Prostate cancer is the second most fatal male cancer. Lung cancer is the first. In the U.S. alone, there are 100,000 new cases each year, and 30,000 deaths. Its incidence increases with age, and is most common in the 60 to 80 age group. One in 11 men will suffer from the disease and it is on the increase; nobody knows why.
One theory suggests environmental causes, e.g., Japanese men living in Japan have a low rate of prostate cancer. If they move to Hawaii, this low rate soars, though it stays below the rate for the native population. A recent British study suggests lack of regular ejaculation increases the risk.
Black men in the U.S have the highest rate in the world. This only happened in the last few decades. A dietary factor may be over-consumption of saturated fats, which have the ability to change hormones in the body. Eat carrots for beta-carotene, which now seem to be an anti-cancer food.
Millions of men over age 50 have tiny cancer lumps in the prostate which are harmless and inactive (dormant). They appear benign. They do not grow. Death from natural causes occurs in the natural time span. Medical opinion is divided over whether to remove these inactive lumps or not. There is a risk surgery will activate dormant cells which then start to grow. Prostate cancer can be treated and cured if it is detected early enough. It would seem a prudent option to have regular colo-rectal examinations.
Cancer Therapy
Malignant prostate cancer occurs mainly over age 60. Unhappily, in many cases, there are no obvious first signs. Pain comes on suddenly, in weeks rather than months. It hurts just above the pubic hairline, in the groin, or lower spine. Pain can spread to the legs. Until recently, the disease was rarely diagnosed until it was advanced, and little could be done. Regular colo-rectal check-ups now avoid this unhappy state.
Radical Prostatectomy
This is surgical removal of the entire prostate and seminal glands. The operation saves life, but the side effects can be severe. Impotence usually follows in men over age 70. In younger men, potency generally returns within a year. At age 40 plus, 90 percent of men become potent again. At age 50 plus, it is 80 percent. At age 60 plus, 60 percent. Sadly, within all-age groups, 2.5 percent to 5 percent of men suffer some degree of incontinence.
Radiation Therapy
There are a variety of ways in which radiation therapy is used”. These depend upon the man’s general health and how far the tumor has progressed. One type of radiotherapy is external beam radiation. The beam can be sharply focused on the tumor which avoids damage to nearby tissues. The course is spread over six to 1 seven weeks. High doses of rads are involved. Only 50 percent of all-age men become impotent. But there is a chance radiation therapy does not destroy all the tumor cells.
Hormone Therapy
If the female hormone estrogen is given, it stops testosterone production. Estrogen therapy can be an effective way to make the tumor regress. But the high doses put a strain on blood circulation. They increase the risk of blood clots in the heart or brain. Some surgeons recommend castration; both testicles are removed to stop further hormone production. Though this may seem unacceptable, it is an appropriate choice in very grave illness.
It is hoped new drugs in the trial stage will have the same effects as estrogen. They involve chemical castration without affecting blood circulation. They act by stopping the pituitary from producing luteinizing hormone which blocks the production of testosterone. And it is hoped a new combination therapy may be effective for milder cases. This is a very brief overview. If prostate cancer is diagnosed, ring 1-800-4-CANCER of the Cancer Information Service for more detailed information. Or send for free booklets by the Department of Health and Human Services, Public Health Service and National Institutes of Health.
