Prostate Cancer Awareness Week
(pcaw.org) has compiled information on the issue of Prostate
The Long Version:
Prostate Enlargement (Benign
What is the prostate?
The prostate is a doughnut-shaped cluster of glands located at the
bottom of the bladder about halfway between the rectum and the base
of the penis. It encircles the urethra, the tube that carries urine
from the bladder out through the penis. The walnut-sized gland
produces most of the fluid in semen. Contraction of the muscles in
the prostate squeeze fluid from the prostate into the urethral tract
during ejaculation. It makes up the bulk of the ejaculate and
nourishes and transports the sperm.
Cancer of the prostate is the leading cause of cancer death among
non-smoking American men and African-American men are 2 ½ times
more likely to get the disease than any other ethnic group in the
world. It is still unknown exactly why African-American men have the
highest incidence of prostate cancer in the world. Research has
shown, though, that they typically develop the disease earlier than
white Americans, but are diagnosed with it later, so their mortality
rate is much higher than that of whites. One of every eight
African-American men will develop the disease in his lifetime. It is
primarily a disease of aging. Men in their thirties and forties
rarely develop prostate cancer, but the incidence increases steadily
after the age of fifty-five. Approximately 80 percent of all cases
occur in men over the age of sixty-five and by the age of eighty, 80
percent of all men have prostate cancer to some degree. The American
Cancer Society estimates that more than 381,000 new cases of prostate
cancer will be diagnosed in 1998 and over 41,000 men will die of the
disease. A male baby born today has a 13 percent change of developing
prostate cancer at some time in his life, and a 3 percent change of
dying from the disease. Many experts feel that every man will
eventually develop prostate cancer if he lives long enough.
The three most common prostate problems are: infection
(prostatitis), prostate enlargement (benign prostatic hupertrophy),
and prostate cancer.
Currently, both the American Urological Association and the
American Cancer Society recommend annual rectal exams as part of a
mans annual health checkup for all men from ages 40 to 70, and
beginning at age 40 for men at high risk (African-American men and
those with a family history of the disease)and all men 50 and over
add a PSA blood test every year as well. According to Dr. Crawford,
these guidelines might need to be redefined. When prostate cancer is
detected and treated in its early stages, it has a high cure rate.
They encourage discussing the options with your medical care
Based on past screenings conducted during Prostate Cancer
Awareness Week, Dr. Crawford and his colleagues have observed that in
men ages 50 to 59, the prostate cancer detection rate was the same
regardless of whether they were screened every year or every two
years. For men between the ages of 60 and 70, thought, the prostate
cancer rate was higher if they only were screened every two years
versus annually. Therefore, it may only be necessary for normal-risk
men in their 50s to be screened every other year. Dr. Crawford also
suggests that high-risk men between the ages of 35 and 39 and
normal-risk men between the ages of 45 and 49 should get a baseline
PSA test. This recommendation is based on PCAW data revealing that
the majority of positive biopsies in high-risk men screened between
the ages of 40 and 49 were detected in their first year of screening.
Further studies indicated that 95 percent of all prostate cancers
among high-risk men were found in the first two years of a mans
screenings. "Because we have no cure for advanced prostate cancer,
early diagnosis and treatment are essential," Dr. Crawford said.
"Asymptomatic men can choose to know if they have
prostate cancer so that they can know to choose from
treatment alternatives that can cure their cancer." Because early
prostate cancer usually does not have any symptoms, it is extremely
difficult to detect without testing. In fact, screenings using both
PSA and DRE tests have proven to be the only reliable method of
identifying the disease when it can be cured most easily. Currently,
58 percent of all cases are discovered while the cancer is still
localized and at its most curable stage. You doctor can detect
prostate cancer by digital rectal examination (dont die from
embarrassment) and by a PSA (prostate-specific antigen) blood
Prostate infection (Prostatitis)
Prostatitis, common in men of all ages, is the inflammation of
the prostate gland. The usual cause is infectious bacteria that
invade the prostate from another area of the body. Hormonal chances
associated with aging may also be a cause. The inflammation can
result in urine retention. This causes the bladder to become
distended, weak, tender and itself susceptible to infection.
Infection in the bladder is in turn early transmitted up the urethras
to the kidneys.
