Hamilton NEW ZEALAND
Biomedical Therapies for Optimum Health
Hamilton NEW ZEALAND
Biomedical Therapies for Optimum Health
A most common cancer in males; it is not just a disease of old men for its likely to begin as early as in the 30's or 40's but manifest later in life. A slow cancer usually, but more rapid acceleration being a marker of severity often. It is in many ways the male equivalent to female breast cancer sharing certain characteristics.
PC is becoming epidemic some say.
Anatomy of the male genital tract
The image shows a large prostate cancer (yellow tissue) beneath the bladder. Notice on the very right side of the image is part of the rectum; this particular cancer would be felt by a digital rectal examination (DRE). In the early stages, a cancer of only a few mms or cms even may not be picked up by DRE. Unfortunately, by the time it is palpable (felt) it wil be quite large. This is fortunately still very treatable.
See how the prostate gland wraps around the urethra, the tube carrying urine and semen out. Symptoms of urination slowing may result from an enlarging prostate - but may be common benign or non-cancerous prostate hypertrophy (enlargement).
Hereditary PC: (HPC)
About 1:20 cases of PC will be passed down blood lines - just like 5% in breast cancers. Its defined as either:
The gene is passed from father to son, and from father to daughter and her son. So if HPC is present about half of the sons will get PC, and half of those before 55. So maternal grandfather history of PC is most relevant. So is all family PC incidence. To make it more complex, even breast cancer in a family line can increase the risk of prostate cancer!
So how can we check for PC with a family risk of PC or breast cancer? Doing regular PSA tests after 40 is one recommendation. PSA will be covered later.
Poor fuel = mechanical and electrical faults. Initially reparable but ignored or picked up late, irreversible damage. There are certain foods and substances within foods associated with cancer prevention or reduction:
Lycopenes are highly researched and the evidence very strong for cancer prevention in prostate, colon (bowel), lung, stomach and pancreas. They are the red substances in tomato-based products. Even the favourite tomato sauce, juice and pizza base concentrate are rich in lycopenes. One can also supplement Lycopenes.
Just 3-4 serves of tomato sauce a week or equivalent lycopene product, reduces the incidence of all grades of PC by 35% and advanced PC by 50%!
How so? Mechanisms include anti-oxidant activity, possible cancer cell inhibition, synergistic effect with Vit D as examples.
Low calorie diet - fat contains twice the calories (energy) of carbs and proteins. Reducing (caloric reduction) total energy input (just eat less!) means major reducton in cancer and heart attacks anyway.
So here is the DIET again, see Mediterranean Diet! >>
THE MOST CONSISTENT PREDICTOR OF HEALTH AND LONGEVITY IS TO EAT SMALL AMOUNTS OF QUALITY FOOD
You cant have it both ways and expect to get away with it - unless you really have super genes or gamblers' luck
Poly-unsaturated fatty acids - PUFA - you have heard of Omega 3 and 6 fats. Fish oil and flax oil are Omega 3 and Evening primrose oil Omega 6. Olive oil is Omega 9.
Omega 3 especially the marine type is a very potent anti-inflammatory and cancer risk reducing oil.
Click for the Prostate Supplement Protocol >>>
Prostate Specific Antigen is a substance, a normal enzyme, produced by the prostate to liquify semen amongst othe functions. There is a 'normal' range, usually up to 4, depending on age. However, younger men should really be under 2. If there is a higher level for age, then this warrants investigation. Other factors can also increase PSA such as inflammation, ejaculation, riding bicycles and so on. So several tests may be needed to be sure about a raised level.
Free PSA to Total PSA ratio. (FPSA:TPSA) as a percentage
PSA itself has several sub-types. The 'free' type is usually from non-cancerous enlargement, while the 'total' type is from the growing cancer clone cells. So the LOWER the ratio, under 15%, the more likely its cancer. Even lower % can mean the cancer has spread. However, inflammation (prostatitis infection) can also have a low ratio so if the gland is tender with no other suspicious features on DRE, then treat with antibiotics for 6 weeks and recheck PSA'a later.
PSA is up, what happens next
Its not an automatic diagnosis, it depends upon:
If the results suggest PC the next thing is to do is find out if it IS cancer and whether it is confined within the prostate gland or spread. Treatment options depend completely upon this.
Also to consider is the age and overall condition of the man. With a man of 78 with severe heart disease or Alzheimers it may not be appropriate to have him undergo biopsies, MRI scans etc. PC does tend to be a quite slowly progressing disease and many men can live 10-20 years with their cancer.
Now its important to 'stage' the PC. The notation of TNM is used. 'T' describes the Tumour itself and its location and spread. 'N' describes Nodes; these are local lymph nodes where cancer cells first go to. 'M' describes Metastasis, which is spread beyond to other organs or tissues. Bone is the first target usually.
By doing regular PSA and DRE exams, men can have their PC diagnosed way before it has spread to nodes and bones. Treatment is far more successful early.
PSA is not absolute. Sometimes there can be a normal PSA but high Gleason scores of 4-5. Here the skill and experience of the prostate oncologist is crucial to put together all information.
