P rostate Cancer
Select from the following topics to learn about Prostate Cancer prevention, diagnostics, treatment and more.
The Use of Testosterone in Men With Prostate Cancer
There has been a dramatic change in thinking regarding testosterone levels and prostate cancer. At present, there is no evidence based data that supports a causal linkage between high testosterone levels and the initiation of prostate cancer. On the contrary, there is evidence that a low testosterone level may increase the incidence of prostate cancer.
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Brachytherapy - Pellets for the Prostate
The best treatment for prostate cancer that is confined to the gland itself is radical surgery or radiation therapy. Radiation therapy can be delivered external to the body but the high energy radiation waves also may cause injury to the surrounding tissue such as the bladder and the rectum. In the last few years a new treatment option has been added which makes use of tiny radioactive pellets, about the size of a staple, which is directly place into the prostate using hollow needles. These implants deliver a highly concentrated radiation dose into the cancer and a much lower amount of radiation is applied to the surrounding tissues. There are two types of radioactive seeds, iodine and palladium. 
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Pellets for the Prostate - Effective Treatment for Prostate Cancer
The best treatment for prostate cancer that is confined to the gland itself is radical surgery or radiation therapy. Radiation therapy can be delivered external to the body but the high energy radiation waves also may cause injury to the surrounding tissue such as the bladder and the rectum. In the last few years a new treatment option has been added which makes use of tiny radioactive pellets, about the size of a staple, which is directly place into the prostate using hollow needles. These implants deliver a highly concentrated radiation dose into the cancer and a much lower amount of radiation is applied to the surrounding tissues. There are two types of radioactive seeds, iodine and palladium.
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Gleason Grading for Prostate Cancer
Physicians use the term "grade" to describe the appearance of thin slices of cancer tissue when it is observed under a microscope. In the case of prostate cancer tissue, the most common system used in the USA to grade the appearance of this tissue is called the Gleason grading system, after the physician who first described this system.
The Gleason grading system is not the only grading system in use around the world. However, because it is the one most commonly used in the USA, it is the one we will try to explain here. If your physician talks to you about the grade of your prostate cancer, you may want to ask if it is the Gleason grade that he or she is referring to.
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Hormone Refractory Prostate Cancer
Most patients with advanced prostate cancer are placed on some form of hormone treatment as the primary therapy for their prostate cancer. Hormone refractory prostate cancer (also known as 'HRC') refers to patients whose cancer is progressing after or while on hormone therapy.
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New Test for Prostate Cancer
A new blood test is now available to help identify prostate cancer and avoid unnecessary prostate biopsies. The older Total PSA test measured the prostate specific antigen (PSA), which is a protein produced by the prostate gland. The prostate gland is a walnut sized sex gland in men that makes the fluid that carries the sperm. Higher Total PSA levels can indicate prostate cancer, but the levels can also rise due to non-cancerous conditions such as benign enlargement of the prostate gland and prostate gland infections. The greatest criticism of the Total PSA test has been that it was not specific enough to detect prostate cancer. Men with elevated PSA tests were subjected to prostate biopsies which is expensive and moderately uncomfortable and only 25% of men who have biopsies based on an elevated Total PSA will have prostate cancer.
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Premalignant Prostate Lesions -- P.I.N. Of Prostate
(Prostatic Intraepitheal Neoplasia)
Recently, you underwent a prostate biopsy because of a suspicion that you have a prostate malignancy. Over the past few years we have learned a great deal about the various types of prostate problems that may occur. Saying that prostate biopsies are either benign or malignant is a simplification of a very difficult and complex task. Prostate tissue can present with many different findings and the pathologist's job to interpret these findings is difficult in many cases. Recently, we have been able to determine that premalignant prostate lesions exist. This means that cancer is NOT present, but the changes seen under the microscope suggest that cancers MAY develop later on. We have come to call these findings 'prostatic intra-epithelial neoplasia' or 'PIN.' The pathologists will rate or grade PIN lesions from 1 to 3 with 1 being only slightly unusual and grade 3 being very unusual and very close to being called cancer or malignant. More recently, PIN has been reclassified as Low grade and High grade, with PIN 1 being Low grade and PIN 2 & 3 being High Grade.
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Preventing Prostate Cancer
You are what you eat! An old adage, yet true as far as the risk of developing certain cancers is concerned. Environmental factors are clearly involved in the development of both prostate and breast cancers and the risk is considerable.
In a recent review of the effects of evolution and diet on the development of species specific cancers in Urology, Donald S. Coffey of the Johns Hopkins Hospital, found a close relationship between the development of the Western-type diet with its increased fat intake, obesity, and burned food processing, and the development of hormonally sensitive cancers like prostate and breast.
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Prostate Cancer - The Disease you can avoid
Prostate cancer is the most common form of cancer found in American men. Only lung cancer causes more deaths in men. The American Cancer Society estimates that more than 230,000 new cases of prostate cancer were diagnosed in United States in 2005. While the number of new cases continues to climb, death rates from prostate cancer are dropping. Greater public awareness and early detection may in part explain why. Treatment of prostate cancer in its initial stages can be effective. In the past year, the outlook for men with this diagnosis has improved dramatically. Over the last 20 years, survival rates for all stages of prostate cancer combined have increased from 67% to 97%.