There are two types of prostate infection, acute and chronic.
Acute infections come on suddenly and have some or all of the follow
symptoms: Fever and chills, pain and burning on urination and
ejaculation, strong and frequent urge to urinate while passing only
small amounts of urine, lower back or abdominal pain, blood in the
urine (occasionally). Symptoms of chronic prostatitis are usually
milder than those of an acute infection and fever and chills are
usually not present. Either infection may occur with a urinary tract
Sometimes, men will have painful urinary symptoms without
infection. This condition may be called prostatodynia and is often
related to stress or anxiety. Prostate infections usually respond
well to home care and antibiotic treatment. If the infection recurs,
long-term antibiotic treatment may be needed.
Prostatitis Treatment Options
Options for the home treatment:
- Drink as much water as you can tolerate
- Eliminate all alcohol and caffeine from your diet.
- Hot baths help soothe pain and reduce stress
- Aspirin or ibuprofen may help ease painful urinary
Other treatment options:
- If the prostate is infected, treatment with antibiotics and
analgesics may be necessary.
- Although antibiotics are often used to treat prostatitis, the
long-term use of such drugs can lead to bacterial resistance,
which in turn necessitates more potent drugs, more expense, and
more medical complications.
When to call a doctor
It's time to check with your doctor:
- If urinary symptoms occur with fever, chills, vomiting, or
pain in the back or abdomen
- If urine is red or pink with no dietary reason. Always call a
doctor is your have blood in your urine.
- If symptoms continue for 5 days despite home care.
- If there is a sudden change or worsening of symptoms.
- If you have pain on urination or ejaculation and a discharge
from the penis.
Prevention of prostatitis
Ways to prevent prostatitis:
- Increase your fluid intake to as much as 8 to 12 glasses per
day. You are drinking enough when you are urinating more often
than usual. Extra fluids help flush the urinary tract clean.
- Avoid alcohol and caffeine. Caffeine can cause a strong and
frequent urge to urinate. Remember that colas contain caffeine as
well as coffee and tea.
- Keep stress under control. A high level of stress is closely
associated with prostatodynia.
Prostate Enlargement (Benign Prostatic
As men age, the prostate may enlarge. This seems to be a natural
process and is not really a disease. Benign prostatic hypertrophy is
the gradual enlargement of the prostate. It occurs in approximately
half of all men over the age of fifty and three quarters of men over
seventy years of age - a total of about 10 million American men - and
is largely attributable to hormonal chances associated with aging.
After the age of fifty or so, a mans testosterone and free
testosterone levels decrease while the levels of other hormones, such
as prolactin and estradiol, increase. This creates an increase in the
amount of dihydrotestosterone - a very potent for of testosterone -
within the prostate. This causes a hyperplasia (overproduction) of
prostate cells, which ultimately results in prostate enlargement.
While not cancerous, however, as the gland gets bigger, it tends to
squeeze the urethra and cause urinary problems. If it becomes too
large, it obstructs the urethral canal, interfering with urination
and the ability to empty the bladder completely. Because the bladder
cannot empty completely, the kidneys also may not empty as they
should. Dangerous pressure on the kidneys can result. In severe
cases, the kidneys may be damaged both by pressure and by substances
in the urine. Bladder infections are associated with both prostatitis
and enlarged prostate.
The major symptom of enlargement of the prostate is the need to
pass urine frequently, with frequency increasing as time goes on. A
man may find himself rising several times during the night to
urinate. There can also be pain, burning and difficulty in starting
and stopping urination. The presence of blood in the urine is not
An enlarged prostate gland is not a serious problem unless
urination becomes extremely difficult, or backed-up urine causes
bladder infections or kidney damage. Some dribbling is very common
and not necessarily a sign of prostate problems.
Surgery is usually not necessary for an enlarged prostate.
Although surgery used to be a common treatment, recent research shows
that most cases of prostate enlargement do not get worse over time as
previously thought. Many men find that their symptoms are stable and
some even clear up on their own. In these cases, the best treatment
is no treatment at all. Drugs are available that may help improve
symptoms in some men. Your doctor can advise you on the various
Prostate Enlarement Treatment Options
- Avoid antihistamines and decongestants, which can make urinary
- If you are bothered by a frequent urge to urinate at night,
cut down on beverages, especially alcohol and caffeine, before
- Dont postpone urinating, and take plenty of time. Try
sitting on the toilet instead of standing.
