10 January 2013

Zambia: Understanding Prostate Cancer Traces

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THE physical structure of a human being is studied under several academic disciplines that focus on different aspects of its parts and their operation.

You may find it amusing that some people may not know more about their bodies apart from the head, shoulder, knees and toes from the childhood song at preschool.

Nevertheless, my incense of bringing this is that we may take it for granted that our Zambian community, especially in our rural set-ups knows who can be afflicted by cervical cancer for example, but to them it's just fresh, hence the need to have anatomic parts of the body, especially those that matter a lot in explaining disease translated in our local language as it will enrich our vocabulary.

Consequently, our hope would be that we will not have a man at our clinic complaining of having symptoms typical of cervical cancer, when it is not! To solve this nightmare, men may experience cervical cancer like symptoms when they have prostate cancer.

Prostate Cancer is malignancy of the prostate gland which is a walnut-sized organ located under the bladder in males surrounding the urethra, which is the tube that carries urine from the bladder to the manhood.

The specific mechanisms that lead to the development of prostate cancer are still unknown like for many other cancers, but several risk factors have been identified that increase the chances of developing the disease.

Incidence increases with age as prostate cancer seldom develops before the age of 40; two out of three cases occur in men at the age of more than 65.

Family history also plays an important role in who develops prostate cancer. Men whose fathers or brothers develop prostate cancer are more likely to develop the disease.

Researchers are beginning to identify genetic markers of prostate cancer. For instance, the gene known as hereditary prostate cancer 1 (HPC1) appears to significantly predispose men to prostate cancer when inherited in a mutated form.

Environmental factors, such as workplace exposures to cadmium, have also been associated with an increased risk of prostate cancer.

A growing body of evidence links diets rich in animal fats, such as red meat or high-fat dairy products, with prostate cancer.

Dietary differences are believed to explain why the incidence of prostate cancer is 120 times greater in the United States than in China, where fatty foods are not part of the general diet.

Some fruits and vegetables seem to act as a shield against prostate cancer.

A study reported in 1995 found that tomatoes offer protection against prostate cancer. Subsequent research has focused on lycopene, an antioxidant found in tomatoes and certain other fruits.

Antioxidants neutralise free radicals, molecules in the body that make cells more vulnerable to cancer-causing agents. Other studies suggest that cruciferous vegetables, such as broccoli, cauliflower, and Brussels sprouts, have some protective effect.

Some evidence suggests that long-term, moderate doses of vitamin E, a type of antioxidant, may block the progress of prostate tumors.

Selenium, an element found in tiny amounts primarily in plants and yeasts, has also been associated with a lowered risk of certain cancers, although large amounts of selenium are toxic (poisonous).

Prostate cancer usually progresses slowly and produces no symptoms in its initial stages.

Warning signs may eventually include difficult or painful urination; frequent urination, especially at night; and blood in the urine or semen.

Pain in the lower back, pelvis, or upper thighs may signal that prostate cancer cells have spread to the ribs, pelvis, and other bones.

These symptoms, however, may have other causes, such as infection or prostate enlargement. Prostate enlargement is a natural result of the aging process.

Many doctors perform screening tests for prostate cancer during regular physical exams in order to identify the disease in its earliest and most curable stages. Doctors perform a digital rectal examination, in which the physician slips a gloved finger into the rectum to feel the size, shape, and firmness of the prostate. If cancer is present, a physician may feel a nodule or other prostate irregularity.

Another screening test, the prostate-specific antigen (PSA) test, measures levels of a protein called prostate-specific antigen in the blood. Prostate cancer cells overproduce this protein, causing an elevation of PSA levels in blood.

Most men have PSA levels lower than 4.0 nanograms per millilitre (ng/ml) of blood, and that level is considered normal.

However, a higher level does not necessarily indicate the presence of cancer. Infections and certain drugs can also elevate PSA levels.

If screening tests suggest cancer may be present, a physician will usually perform a biopsy.

In this procedure a physician inserts a needle through the wall of the rectum and extracts a sample of tissue from the prostate. The tissue is then examined under a microscope for the presence of cancer cells.

It would be important that men aged 50 years and older consider having an annual digital rectal exam and PSA test.

