Prostate Cancer

From Health Facts

Editor-In-Chief: Dr. Heidi Kussmann, ND, FABNO

Prostate cancer incidence is uncommon in men under 50 years of age. The median age of diagnosis is 68 with the incidence increasing with age. It is the third most common cancer in men and accounts for 6% of cancer deaths worldwide.^[1] The overall 5-year relative survival rate for prostate cancer is reportedly over 95%.

Contents 1 Naturopathic Assessment 1.1 Causal Factors 1.1.1 Lifestyle 1.1.2 Social 1.1.3 Environmental 1.1.4 External 1.1.5 Medical Interventions 1.1.6 Genetics 1.2 Diagnostic Tests 1.3 Associated Conditions 2 Characteristics 3 Naturopathic Treatment 3.1 Cancer Specific Treatments 3.2 Supportive Care 4 References

Naturopathic Assessment

Assessing for prostate cancer is common in men over the 60 due to its increasing incidence. The symptoms that are normally correlated with prostate disorders include nocturia (increased urination at night), polyuria (increased urination frequency), urinary hesitancy and dysuria(painful urination).

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Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. A detailed assessment is required to determine which factors are contributing to prostate cancer.

Lifestyle

• Dietary Factors

• A high-fat diet may be a contributing factor.^[2], ^[3]

• High Vitamin A levels and low Vitamin D tend to associated with increased risk.

Social

• Stress

• Chronic stress is associated with increased risk of cancer.

Environmental

• Heavy Metals

• Exposure to cadmium, typically through smoking, increases the risk.

• Demographics

• In the world, demographic studies have shown that Sweden has the highest prostate cancer risk and Taiwan and Japan have the lowest risk.

External

• Smoking

• Smoking increases a person's risk of developing prostate cancer.

Medical Interventions

• Medical Procedures

• Vasectomy produces anatomic, hormonal and immunologic changes and, although not substantiated by clinical studies, has been reputed to be associated with atherosclerosis, prostate cancer, testicular cancer and urolithiasis.^[4]

Genetics

• Race

• Black men have the highest incidence of prostate cancer of any group.

• Family History

• Familial history of prostate cancer raises risk seven times if the affected relative was diagnosed by 50 years of age, and four times if diagnosed after 70 years of age.

Diagnostic Tests

Early detection and screening via annual Digital Rectal Examination (DRE) and serum PSA are routine. Symptoms of urinary hesitation and dribbling, frequent night-time urination, poor urine stream, and blood at the end of urination may indicate the need to rule out prostate cancer. Diagnostic testing for prostate cancer include:

• Blood tests that are often requested included Urinalysis, CBC, Kidney Function Test, PSA and PSA ratio, testosterone and Liver Function Tests.

• To confirm prostate cancer it is ideal to detect the presence of hypermethylated glutathione S-transferase (GSTP1) gene as it is not hypermethylated in benign hyperplastic prostate tissue would also be helpful to rule out the false positives that occur with the PSA test.^[5] , ^[6], ^[7]
• A suggested proteomic method of biomarker detection includes identifying polypeptides secreted from human prostate cancer cells grown in culture in the presence and absence of androgen. Other markers include prostate acid phosphatase, prostate-specific membrane antigen, prostate inhibin peptide, PCA-1, PR92, prostate associated glycoprotein complex, protein-mucin antigen, 12-lipoxygenase, and p53. Further the three genes P503S, P504S, and P510S are all overexpressed in cancerous prostate tissue. ^[1]

• Imaging Studies

• If prostate cancer is suspected it is common for additional diagnostic tests to be ordered including: bone scan, pelvic CT scan, pelvic MRI or endorectal MRI or prostascint scan.

Associated Conditions

Conditions that have similiar symptoms include:

• Benign prostatic hyperplasia (BPH)
• Chronic prostatitis
• Altered estrogen and androgen metabolite levels.

Characteristics

The different types of prostate cancer include:^[8]

• Adenocarcinoma is the main cellular type of prostate cancer
• Transitional
• Small cell carcinoma
• Squamous cell carcinomas
• Sarcoma

Symptoms of prostate cancer include:

• Urinary hesitation and dribbling
• Frequent night-time urination
• Poor urine stream
• Blood at the end of urination

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body. A treatment strategy is the most effective when it addresses the underlying causal factors. The treatment for prostate cancer depends on the staging (progression) of the cancer, an individual's symptoms, vitality and other conditions. The treatment strategies include: Prevention, Cancer Specific Treatments, Supportive Care and Prevent Recurrence. Many patients survive 15 years or longer with prostate cancer after diagnosis even without treatment. Also because of the advanced age of the men who develop prostate cancer they usually die from other health conditions, with prostate cancer but not because of it.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Cancer Specific Treatments

Follow the general guidelines for cancer specific treatments. Additional treatments that are specific to prostate cancer include:

• Dietary recommendations
• Nutritional Supplementation
• Acupuncture

Supportive Care

Follow the general guidelines for supportive care especially when conventional treatments such as surgery or radiation therapy are chosen. Specific considerations for prostate cancer include:

• The complications often seen in prostate cancer include: radiation-induced dysuria, radiation-induced urinary frequency, erectile dysfunction, hot flashes, rectal bleeding, urinary incontinence, urinary urgency, nocturia, diarrhea, or hematuria.

References

1. ↑ ^{1.0 1.1} Ruddon RW (2007) Cancer Biology 4th ed. Oxford University Press, pp 442.
2. ↑ Muir CS, Nectoux J, Staszwski J (1991) The epidemiology of prostate cancer. Geographical distribution and time trends. Acta Oncol;30:133-140.
3. ↑ Kaul L, Heshmat MY, Kovi J, et al. (1987) The role of diet in prostate cancer. Nutr Cancer;9:123-128.
4. ↑ Raspa RF (Nov 1993) Complications of vasectomy. Am Fam Physician.;48(7):1264-8. PMID: 8237740
5. ↑ Lee WH et al. (1994) Cytidine methylation of regulatory sequences near the pi-class glutathione S-transferase gene accompanies human prostatic carcinogenesis. Proc Natl Acad Sci USA;91:11733-7.
6. ↑ Esteller M et al. (1998) Inactivation of glutathione S-transferase P1 gene by promoter hypermethylation in human neoplasia. Cancer Res;58:4515-8.
7. ↑ Cairns P et al. (2001) Molecular detection of prostate cancer in urine by GSTP1 hypermethylation. Clin Cancer Res;7:2727-30.
8. ↑ Casciato DA. Manual of Clinical Oncology 5th ed. Lippincott Williams & Wilkins 2004. Pp 309-316.