The complementary approach to the management and treatment of prostate cancer is quite different from the conventional approach and perhaps more beneficial for some patients. In this article I will discuss the prostate gland, describe the nature of prostate cancer including how it is diagnosed and classified, discuss conventional treatment approaches and the controversies associated with the conventional treatments, and finally, outline some alternative treatments we utilize.
Before beginning this outline, let me first give you my conclusion. All prostate cancer patients should use alternative cancer therapies. In general, they should be used prior to beginning conventional treatment. When the prostate cancer patient is receiving conventional treatment, he should also incorporate alternative therapies in order to reduce the side effects of conventional treatment, improve the results, and possibly allow the patient to be able to discontinue the conventional treatments.
The prostate gland-that’s prostate, not prostrate, is found only in males and is normally about the size of a walnut in men. It is located below the bladder and in front of the rectum. Urine formed in the kidneys passes to the bladder in tubelike structures called ureters. From the bladder, urine passes to the outside through another tubelike structure called the urethra. The urethra passes through the middle of the prostate and the part of the urethra located in the prostate is called the prostatic urethra. When a portion of the prostate enlarges, it may impinge upon the flow of urine. This condition when it is benign, that is not cancerous, is called BPH or benign prostatic hyperplasia. The other major conditions involving the prostate are prostatitis and prostate cancer, which will be the subject of this series.
Just how much of a problem is prostate cancer? It is a major health problem for many reasons. The American Cancer Society estimates that in the United States one in six men will eventually be diagnosed with prostate cancer--that’s one in six men. In 1995 in the United States, 244,000 men will be diagnosed and 40,400 will die from the disease, making it the second leading cancer killer in men, behind lung cancer. More men will be diagnosed with prostate cancer than women with breast cancer, although the number of deaths of each will be about the same. Prostate cancer in men is quite analogous to breast cancer in women.
In spite of this high incidence, the problem is even greater because with prostate cancer, one must distinguish between clinical and microscopic cancer. Much of the prostate cancer that occurs in men is never diagnosed because many men with prostate cancer die of other causes, never knowing they ever had it. For example, a recent study involving careful pathological examinations of the prostate glands during the autopsies of men killed in accidents revealed some alarming figures. The incidence of microscopic prostate cancer was 80% in men between the ages 70 and 80 years old, 40% in men between 50 and 60 years old, 34% in men between 40 and 50 years old, and 27% in men between 30 and 40 years old. To me these statistics were truly amazing. Keep in mind, however, that these statistics refer to microscopic prostate cancer and not to clinical prostate cancer, which is diagnosed while the person is alive.
How Does a Doctor Diagnose Prostate Cancer?
Several years ago, the major way of diagnosing relatively early prostate cancer was through a digital rectal examination, in which the physician inserts a gloved finger into the rectum and feels a hard nodule on the prostate. A biopsy of the nodule would confirm the diagnosis. Sometimes the diagnosis would be made of advanced prostate cancer when the patient presented to the doctor with bone pain and further workup revealed that he had prostate cancer with spread to the bone or bone metastases already. Today, however, the diagnosis of prostate cancer is being made much earlier most of the time because of a simple blood test called the prostate specific antigen or PSA. Next week I’ll discuss the pros and cons of the PSA, another procedure called the transrectal ultrasound of the prostate, the pros and cons of biopsy of the prostate and the staging and grading of prostate cancer.