PSA testing can be done regularly at intervals depending on individual factors. The speed that it goes up is called the 'acceleration'. Another way of looking at cancer progress is the 'doubling rate' of the PSA.
Biopsy
This is crucial to understanding the 'degree' of cancer and planning treatment. Under local and general sedation, multiple biopsies are carefullly taken to get a good representaton of the whole gland. Its not 100% as a small cancer could be missed - its a bit like poking sticks into a haystack to find a hidden object. Its still the best we have. Once taken, these are examined and scored according to degree of cancer. This is the GLEASON SCORE.
Gleason Score
This is a scale of 5 grades, 1-5 and subgrades 1-5 of each as well. The two are added together to egt a score, so a Gleason 3,4 is a 7. A Gleason 3,4 is also a 7. The higher the score the more malignant or cancerous the PC. Gleason grade 4-5 usually means more aggressive and more likely spreading cancer.
Unfortunately, the diagnosis and staging by Gleason Scoring can vary from pathologist to pathologist depending on experience with PC. Discuss this with your doctors. A second opinion to validate may be indicated if a borderline result or the implications serious.
PAP - Prostatic Acid Phosphatase
Another enzyme blood test which can correlate with predicting risk of recurrence of PC. Its ideal to get a baseline bPAP to then follow regularly.
Transrectal Ultrasound
An ultrasound probe inside the rectum can 'view' the consistency of the gland. It also 'guides' the biopsy process.
MRI - CT - Bone scans - PET scan (not available in many centres)
These more sophisticated imaging techniques are used to further assess the extent of spread of cancer beyond the prostate gland. They can only 'see' macro dsiease, maybe 1cm. Micro-disease of 'cells' cannot be 'seen'. However, if there is a high PSA, Gleason score and PAP, it is certain there will be cells out there. Measures should be taken to aggressively treat these cells with combined mainstream and other natural supportive strategies.
CT scans aren't that great. CT cant 'see' small cancer spread. The PA and Gleason score gives far better information. More sophisticated MRI and PET scans are better but not available in some areas.
Bone scanning is the most important imaging procedure to assess the presence of bone metastases (secondary deposits). It is necessary if the PSA is high (above 10) and the Gleason above 6.
In summary
Management of PC varies from centre to centre and physician to physician. Experts have an array of computerised tools for assessing all information and the providing predictive results from which an optimum management plan is derived. It all depends on whether the cancer is confined to the prostate gland. If so, cure is more likely. It is based on the following options:
Watchful waiting - wait and watch! - depends on above factors - can be a very good option in certain cases. But MUST do diet, lifestyle and supplements.
Destroy the prostate and cancer - how though is the $64,000 question. With several options available, there is no clear winner. All depends on local skill, facilities and experience of the surgical or radiotherapay 'artists.'
Often combined Brachytherapy and EBRT is used.
Must do full and thorough evaluation beforehand as once you have RT you cannot do anymore Gleason testing.
Radical Prostatectomy and RT when compared has about the same results long term.
Side-effect risks to bladder and rectum from all radiation methods is balanced against the need for a dose of RT that will kill maximum tumour. Severe side-effects can occur even with advanced methods. It is a big skill on the part of the oncologists.
Androgen Deprivation Therapy - ADT - Hormone Therapy. LHRH agonist. They block the pituitary gland secretion of LH hormone. Exampe is Zoladex. Also referred to as non-surgical orchidectomy as it blocks male hormones Testosterone T and dehydrotestosterone DHT . Older ways were to remove the testicles. Cancer cells once deprived of T and DHT will die off. Blood vessels to the area shrink further stopping cell growth. It can be very effective when the major bulk of the cancer is 'androgen-sensitive'.
PDT and SPDT option - a novel treatment in several centres in the world. Beaming safe intense energy in the form of light has captured the imagination of researchers for decades. Getting light to penetrate the skin and deeper has been the challenge. PDT means, Photodynamic Therapy. Many medical specialist clinics use this for skin cancers - first applying a sensitizer, which intensifies the light energy effects, killing cancer cells. Advances in Ireland 10 years ago resulted in sensitizers of a chlorophyl (almost the same as human haemoglobin without the iron) being injected before the intense light bed exposure.
In the last 5 years, a Melbourne centre has developed this further using an inproved and safer sensitizer given sublingually (absorbed under the tongue) and using more intense light forms. The light still loses intensity deeper, a drawback. Recently, by incorporating a metal-chlorophyl compound as the sensitizer, they uses PDT together with Ultrasound to penetrate to unlimited depth - this is SPDT - Sono-photo-dynamic therapy.
This clinic, the OPAL Clinic, has best results with prostate and breast cancers. It is very good once the bulk of the cancer has been removed - ie for 'mopping up'. As prostate cancer is not a bulky cancer, then SPDT may be considered as a first option for men who do not want RP, RT or ADT as their first-line treatment.
Our clinic can advise a Protective Prostate supplement regime. Read more >>>