- If dribbling after urination is a problem, wash your penis
once a day to prevent infection.
- Enlarged prostate may be treated surgically with a procedure
called transurethral resection of the prostate (TURP). About
350,000 TURPs were done in the United States in 1990. The
procedure is twice as likely than are drugs or other treatments to
provide long-term relief. Side effects of the procedure include
retrograde ejaculation (in which the semen is pumped back up into
the bladder) and in some cases impotence or incontinence. About 15
percent of men who have the procedure need another operation
within eight years. Newer surgical procedures using laser
technology and other technologies are available, but TURP remains
the standard treatment. TURP is not used for prostatitis.
- The drug finasteride (Proscar) may be used to treat moderate
prostate enlargement. It blocks an enzyme that converts the male
hormone testosterone into dihydrotestosterone, which promotes the
growth of prostate tissue. The drug has been shown to increase
urine flow in 30 percent of test cases and to reduce the size of
the prostate by 20 percent in more than half the test cases. In
addition, because it reduces the amount of prostate tissue, it can
skew the results of the blood test used to detect prostate
- Engaging in sexual intercourse while the prostate is infected
and irritated may further irritate the prostate and delay
- Vasectomy for sterilization has been linked to prostate
disorders and even cancer.
- Zinc deficiency is linked to enlargement of the prostate. Soil
used for farming is often deficient in zinc, and unless you eat
hulks of cereals or brewers yeast, it is difficult to get
enough zinc in the diet. Alcohol causes a deficiency of zinc and
other serious nutritional deficiencies. However, too much zinc
(over 100 milligrams a day) can depress immune function.
- The injectable drug leuprolide (Lupron) may shrink an enlarged
prostate. Side effects that can occur include impotence, decreased
libido and even hot flashes. You should take this drug only if you
are not concerned with potency. It is available by a doctors
- All men aged forty or over should have a yearly rectal
examination, during which the prostate gland is checked.
When to call your doctor
It's time to call your doctor:
- If fever, chills, or back or abdominal pain develop.
- Diuretics, tranquilizers, antihistamines, decongestants, and
antidepressants can aggravate urinary problems. If you take these
drugs, ask your health professional if there are other medications
without these side effects.
- If the symptoms of an enlarged prostate last longer than two
weeks. Early examination enables you to confirm the diagnosis and
consider treatment options.
Prevention of acute prostatitis and enlarged
Ways to prevent acute prostatitis and enlarged prostate:
- Acute inflammation or enlargement of the prostate gland often
responds to certain herbal teas. If no improvement takes place or
if the symptoms recur, consult a urologist.
- Take steps to reduce your blood cholesterol level. Studies
have shown a connection between high cholesterol and prostate
disorders. Cholesterol has been shown to accumulate in enlarged or
cancerous human prostates.
- Alternative treatments may be employed by herbalists or
naturopaths. Natural systems of medicine, which include the use of
healing herbs, diet, exercise, and relaxation techniques, can
reduce and prevent symptoms associated with BPH. Such natural
approaches are thousands of years old and used throughout the
world to support and restore health. Some of them, like extracts
of the fruits of saw palmetto, a small palm that grows in the
southeaster U.S., have long been noted as effective to support
prostate health. Research now shows that this safe, simple
preparation may equal widely prescribed pharmaceutical
preparations in treating BPH, without the side effects. Other
herbs that contribute to prostate health are also reviewed in
Christopher Hobbs book: Saw Palmetto: The herb for prostate health
and are explained in detail.
- Use hydrotherapy to increase circulation in the prostate
region. One method involves sitting in a tub that contains the
hottest water tolerable for fifteen to thirty minutes once or
twice a day. Another form of hydrotherapy involves spraying the
lower abdomen and pelvic area with warm and cold water,
alternating between three minutes of hot water and one minute of
cold. Still another technique involves sitting in hot water while
immersing the feet in cold water for three minutes, and then
sitting in cold water while immersing the feet in hot water for
- Eat 1 to 4 ounces of raw pumpkin seeds every day. Pumpkin
seeds are helpful for almost all prostate troubles because they
are rich in zinc. As an alternative, pumpkin seed oil can be taken
in capsule form.
