YOU AND YOUR PROSTATE

WHAT IS THE STATE OF YOUR PROSTATE?

A Time Bomb In Men's Plumbing System

The word "prostate" comes from Medieval Latin prostate and Medieval French prostate. The ancient Greek word prostates means "one standing in front", from proistanai meaning "set before". The prostate is so called because of its position - it is at the base of the bladder.

Prostate cancer is a disease which only affects men.  After non-melanoma skin cancer, prostate cancer is the most common cancer among men.

Prostate cancer is one of the leading causes of cancer death among men of all races.

According to the American Cancer Society about 2 men in 7 will be diagnosed with prostate cancer during his lifetime.

Prostate cancer mainly occurs in older men - about 6 cases in 10 are diagnosed in men 65 years or older. It's also surprising to know that it's becoming common with men under the age of 40 years now

Almost all prostate cancers are adenocarcinomas - cancers that begin in cells that make and release mucus and other fluids.

Prostate cancer often has no early symptoms.

Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine.

Most men diagnosed with prostate cancer do not die from it. More than 2.9 million men in the US diagnosed with prostate cancer at some point are still alive today.

What is the prostate?

The prostate is an exocrine gland of the male reproductive system, and exists directly under the bladder, in front of the rectum. An exocrine gland is one whose secretions end up outside the body e.g. prostate gland and sweat glands. It is approximately the size of a walnut.

The urethra - a tube that goes from the bladder to the end of the penis and carries urine and semen out of the body - goes through the prostate.

There are thousands of tiny glands in the prostate - they all produce a fluid that forms part of the semen. This fluid also protects and nourishes the sperm. When a male has an orgasm the seminal-vesicles secrete a milky liquid in which the semen travels. The liquid is produced in the prostate gland, while the sperm is kept and produced in the testicles. When a male climaxes (has an orgasm) contractions force the prostate to secrete this fluid into the urethra and leave the body through the penis.

Urine Control

As the urethra goes through the prostate: the prostate gland is also involved in urine control (continence) with the use of prostate muscle fibers. These muscle fibers in the prostate contract and release, controlling the flow of urine flowing through the urethra.

In the vast majority of cases, the prostate cancer starts in the gland cells - this is called adenocarcinoma. In this article, prostate cancer refers just to adenocarcinoma.

Prostate cancer is mostly a very slow progressing disease. In fact, many men die of old age, without ever knowing they had prostate cancer - it is only when an autopsy is done that doctors know it was there. Several studies have indicated that perhaps about 80% of all men in their eighties had prostate cancer when they died, but nobody knew, not even the doctor.

Experts say that prostate cancer starts with tiny alterations in the shape and size of the prostate gland cells - Prostatic intraepithelial neoplasia (PIN).

Doctors say that nearly 50% of all 50-year-old men have PIN. The cells are still in place - they do not seem to have moved elsewhere - but the changes can be seen under a microscope. Cancer cells would have moved into other parts of the prostate. Doctors describe these prostate gland cell changes as low-grade or high-grade; high grade is abnormal while low-grade is more-or-less normal.

Any patient who was found to have high-grade PIN after a prostate biopsy is at a significantly greater risk of having cancer cells in his prostate. Because of this, doctors will monitor him carefully and possibly carry out another biopsy later.

The Prostate Produces Prostate-specific antigen (PSA)

The epithelial cells in the prostate gland produce a protein called PSA (prostate-specific antigen). The PSA helps keep the semen in its liquid state. Some of the PSA escapes into the bloodstream. We can measure a man's PSA levels by checking his blood. If a man's levels of PSA are high, it might be an indication of either prostate cancer or some kind of prostate condition.

It is a myth to think that a high blood-PSA level is harmful to you - it is not. High blood PSA levels are however an indication that something may be wrong in the prostate.

Male hormones affect the growth of the prostate, and also how much PSA the prostate produces. Medications aimed at altering male hormone levels may affect PSA blood levels. If male hormones are low during a male's growth and during his adulthood, his prostate gland will not grow to full size.

In some older men the prostate may continue to grow, especially the part that is around the urethra. This can make it more difficult for the man to pass urine as the growing prostate gland may be causing the urethra to collapse. When the prostate gland becomes too big in this way, the condition is called Benign Prostatic Hyperplasia (BPH). BPH is not cancer, but must be treated.

Prostate cancer

Classification of Prostate Cancer

It is important to know the stage of the cancer, or how far it has spread. Knowing the cancer stage helps the doctor define prognosis - it also helps when selecting which therapies to use. The most common system today for determining this is the TNM (Tumor/Nodes/Metastases). This involves defining the size of the tumor, how many lymph nodes are involved, and whether there are any other metastases.