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Prostate Cancer a Consumer’s Guide
Each year nearly 250,000 men will be diagnosed with prostate cancer. The disease will cause nearly 40,000 deaths. Most men with prostate cancer can be helped. This article will review the function of the prostate gland, the causes of prostate cancer and how the diagnosis of prostate cancer is made.
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The Prostate Cancer Outcomes Study
The Prostate Cancer Outcomes Study (PCOS) was initiated in 1994 by researchers at the National Cancer Institute (NCI) to look at the impact that treatments for primary prostate cancer have on the quality of life of patients. PCOS is a collaboration with six cancer registries that are part of NCI's Surveillance, Epidemiology, and End Results (SEER) Program. (The SEER Program was established by NCI in 1973 to collect cancer data on a routine basis from designated population-based cancer registries in various areas of the country.)
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Prostate Cancer - The role of the partner
Although problems with the prostate gland will eventually affect more than half of American men, it's a topic that many would rather not talk about. The personal and sexual nature of prostate problems embarrasses many men and keeps them from getting a quick, painless examination that can detect disorders soon enough for effective treatment. In the case of prostate cancer, the treatment could be life saving. Not only does this condition affect the man, prostate cancer also has an impact on the man's partner or significant other.
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Prostate Specific Antigen (PSA)
PSA stands for Prostate Specific Antigen and is a blood test that is used to screen for the presence of prostate cancer.
The prostate is the gland, found only in men, which is located between the urinary bladder and the urethra (the urinary channel that runs through the penis). The prostate's function is to make seminal fluid or semen that is ejaculated during intercourse. Note that sperm is made in the testicles and is only a small fraction of the seminal fluid. Antigen is a medical or biological term for a substance, usually a protein, that stimulates the body to make antibodies.
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PSA for the Primary Care Physician
Prostate specific antigen (PSA) is a protein that is produced by the prostate and is usually only detectable at very low levels in the blood of healthy men. PSA is produced by the epithelial cells in the prostate gland and is normally secreted into the semen or lost in the urine. The only known function of PSA is in male fertility to hydrolyze the coagulum of the ejaculate.1
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Prostate-specific antigen testing for prostate cancer: Practical Interpretation of Values
The mere mention of prostate cancer strikes fear in the hearts of men. Fortunately, prostate-specific antigen (PSA) is now a recognized tumor marker that can indicate but not exclude the presence of this potentially fatal disease. In this article, Drs. Randrup and Baum explain the nature of PSA and the practical application of serum PSA determination. Also discussed are three PSA-based strategies for early diagnosis and guidelines for interpreting PSA values in the primary care setting.
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The Straight Poop on the PSA Test for Prostate Cancer
Did you know that nearly 30,000 men die each year from prostate cancer? That's half the capacity of the Superdome. That's the bad news. The good news is that if men would obtain a digital rectal exam and a prostate specific antigen (PSA) blood test, most of those death could be prevented. Click here to learn more.
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Understanding Your Test Results
Screening doesn’t show whether you have prostate cancer, only whether you need further testing.
Prostate cancer screening consists of 2 examinations:
A physical exam of the prostate, the Digital Rectal Exam or DRE.
A blood test that measures levels of Prostate Specific Antigen or PSA.
These exams are done together to increase the accuracy of diagnosis.
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Use of Testosterone Therapy in Patients With Prostate Cancer
Testosterone is the male hormone which is mainly produced by the testis. Small quantities are made in other organs (eg adrenal gland), but in a man this contributes only a small amount of the total. Testosterone is a hormone which is released into the blood which will have effects on other parts of the body. When men have a lack of testosterone the condition is termed hypogonadism.
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Testosterone Treatment in Men With Prostate Cancer - The Controversy
I have been a proponent of testosterone replacement therapy in men with documented low levels of testosterone. Men with low testosterone present with lethargy, malaise, decrease in libido, erectile dysfunction, falling asleep after meals and loss of muscle mass. The diagnosis is easily made with a blood test, the serum testosterone level, and is easily treated with injections of testosterone or the application of testosterone gels to the skin. The treatment is contraindicated in men with difficulty with urination, untreated obstructive sleep apnea, high blood counts, and in men with prostate cancer.
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Treatment Overview Of Prostate Cancer
There are treatments for all patients with cancer of the prostate. Three kinds of treatment are commonly used:
surgery (taking out the cancer cells),
radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells) and
hormone therapy (using hormones to stop cancer cells from growing).
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Treatment Of Prostate Cancer With Herbal Therapy
To date, no definite evidence exists to show that any dietary changes or herbal therapy will cure prostate cancer. We do know that people with high fat diets and animals fed high fat diets have a higher incidence of prostate cancer. Low fat diets may be preventative, but once a cancer is formed, changing diets will not cure the cancer. The only mineral or herb which might protect against prostate cancer is selenium according to a small number of studies. Selenium use will not cure a prostate cancer. Much work is still being done to find active herbal preparations for the treatment and prevention of prostate cancer. An Alternative Interventions Symposium was held in May 1998 at the University of Chicago to review current herbal, dietary and other treatment alternatives for prostate cancer.
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Reprinted with permission from Neil Baum MD (neilbaum.com) and Dialog Medical (dialogmedical.com).
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