- Eliminate from your lifestyle such items as tobacco, alcoholic
beverages (especially beer and wine), caffeine (especially coffee
and tea), chlorinated and flouridated water, spicy and junk foods,
and tomato and tomato products. Limit your exposure to pesticides
and other environmental contaminants.
- If you have prostatitis, increase your fluid intake. Drink two
to three quarts of spring or distilled water daily to stimulate
urine flow. This helps to prevent cysitits and kidney infection as
well as dehydration.
- Get regular exercise. Do not ride a bicycle, however; this may
put pressure on the prostate. Walking is good exercise.
- If your prostate is enlarged, be cautious about using
over-the-counter cold and allergy remedies. Many of these products
contain ingredients that can inflame the condition and cause
- Avoid exposure to very cold weather.
Although it is relatively common, in most cases prostate cancer
is a slow growing cancer. Most prostate cancers arise in the rear
portion of the prostate gland; the rest originate near the urethra.
Prostate cancers double in mass every six years, on average.
The disease often causes no symptoms at all until it reaches an
advanced stage and/or spreads outside the gland. Or it could be one
or more of the following: Pain or a burning sensation during
urination, frequent urination, a decrease in the size and force of
urine flow, an inability to urinate, blood in the urine, and
continuing lower back, pelvic or suprapublic discomfort. However,
these symptoms most often are caused not by cancer but by benign
enlargement or inflammation of the prostate. Thats why
professional evaluation and diagnosis is so necessary.
The rate of prostate cancer in the U.S. is rising. In part, this
is due to the aging of our population. Just a generation ago, the
life expectancy for white men was sixty-five years; today, it is
close to eighty years. However, the rate of prostate cancer is
rapidly rising in all men, even those under fifty. This is
significant because, in general, the younger a man is when he is
diagnosed with prostate cancer, the worse his prognosis. The increase
in prostate cancer among younger men points to the role of diet and
exposure to environmental toxins in the development of the
African-American men have the highest incidence of prostate
cancer, while Asian-American have the lowest. Men with a family
history of prostate cancer also run a higher risk of developing the
disease. The incidence is higher among married men that it is among
unmarried men. Also at increased risk are men who have had recurring
prostate infections, those with a history of venereal disease, and
those who have taken testosterone. Researchers have also found a link
between a high-fat diet and prostate cancer. This may be due to the
fact that heavy fat consumption raises testosterone levels, which
could then stimulate growth of the prostate, including any cancer
cells it may be harboring. Exposure to cancer-causing chemicals
increases risk as well. Some experts believe that vasectomy may
increase a mans chances of developing prostate cancer. And,
while it isnt conclusive, some medical professionals are
recommending to have the vasectomy reversed.
It is believed by most that there is no way to prevent the
disease, but early detection can make it possible to catch the cancer
before it spreads to other parts in the body. A careful rectal exam
of the prostate is the simplest and most cost-effective approach for
detecting prostate cancer. The American Urologic Association
recommends that ever man have an annual exam beginning at least by
age forty. The American Cancer Society no longer recommends testing.
They suggest discussing the options with your health care
professional. (Wonder what that's all about? When early detection
clearly saves lives, who gains from not being tested except those who
know they don't have prostate cancer. And, without symptoms, who
knows? Maybe the doctors and hospital and funeral homes gain?
Families sure don't. Gives one something to think about!) A
blood test to detect elevated levels of a substance called
prostate-specific antigen (PSA) is an excellent screening test for
prostate cancer. PSA is currently the most valuable "tumor marker"
available to diagnose and evaluate the effectiveness of therapy for
prostate cancer. A PSA test result between 0 and 4 is considered to
be within the normal range; a PSA over 10 is assumed to indicate
cancer until proven otherwise. High PSA levels can be caused by
factors other than cancer, including benign enlargement or
inflammation of the prostate, an activity as innocuous as bicycle
riding, or even the rectal exam itself. If a mans PSA level is
found to be high, the test should always be repeated, because it does
yield false-positive or false-negative results an estimated 10 to 20
percent of the time. Having the test repeated every year may help a
physician to better interpret the results; in healthy men, PSA levels
tend to remain relatively stable, rising only gradually from year to
year, while cancer causes the levels to rise more dramatically.
