Health Resources

Prostate cancer is the cancer which develops in the prostate gland, the gland which is responsible for secreting one of the fluids that constitutes semen in males. In prostate cancer the cells grow and multiply uncontrolled by the body’s normal functions, so that eventually the mutated cells move out or metastasize into adjacent organs like the bones or the liver. This spread often causes pain, difficulty urinating and other symptoms.
Prostate cancer can progress either rapidly or slowly. Prostate cancer which spreads faster than normal characterized by highly abnormal cells is referred to as aggressive prostate cancer.

What Is Aggressive Prostate Cancer

Aggressive prostate cancer is the condition where the cancer spreads too rapidly compared to the typical type of prostate cancer and mutated cells are very different from normal, healthy cells in appearance. Aggressive prostate cancer also does not go into remission despite a lowered level of androgens as a result of androgen-deprivation therapy, which is one of the first-line treatments against the disease.

Recently, a protein was identified to be a good predictor of the nature of the prostate cancer involved, that is, if it will mutate into the aggressive form or not. p27 is the protein that normally functions to suppress tumor growth. It has been found that patients with aggressive prostate cancer have very low levels of this protein. Aggressive prostate cancer has a worse prognosis than the typical type of prostate cancer, and patients with this disease also face a higher risk of recurrence.

How To Identify Aggressive Prostate Cancer

A yearly prostate examination is ideal for early detection of possible tumors in the prostate, especially since prostate cancer usually does not come with visible signs and symptoms. A routine physical inspection can be done through a digital rectal examination or a transrectal ultrasound, while a tumor biopsy is done to confirm the diagnosis of a malignant tumor.

There are many ways to determine how aggressive the cancer is. Tumor markers are often used to determine if the cancer is low-risk, intermediate risk, or high risk, with aggressive prostate cancer falling under the last category. These markers include prostate-specific antigen (PSA) levels, the PSA velocity, and the Gleason score. PSA is a substance which is normally produced by the prostate gland in little amounts. Higher-than-normal levels of PSA in the blood often signal an infection, an enlargement, or a disease in the prostate. The PSA velocity can show if the cancer is the aggressive or not. Studies have shown that when PSA levels rise sharply a few months before surgery, it is often an indication that the cancer is aggressive. The Gleason score, on the other hand, can also show how aggressive the cancer is by grading of the appearance of the mutated cells. The more abnormal the cells appear, the more aggressive they are.

As with most diseases, early detection may just make the difference between a good and bad prognosis. Although it cannot lower the risk for aggressive prostate cancer, annual digital prostate exams, transrectal ultrasound and other physical exam tests can identify potential cancerous tumors at an earlier time when treatment can be most effective.

A prostate nodule is any growth on the prostate which can be felt upon a digital rectal examination. Characterized as hard, soft, smooth or gritty, prostate nodules or the thickening in some portions of the prostate often develop as men grow older.

The evaluation for a prostate nodule may be included in the evaluation for prostitis or a possible infection. As a rule, all prostate nodules found require further evaluation to rule out the possibility of cancer, which may come without any other symptom.

Benign Prostate Nodules

A nodule does not automatically mean that cancer is present. Hard, rocky nodules may indicate calcification or a case of benign prostatic hyperplasia, where the epithelial and prostatic stromal cells multiply and grow large enough to form large nodules around the periurethral region of the prostate. Surgical removal is often necessary if the nodule has grown large enough to block the urethral canal and cause problems with urination. Sometimes, after a PSA test has shown borderline or elevated levels and there is presence of an infection, the doctor may initially put the patient in antibiotics for 2 to 4 weeks, after which the tests are repeated. If all tests are normal within this time, cancer can be ruled out, although a repeat exam is needed in 3 to 6 months.

Cancerous Prostate Nodules

About 50% of prostate nodules are malignant. Although a digital rectal examination cannot determine whether a nodule is cancerous or not, a biopsy can. A biopsy often follows when the doctor finds abnormal results from a Prostate Specific Antigen test. Once the biopsy has revealed cancer, important variables which are then taken into consideration will include grading and staging. Grading of the cancerous prostate nodule makes use of the Gleason score, which determines the degree of abnormality of the prostate cells from 2 (least aggressive) to 10 (most aggressive).

Staging, on the other hand is done on the basis of the DRE. A cancerous nodule is staged as follows:

T1c (PSA detected)
T2a (small prostate nodule)
T2b (larger prostate nodule)
T3 (very large prostate nodule with probable spread outside of the prostate)
T4 (prostate cancer spreading into adjacent organ such as the bladder)

Prevention And Treatment Of Prostate Nodules

There is no known cause why the prostate tends to enlarge as men get older, and why some men found to have prostate nodules develop prostate cancer and some don’t. Experts think genes and diet may play a role. Good nutrition may contribute to overall prostate health. Men who eat fruits and vegetables, foods that naturally contain antioxidants like lycopene and minerals like selenium lowered their risk for the disease significantly.

