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Cancer, Prostate

Prostate cancer is the most common form of cancer in men in the United States. Nearly 317,000 new cases are diagnosed each year. The prostate is a male sex gland about the size of a walnut located below the bladder and in front of the rectum. It surrounds the upper part of the urethra, the tube that empties urine from the bladder. The prostate produces a thick fluid that forms part of semen.

Signs and Symptoms

Prostate cancer is accompanied by the following signs and symptoms.

bulletA need to urinate frequently, especially at night
bulletDifficulty starting urination or holding back urine
bulletInability to urinate
bulletWeak or interrupted flow of urine
bulletPainful or burning urination
bulletPainful ejaculation
bulletBlood in urine or semen
bulletFrequent pain or stiffness in the lower back, hips, or upper thighs

What Causes It?

Although the exact cause is unknown, environmental and genetic factors and diet are suspected. Workers exposed to cadmium and those in tire and rubber manufacturing or sheet metal, as well as farmers, have high death rates from prostate cancer.

Who's Most At Risk?

People with the following conditions or characteristics are at risk for developing prostate cancer.

bulletFamily history (first- or second-degree relative)
bulletDiet high in saturated fat
bulletOccupational exposures
bulletAge over 55 years
bulletAfrican-American descent

What to Expect at Your Provider's Office

Men with a family history of prostate cancer and African-American men should undergo a digital rectal exam (DRE) and prostate specific antigen (PSA) measurement every year beginning at age 40. All other men should have yearly DREs and PSA measurements beginning at age 50.

If you are experiencing symptoms associated with prostate cancer, you should see your health care provider. Do not wait until you feel pain. The exams and tests may include the following.

bulletA DRE, in which the provider feels the prostate through the rectum to check for hard or lumpy areas
bulletBlood tests, including a PSA and prostate acid phosphatase (PAP). The level of PSA in the blood may rise in men who have prostate cancer, and the level of PAP rises above normal in many prostate cancer patients, especially if the cancer has spread beyond the prostate
bulletUrine test, to check the urine for blood or infection

Additional tests may include ultrasound, computed tomography (CT) scan, and magnetic resonance imaging (MRI).

If cancer appears to be present, a biopsy will be performed. The provider will remove a small amount of prostate tissue, usually with a needle, and a pathologist will examine the tissue under a microscope to check for cancer cells.

Treatment Options

Treatment Plan

A treatment plan depends on the tumor stage (extent of disease) and grade (how fast the cells are likely to grow or spread to other organs), along with pretreatment PSA levels and the wishes of the individual. Surgery, radiation therapy, and treatment with medication are possible options. But, not all men require treatment. The individual and his provider should consider the benefits and possible side effects of each option, especially the effects on sexual activity and other quality-of-life concerns.

Drug Therapies

Your provider may prescribe the following medications.

bulletHormone therapy, to prevent the prostate cancer cells from getting the male hormones they need to grow
bulletChemotherapy
bulletRadiation therapy

Surgical and Other Procedures

Surgery is a common treatment for patients in the early stages of prostate cancer. With radical prostatectomy, the entire prostate is removed, either through an incision in the abdomen or through an incision between the scrotum and the anus. Nearby lymph nodes are sometimes also removed through an incision in the abdomen. The pathologist will check the lymph nodes to see if the cancer has spread to other parts of the body.

Complementary and Alternative Therapies

A comprehensive treatment plan for prostate cancer may include a range of complementary and alternative therapies.

Nutrition

bulletEat only hormone-free, organic, unprocessed foods.
bulletEat small, frequent meals for easy digestion and to keep your blood sugar levels steady.
bulletIncrease dietary fiber, legumes, soy, garlic and onions, sea vegetables, broccoli, brussels sprouts, and apricots.
bulletAvoid alcohol (especially beer), spicy foods, sugar, saturated fats (animal products), caffeine, nitrates, and additives.