Ultrasound scanning of the prostate is often done to follow up on
an abnormal rectal exam or PSA test. Other diagnostic tests,
including computerized tomography (CT) scans, bone scans, and
magnetic resonance imaging (MRI) may be necessary, but are costly.
Ultimately, if test results point consistently to the presence of
cancer, a tissue diagnosis must be done to confirm it. This can be
done only by microscopic examination of a needle biopsy, preferably
directed under ultrasound control. Repeated biopsies may be needed in
some cases. This invasive procedure may itself cause complications.
Bleeding, urinary retention, impotence and sepsis (blood poisoning)
have been reported.
Prostate Cancer Treatment Options
Some of the treatment options for prostate cancer:
- If the disease is caught early, treatment is usually
successful. If the cancer has spread beyond the prostate, however,
it is difficult to treat and cure. Unfortunately, prostate cancer
can be difficult to diagnose in its early stages. Many cases are
diagnosed only after the cancer has spread outside the gland. Once
this happens, the survival rate over the next five years is about
40 percent. If the disease spreads to the lymph nodes, bones or
other organs, the chances of survival drop to 20 percent.
- Berries help protect DNA from damage and mutation that may
result in cancer.
- Experimental therapies such as cryoablation (freezing of
cancer cells) and laser surgery are sometimes used in prostate
- If the cancer has spread into the capsule of the gland, the
standard approach is some form of radiation therapy. Ten-year
survival rates are 50 to 60 percent. Radiation therapy leaves men
impotent 50 percent of the time. It may also adversely affect the
bladder and rectum. (See Brachytherapy
- seed implants.)
- If the disease is confined to the prostate and a man is
healthy and under seventy years old, removal of the gland (radical
prostatectomy) is often recommended. About 50 percent of men who
have this done, even with the new "nerve sparing" techniques,
become impotent. Significant incontinence occurs in up to 25
percent of cases. Watchful waiting, with nutritional support and
lifestyle change, is becoming the preferred approach if the cancer
is in the early stages.
- If the cancer has spread outside the gland, treatment is aimed
at trying to block production of testosterone, which fuels the
cancer. This can be done by means or orchiectomy (surgical removal
of the testes) or by suppressing the production and action of
hormones. For the latter, either goserelin (Zoladex) or leuprolide
(Lupron) is given by monthly injections (they are fundamentally
the same drug); in addition, flutamide (Eulexin) is taken orally.
Together, these agents effectively shut down testosterone
production and use by the body. Both orchiectomy and hormone
suppression cause impotence in nearly 100 percent of the
- Estrogens have been used effectively for the treatment
of prostate cancer for sixty years. However, they can cause breast
growth and other feminising effects, as well as cardiac
- Many consider prostate cancer to be one of the most
overtreated diseases in America. Physicians in Europe have long
used a conservative approach with comparable results. In addition,
a 1994 report in The New England Journal of Medicine reported on a
large group of men who refused traditional treatment.
Surprisingly, they fared just as well as - and possibly better
than - men who did accept medical treatment. A conservative
approach making critical lifestyle and dietary changes and using
nutritional supplementation may work just as well. And yet, 31,000
men will die of prostate cancer this year because they either
didn't catch it time, or chose watchful waiting past the cut-off
point. That's roughly the same percentage of women who die of
- Dr. Hans Nieper, a German cancer specialist, uses Carnivora, a
substance derived from a South American plant, to treat prostate
cancer. Fresh cabbage and carrot juice are used in clinics
worldwide in cancer therapy.
- A high-fat, low-fiber diet is linked not just to heart
disease, but also to prostate cancer. Chemical reactions occur
when fat is cooked, leading to the production of free radicals,
which play a major role in certain cancers. It is logical to
assume that the accelerating increase in prostate cancer since the
1950s must be attributable at least in part to a parallel increase
in fat consumption in the U.S. According to the Journal of the
National Cancer Institute, men who eat red meat five times a week
may have a risk of prostate cancer that is nearly three times
higher than that for men who eat red meat less than once a week.