For men in their forties or older, an annual DRE may be necessary, especially for high-risk individuals. In some cases, whether the nodule is benign or malignant, surgical excision or complete removal of the nodule may become necessary.

It is a fact that eating a healthy, well-balanced diet is really good for us. A healthy diet keeps unwanted pounds at bay, and has been linked to lower risks for certain cancers in some studies. Doctors often advice men to make serious changes in the way they eat, especially those who are suspected to be at risk for developing prostate cancer or those who are discovered to have suspicious prostate nodules or other symptoms. The risk for prostate cancer may be lowered in healthy men if healthier dietary changes are made at an earlier time and even with a positive cancer diagnosis, a good prostate diet will still be a necessary part of the treatment.

The Perfect Prostate Diet: Is There One?

Although there is no official nutritional guideline made specifically for prostate cancer treatment, doctors advice a well-balanced prostate diet that is low on saturated oils and fats, processed meats, sugars, and high on fresh fruits and vegetables. One study conducted by Swedish scientists and published in the Cancer Causes and Control Journal revealed that the most effective diet for combating this type of cancer is a prostate diet composed of phytoestrogens, substances from plants which have a weak estrogenic effect. Phytoestrogens are taken up by the same parts of the body which naturally produce estrogen. Estrogens, incidentally, are used in conventional treatments of prostate cancer, specifically androgen ablation therapy to reduce the levels of male hormones in the body. Although estrogen can cause negative cardiovascular effects when taken by men in large doses, the small dose found in plants may be beneficial in the prevention of prostate cancer.

The consumption of meats and dairy products should be curved when one is following a good prostate diet. It has been shown that daily consumption of meat triples the risk for prostate enlarging and daily consumption of dairy products, even milk, doubles that risk.

The ideal prostate diet is one which is also rich in antioxidants, substances which are readily found in fresh fruits and vegetables. Antioxidants play a major role in the body’s immune system and are known to fight off cancer. In a 1995 study conducted by Harvard, it was found out that men who ate at least 10 servings of tomato-based foods per week reduced their risk for prostate cancer by 45%. The protective agent in this case is believed to be lycopene, a natural antioxidant found abundantly in tomatoes.

In effect a good prostate diet should be one that contains fresh and plant-based foods, since these contain antioxidants and natural vitamins and minerals which all play a protective role in keeping the risk for the disease as low as possible.

Even despite the positive diagnosis of prostate cancer, a prostate diet can still improve the quality of life of the patient. A healthy prostate diet is a necessary complement to any form of cancer therapy and can possibly help slow down the progression of the disease.

Taking The Fear Out of having a Prostate Biopsy

If you are showing symptoms that may suggest that you have prostate cancer, such as trouble starting to urinate or prostate pain, then your doctor will recommend a procedure known as a prostate biopsy. A prostate biopsy is a simple procedure that is usually performed by a urologist and is the only way of making a positive diagnosis of prostrate cancer.

Although a prostrate biopsy sounds like a big deal it really isn’t. Most men find that although the procedure is uncomfortable it is relatively pain free and most only feel a small amount of pain following the procedure.

Today, there are a number of ways in which a prostate biopsy can be carried out. The most common procedure is known as the core needle biopsy. In this instance the doctor will use a biopsy gun to remove small samples of tissue from the prostrate. The biopsy gun fires a needle into the sample area and removes the tissue. Once the tissue samples have been collected they are then sent to the laboratory where they will be analyzed to see if cancer is present.

This procedure is usually done under a local anesthetic and normally takes no longer than half an hour.

Another way to do a prostate biopsy is to access the prostate gland via the urethra. As the urethra passes through the prostate gland a lighted scope that has a cutting loop attached to it is inserted into the urethra to collect the tissue samples.

This particular procedure takes 30-45 minutes and although usually done under local anesthetic may sometimes be carried out under general anesthetic.

A less common way to perform a prostate biopsy is to collect the tissue samples with a needle through the perineum. The perineum is located between the rectum and the scrotum and the urologist will keep the prostate steady by inserting a finger into the rectum. He will then use a biopsy needle that will be inserted through a small incision.

Carried out under a local anesthetic this is the quickest way to perform a prostate biopsy as it only takes about 15 minutes but is a procedure that is not often used.

Before your prostate biopsy your doctor should explain any complications that could occur for instance, there may be discomfort and bruising at the biopsy site, there may be prolonged bleeding from the biopsy site or you could have problems urinating.