Potentially beneficial nutrient supplements include the following.

bulletVitamin C (1,000 mg three to four times per day), vitamin E (400 IU two to three times per day), coenzyme Q10 (100 mg three times per day), and selenium (200 mcg twice per day)
bulletCarotenoids, especially lycopene (100,000 IU two to three times per day)
bulletEicosapentaenoic acid (EPA) and evening primrose oil (EPO) (1,500 mg three times per day)
bulletZinc (30 mg per day)
bulletGlutathione (500 mg twice per day)
bulletBromelain (250 to 500 mg between meals)

Herbs

Herbal remedies may offer relief from symptoms. Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp. per cup of water steeped for 10 minutes (roots need 20 minutes).

bulletTurmeric (Curcuma longa): 500 mg four times a day with bromelain
bulletSaw palmetto (Serenoa repens): 300 mg standardized extract three times a day
bulletHoxsey Formula (available commercially): 60 drops two to three times a day for six months or longer

Combine the following herbs in equal parts. Take 30 to 60 drops tincture three times a day.

bulletMistletoe (Viscum album)
bulletGromwell (Lithospermum ruderale)
bulletFenugreek (Trigonella foenum-graecum)
bulletChaste tree berry (Vitex agnus castus)
bulletNettles (Urtica dioica)
bulletPoke root (Phytolacca americana)

Homeopathy

Homeopathy may aid in reducing side effects of conventional therapies, reducing symptoms, and improving overall sense of well-being.

Acupuncture

Acupuncture may help stimulate immune function, aid detoxification from chemotherapy, and strengthen a person's overall constitution.

Prognosis/Possible Complications

Prostate cancer is curable if the cancer is confined to the prostate. Locally advanced prostate cancer and cancer that has spread to other organs are often not curable, but survival for five or more years can often be expected.

Following Up

Prostate cancer patients should be examined regularly to be sure that the disease has not returned or progressed. Follow-up tests may include X rays, scans, and laboratory tests, including the PSA blood test.

Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995: 91.

Boik J. Cancer & Natural Medicine: A Texbook of Basic Science and Clinical Research. Princeton, Minn: Oregon Medical Press; 1996: 135, 164.

Branch WT Jr. Office Practice of Medicine. 3rd ed. Philadelphia, PA: Saunders; 1997: 400-406.

Brinker F. The Hoxsey treatment: cancer quackery or effective physiological adjuvant? J Naturopathic Med. 1996; 6(1): 9-23.

Burton Goldberg Group. Alternative Medicine: The Definitive Guide. Tiburon, CA: Future Medicine Publishing, Inc.; 1997: 738-742.

Kruzel T. Naturopathic Specific Condition Review: Prostate Cancer. Protocol J of Botan Med. 1998; 2(3): 176-183.

Gronberg H, Isaacs SD, Smith JR, et al. Characteristics of prostate cancer in families potentially linked to the hereditary prostate cancer 1 (HPC1 locus). JAMA. 1997; 278(15): 1251-1255.

Holleb Al, Fink DJ, Murphy GP. American Cancer Society Textbook of Oncology. Atlanta, GA: American Cancer Society; 1991: 280-283.

Lissoni P, Cazzaniga M, Tancini G, Scardino E, Musci R, Barni S, Maffezzini M, Meroni T, Rocco F, Conti A, Maestroni G. Reversal of clinical resistance to LHRH analogue in metastatic prostate cancer by the pineal hormone melatonin: efficacy of LHRH analogue plus melatonin in patients progressing on LHRH analogue alone. Eur Urol. 1997;31(2):178-181.

Malkowicz SB, Wein AJ. Prostate cancer. In: Kelly WN, ed. Textbook of Internal Medicine. 3rd ed. Philadelphia, PA: Lippincott-Raven; 1997: 1351-1357.

Moul JW. Treatment options for prostate cancer. Part 2--Early and late state and hormone refractory

disease. Am J Man Care. 1998;4(8):1171-1182.

National Cancer Institute. Prostate cancer. PDQ State-of-the-Art Cancer Treatment Summary for Health Professionals; 1997.

Oesterling J, Fuks Z, Lee CT, Scher MI. Cancer in the prostate. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 5th ed. Philadelphia, PA: Lippincott-Raven; 1997: 1322-1376.

Sagalowsky, AI, Wilson JD. Hyperplasia and carcinoma of the prostate. In: Fauci AS , et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1996: 598-602.

Scalzo R. Therapeutic Botanical Protocol for Prostate Cancer. Protocol J Botan Med. 1998; 2(3): 193-196.

Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing; 1988: 113.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.