Butter consumption also appears to contribute to this disease.,
Researchers theorize that a diet high in fat raises the levels of
testosterone and other hormones in the body, which stimulate the
prostate - and any cancerous cells in it - to grow. A high intake
of milk and coffee may also increase the risk of developing
- Research has shown that soybeans and soy products, such as
tofu, soy four and soymilk, have cancer-fighting powers due to the
presence of a protein called genistein. Genistein apparently
retards tumor growth by preventing the growth of new blood vessels
to feed the tumor. It appears to be particularly effective against
prostate cancer, but also works against breast cancer in women and
colon cancer in both sexes.
- A man who is impotent as a result of treatment for prostate
cancer may be able to remain sexually active through penile
prostheses and other devices. (November 1 starts off International
Impotency Awareness Month by reviewing current information on
- Studies from Israel indicate shark cartilage may be effective
in treating prostate cancer. Its antiangiogenic potential seems to
inhibit new blood vessels formation, especially in highly
malignant vascular cancers.
- In 1993, the Journal of the American Medical Association
revealed a connection between vasectomy and an increased risk of
prostate cancer. Reported studies of 48,000 and 29,000 men who had
vasectomies showed a 66-percent and 56-percent higher rate of
prostate cancer, respectively. The risk increased with age and the
number of years since the vasectomy was performed. Since then, a
panel called the National Institutes of Health found no biological
cause-and-effect relationship between vasectomy and prostate
cancer. Not all experts accept that finding, however.
- A man with prostate cancer needs support and understanding
from family members, friends and physicians. Besides coming to
grips with cancer and its treatments, he also has to deal with the
possible loss of sexual potency, which can be very difficult. A
number of the books listed in the reference section below provide
a great deal of detailed information and practical advice to help
the man with prostate cancer and his family to deal with the many
difficult aspects of this disease.
- Diet and nutrition are important not only for treatment, but
for prevention. An anticancer diet is composed primarily of brown
rice, fresh raw fruits and vegetables, fresh juices, legumes, raw
nuts and seeds, and whole grains, and excludes alcohol, coffee,
refined carbohydrates, and strong tea. Regular intake of zinc (50
milligrams daily) and essential fatty acids (in supplement form or
from cold-pressed sesame, safflower or olive oil) in later life
also may help prevent the development of problems.
Prevention of prostate cancer
Since the prostate produces seminal fluid, there is a
long-standing belief that regular ejaculations (two or three times
per week) will help prevent an enlarged prostate. There is little
scientific proof of this, but it is risk-free.
Diet is also a factor. Some recommend to maintain a whole-foods
- Eat plenty of whole grains, raw nuts and seeds, and unpolished
brown rice. Millet cereal is a good source of protein. Eat wheat,
oats and bran. Also eat plenty of cruciferous vegetables such as
broccoli, Brussels sprouts, cabbage and cauliflower and yellow and
deep orange vegetables such as carrots, pumpkin, squash and yams.
This type of diet is important for the prevention of cancer as
well as for healing.
- nclude in the diet apples, fresh cantaloupe, all kinds of
berries, Brazil nuts, cherries, grapes, legumes (including
chickpeas, lentils and red beans) and plums. All of these foods
help to fight cancer.
- Consume freshly made vegetable and fruit juices daily. Carrot
and cabbage juices are good choices.
- Include in the diet foods that are high in zinc such as
mushrooms, pumpkin seeds, seafood, spinach, sunflower seeds, and
whole grains. Zinc nourishes the prostate gland and is vital for
proper immune function.
- Restrict your intake of dairy products. Moderate consumption
of soured products such as low-fat yogurt and kefir is
- If you experience difficulty urinating or notice an increasing
trend toward waking up to urinate during the night, consult your
health care provider. This may indicate prostatic
- Use cold-pressed organic oils such as sesame, safflower or
olive oil to obtain essential fatty acids.
- Do not eat red meat. There is a define correlation between
high red meat consumption (five servings a week or more) and the
development of prostate cancer.
- Eliminate from the diet alcoholic beverages, coffee and all
teas except for caffeine-free herbal teas.
- Strictly avoid the following foods: junk foods, processed
refined foods, salt, saturated fats, sugar and white flour.
