into your body through a vein. Some men do respond to this therapy with some improvement in their cancer, but the treatment is very expensive and requires multiple treatments.

REFERENCES

AskMayoExpert. Prostate, testicular cancer. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.

Niederhuber JE, et al., eds. Prostate cancer. In: Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. https://www.clinicalkey.com. Accessed March 22, 2017.

https://www.mayoclinic.org/tests-procedures/robotic-surgery/multimedia/robotic-prostate-cancer-surgery/vid-20123467

 

TOGETHER WE CAN FIGHT CANCER

Chidimma Adaugo Chukukere.

Oladipupo Adeola.

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Lead Nurse Africa is a Pan-African nursing organization dedicated to public health promotion and professional development.

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