When defining with the TNM system, it is crucial to distinguish between cancers that are still restricted just to the prostate, and those that have spread elsewhere. Clinical T1 and T2 cancers are found only in the prostate, and nowhere else, while T3 and T4 have spread outside the prostate.

There are many ways to find out whether the cancer has spread. Computer tomography will check for spread inside the pelvis, bone scans will decide whether the cancer has spread to the bones, and endorectal coil magnetic resonance imaging will evaluate the prostatic capsule and the seminal vesicles. There are some sings and tests your doctor will run.

Signs and Symptoms of Prostate Cancer

During the early stages of prostate cancer there are usually no symptoms. Most men at this stage find out they have prostate cancer after a routine check up or blood test. When symptoms do exist, they are usually one or more of the following:

-   The patient urinates more often

-   The patient gets up at night more often to urinate

-   He may find it hard to start urinating

-   He may find it hard to keep urinating once he has started

-   There may be blood in the urine

-   Urination might be painful

-   Ejaculation may be painful (less common)

-   Achieving or maintaining an erection may be difficult (less common).

If the prostate cancer is advanced, the following symptoms are also possible:

-   Bone pain, often in the spine (vertebrae), pelvis, or ribs

-   The proximal part of the femur can be painful

-   Leg weakness (if cancer has spread to the spine and compressed the spinal cord)

-   Urinary incontinence (if cancer has spread to the spine and compressed the spinal         cord)

-   Fecal incontinence (if cancer has spread to the spine and compressed the spinal    
     cord).

Causes of Prostate Cancer

Nobody is really sure of what the specific causes are. There are so many possible factors, including age, race, lifestyle, medications, and genetics, to name a few.

1) Age

Age is considered as the primary risk factor. The older a man is, the higher is his risk. Prostate cancer is rare among men under the age of 45, but much more common after the age of 50.

2) Genetics

Statistics indicate that genetics is definitely a factor in prostate cancer risk. It is more common among certain racial groups - in the USA prostate cancer is significantly more common and also more deadly among Afro-Americans than White-Americans. A man has a much higher risk of developing cancer if his identical twin has it. A man whose brother or father had/had prostate cancer runs twice the risk of developing it, compared to other men.

3) Diet

A review of diets indicated that the Mediterranean diet may reduce a person's chances of developing prostate cancer. Another study indicates that soy, selenium and green tea, offer additional possibilities for disease prevention - however, a more recent study indicated that combination therapy of vitamin E, selenium and soy does not prevent the progression from high-grade prostatic intraepithelial neoplasia (HGPIN) to prostate cancer. A diet high in vegetable consumption was found in a study to be beneficial.

Other studies have indicated that lack of vitamin D, a diet high in red meat may raise a person's chances of developing prostate cancer.

4) Medication

Some studies say there might be a link between the daily use of anti-inflammatory medicines and prostate cancer risk. A study found that statins, which are used to lower cholesterol levels, may lower a person's risk of developing prostate cancer.

5) Obesity

A study found a clear link between obesity and raised prostate cancer risk, as well as a higher risk of metastasis and death among obese people who develop prostate cancer.

6) Sexually transmitted diseases (STDs)

Men who have had gonorrhea have a higher chance of developing prostate cancer, according to research from the University of Michigan Health System.

7) Agent Orange

Veterans exposed to Agent Orange have a 48% higher risk of prostate cancer recurrence following surgery than their unexposed peers, and when the disease comes back, it seems more aggressive, researchers say. Another study found that Vietnam War veterans who had been exposed to Agent Orange have significantly increased risks of prostate cancer and even greater risks of getting the most aggressive form of the disease as compared to those who were not exposed.

8) Enzyme PRSS3 Linked to Aggressive Prostate Cancer

Scientists from the Mayo Clinic, Florida, reported in Molecular Cancer Research that PRSS3, an enzyme, changes the environment of prostate cancer cells, making the cancer much more likely to metastasize.

Senior researcher, Evette Radisky, Ph.D., said "This molecule is a protease, which means it digests other molecules. Our data suggests PRSS3 activity changes the environment around prostate cancer cells - perhaps by freeing them from surrounding tissue - to promote malignancy and invasiveness. I don't think PRSS3 is the only factor involved in driving aggressive prostate cancer, but it may be significant for a certain subset of this cancer - the kind that is potentially lethal."

Among men who have surgery for prostate cancer, those who have high total cholesterol and triglyceride levels - two types of fat found in blood - may be at increased risk of disease recurrence. This is according to a study published in the journal Cancer Epidemiology, Biomarkers & Prevention.

Western diet could be fatal for prostate cancer patients

A new study has suggested that following a Western diet - high in red and processed meats, refined grains and high-fat dairy products - could increase the risk of death for people with prostate cancer from both prostate cancer and all causes.

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