After a prostate biopsy you may find that you have blood present in your urine or stools for a few days or you may even have red or reddish brown blood in your semen when you ejaculate. This could last a few weeks.

Your doctor should be notified if the amount of blood increases, you continue to have difficulty urinating or you show signs of a fever and chills.

The important thing to remember is that you may suffer some discomfort for a short while but that is far better than the consequences of not having any symptoms checked out.

The best way of identifying whether a person or even a segment of persons in a given population are suffering from prostate cancer is to perform prostate cancer screening. Such screening is even required for those who do not have a reason to suspect having prostate cancer. At the moment prostate cancer screening can be done in two ways – the first method is to use digital rectal examination or DRE while the other method is using prostate-specific antigen or PSA.

Digital Rectal Examination

Digital rectal examination requires that an examiner inserts his finger (lubricated and gloved) into the person’s rectum to determine whether there is any reason to suspect signs of prostate cancer. On the other hand, prostate-specific antigen or PSA blood tests the concentration of prostate molecules in the blood and will reveal presence of prostate cancer. One thing however needs to be mentioned and that is that prostate cancer screening is not free from controversies and especially when used for elderly males where the benefit is less than clear.

There have been trials conducted to establish whether timely detection through use of PSA is beneficial or not and it seems that only four percent of patients have benefited and mortality rates have declined in the US in the past ten years or so.

Whether or not you should go in for prostate cancer screening depends to a large extent on a number of factors and your doctor is surely going to be the best person to advice you in this regard because there are no cut and dried answers available. In fact, prostate cancer screening is not beneficial for every male; especially not for those males whose life expectancy is short because of suffering from serious diseases

There are numerous instances of males having prostate cancer and not even being aware of their condition and who still are able to live a healthy life. Nevertheless, the density of prostate cancer cases among men is about seventeen percent or one in every six males though only a third of these males will die as a result of prostate cancer.

It is however wise to weigh the various pros and cons of prostate cancer screening before making a call; especially, as you won’t find any clear cut answers as to who should undergo prostate cancer screening and who should not. It is advisable, if you have passed your fiftieth birthday, to have a prostate test done to establish the presence or otherwise of prostate cancer.

If, however, you have passed your seventy-fifth birthday, then getting a prostate cancer screening done would be meaningless. In other cases, the prostate cancer screening may be able to help doctors determine if as well as when prostate cancer developed and the factors that play a role in such determination are your age, race or ethnicity as well as family history and even your diet.

Taking A Closer Look As to Why Prostates Become Swollen

If you are diagnosed with Benign Prostatic Hyperplasia (BPH) it means that you have a swollen prostate. The prostate gland surrounds the urethra and produces the fluid which carries the sperm during ejaculation so a swollen prostate can cause discomfort and other problems especially with the urinary tract.

Almost all men will experience a swollen prostate as they age. There is no known cause as to why the prostate should become swollen other than the aging process.

Should you find that you are experiencing symptoms such as, difficulty in urinating, dribbling after urinating, strong and sudden urges to urinate, difficulty in emptying the bladder completely, incontinence, blood in the urine or pain when urinating there is the possibility that you have a swollen prostate and should visit your health provider.

Your health provider will take a complete medical history and then will perform a digital rectal exam. After which he may then perform other tests such as, a post-void residual test, a urinalysis, a urine culture or a cystoscopy.

The health provider may also run a prostate specific (PSA) test. This is a blood test that screens for the possibility of prostate cancer. The results of a PSA come back in number form and a lower number is better than a higher number. But before having this test tell your health provider what medications you are taking as some medications artificially lower the levels of PSA.

Should the PSA come back at a higher level it does not necessarily mean that cancer is present but your health provider will probably arrange for a biopsy of the prostate gland just to be on the safe side. As is known from all the prostate cancer news early diagnosis is crucial for recovery.

A swollen prostate can be treated in various ways. Should cancer be ruled out then you health care provider might look at treating you with alpha-blockers. These relax the muscles at the neck of the bladder which makes urinating easier.

Or he may use finasteride which shrinks the prostate gland. This has been shown to be really effective in men with a significantly swollen prostate.

Another way that your health provider may treat your swollen prostate is to use heat therapy. This is done under a local anesthetic and as an out- patient.

If the swollen prostate is causing complications or is difficult to manage then another option is to have the prostate gland removed. This can be done as a transurethral resection, an open prostatectomy or a transurethral incision of the prostate. Any of these procedures will require admission to hospital and will be performed under a general anesthetic.

A swollen prostate can also be treated with a balloon dilation or a prostate stent.