Men who have a high risk for the disease should talk to their doctors about starting annual screening tests at a younger age as early as 40 to 45 years.

Annual screening with a PSA test is controversial because there are many false positives that is, elevated PSA levels among men who do not have prostate cancer.

This leads to unnecessary additional procedures. A new DNA test can help predict which men are at high risk for prostate cancer.

After prostate cancer is diagnosed, the physician may decide more tests are necessary to determine if the cancer has spread beyond the prostate gland.

This process is known as staging. Early-stage cancers either have not spread or have spread only to nearby tissues. Later-stage cancers have spread farther and usually require more aggressive treatment.

Various tests are used to determine the cancer's stage. Lymph glands from the pelvis may be surgically removed and examined for cancer cells, or a sample of fluid from the seminal vesicles (glands that secrete semen) may be examined for cancer cells.

In addition, images of the inside of the body made by magnetic resonance imaging (MRI) or computed tomography (CT) scans also can reveal the presence of cancerous tumors.

Prostate cancer sometimes spreads to the bones, and a radionuclide bone scan tests for such spread. In this test a tiny amount of radioactive substance is injected into a vein.

The substance collects in the bones, especially in areas of unusual activity known as "hot spots" for example, where cancer cells are expanding. During the scan the patient lies on a table that passes under the scanner, which makes computer images on which any hot spots in the bones show up.

The treatment of prostate cancer generally depends on the stage of the cancer and on the age of the patient.

In men over the age of 70 with early-stage prostate cancer, the disease often progresses so slowly that they are likely to die of other causes before they develop prostate cancer symptoms.

For this reason, some physicians believe that many patients in this age group can forgo surgery or other treatments as long as their condition is regularly monitored a treatment known as watchful waiting or palliative therapy will be given to alleviate the patient from symptoms that makes them uncomfortable.

In many cases, a prostatectomy which is a surgical removal of the prostate is performed, often in conjunction with radiation. If the surgeon is properly trained, the surgery can be performed with a laparoscope.

Laparoscopic prostatectomy involves smaller incisions, less time in the hospital, and a faster recovery than standard prostatectomies.

Another surgical procedure, transurethral resection of the prostate, involves removing cancerous tissue from the prostate with an instrument inserted through the urethra. Both kinds of surgery can cause impotence and urinary leakage.

A procedure called nerve-sparing surgery can avoid damaging the nerves that control erection, but this procedure may not be possible if the cancer occurs near those nerves.

Radiation therapy is an alternative to surgery in many cases. It uses X rays or other high-energy radiation to kill cancer cells or stop them from growing (see Radiology: Therapeutic Radiology). In external radiation therapy, the radiation is beamed from a machine onto the body. In internal radiation therapy, radioactive material sealed in "seeds" is inserted into the prostate. The procedure, performed under local anesthesia, spares healthy, nearby tissue and appears to be as effective as surgery for men with early-stage prostate cancer.

In some cases hormones are used to treat prostate cancer, especially if the patient is unable to undergo surgery or radiation because of other health problems.

Hormone treatment may also be used for cancers that recur or for shrinking the cancer before surgery or radiation therapy.

The goal of hormone therapy is to reduce body levels of male hormones, especially testosterone, that can fuel the growth of cancers. Chemotherapy which is the use of anticancer drugs is sometimes recommended when the disease has spread beyond the prostate.

These drugs travel in the bloodstream and slow the cancer's growth and spread.

Several other treatments for prostate cancer are under investigation. Cryosurgery uses instruments to destroy cancer cells by freezing them.

Immunotherapy boosts the body's immune-system defenses to fight cancer. High-intensity ultrasound uses high-energy sound waves to destroy cancer cells

In conclusion, prostate cancer is curable if diagnosed early and the risk individuals should take their first step to be screened for the presence of the cancer.

It is only wise enough to live healthy when all is catered for unlike making frantic efforts when all hope is lost in an intervention for an improved health.

The adoption of healthful habits is an investment for better health because some diseases are avoidable, curable and preventable.

The usefulness of any piece of information does not lie merely in reading its content but achieving the practical implication of it to arrive at an optimum comfortable healthy life.

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