Instead of salt, use a kelp or potassium substitute. If necessary,
a small amount of blackstrap molasses or pure maple syrup can be
used as a natural sweetener in place of sugar. Use whole wheat or
rye instead of white flour.
- Unless otherwise recommended, take vitamins and other
supplements daily with meals, with the exception of vitamin E,
which should be taken before meals.
- Try to avoid all known carcinogens. Eat only organic foods, if
possible. Avoid tobacco smoke, polluted air, polluted water,
noxious chemicals and food additives. Use only distilled water or
reverse-osmosis-filtered water. Municipal and well water can
contain chlorine, fluoride and agricultural chemical residue.
- Do not take any drugs except those that are prescribed by your
physician. Always seek counsel and alternative opinions before
deciding which treatments, if any, you will pursue.
- Prostate Massage. We havent been able to
find a lot of information on this subject but understand that
Tibetan monks practice a meditation that includes self-massage of
the prostate. Also, there is a video that focuses on self anal
massage for men that includes a very short mention of prostate
massage about 23 minute in. However, for those wanting to practice
self prostate massage, it provides very good information on
cleanliness and preparation of the anal area prior to starting the
practice. It is available through Erospirit Research Institute and
their website at www.erospirit.org
In most cases, pain is manageable. No one should have to suffer,
especially terminally ill cancer patients. And, while many of the
major pain killers like morphine are controlled by the federal
government, and the DEA has been very active in prosecuting
doctors for alleged "over prescription", many of these patients
report that the pain in too great in lower dosages. (See the film "
and see what you think.)
AIDS and cancer patients have long reported the positive affect of
marijuana to reduce pain and improve the appetite, often an after
effect of chemotherapy. California and Arizona have passed laws
allowing doctors to prescribe marijuana for certain ailments. Even
the New England Journal of Medicine has favored doctors who prescribe
marijuana. However, the federal government, not really caring about
peoples pain, has threatened to charge any doctor prescribing
it with a felony. Similar drugs have not received the governments
okay since they fear a person may become addicted, which is seldom
the case. Regardless of research to the contrary, "Even if the person
is dying, it seems that they (the government) would rather see him
die in pain rather than become an addict for the short time he has to
live," says Dr. Aubrey Pilgrim in his book A Revolutionary Approach
to Prostate Cancer. X-rays can be used to reduce or eliminate pain
for some time and Metastron (Stronitium 89) radiation works well on
bone metastases. Quadremet, which is a radioactive dryg similar to
Metasmon, has fewer side effects and Novantrone is the first
chemotherapy drug approved for treatment of pain from advanced
hormone refractory prostate cancer. For information, call
800.220.6302. Finally, there are a number of ways to deal with pain.
If you arent successful with you current doctor, find one who
will help. No one deseerves to have to live in pain.
The leakage of urine. Other happens after radical prostatectomy.
It often requires the use of under garment pads like Attends or
Depends. Some men are embarrassed about change these pads several
times a day. Some alternatives are: Have a radical prostatectomy
using the Gaker procedure which preserves the bladder sphincter. The
procedure was published in The Journal of Urology, 8/96 or
have your doctor call Dr. Douglas Gaker at 513.423.0739 for a video
on the procedure. You can also do exercises to strengthen the lower
sphincter, which might include the Kegel exercises, originally
developed by Dr. Arnold Kegel for women. These exercises can be done
in private or in public - no one will know. Other treatments that
might help include penile clamps, condom catheters, biofeedback,
artificial urinary sphinter, collagen and fat injections, and
medication. There are other products yet to be approved by the FDA
than are being used in Europe like poly-Teflon which is used instead
of collagen as a bulking agent. (Resources.)
The penis is a vascular organ which requires exercise. A healthy
male will normally experience 3 to 4 erections during their sleep
which may last a hour or more each. They are a normal body function
whose purpose is to oxygenate the penile erectile tissue. Its
inability to achieve and maintain an erection suitable for vaginal
intercourse is called "male erectile dysfunction (ED) or impotency,
for short. Impotency affects over 30 million men and their partners.
So, having to face the possibility of impotency as an after-affect of
prostate cancer treatment can be of major concern. To some men it is
a symbol of the loss of their manhood, and can be critical to a
mans ego and self-image. And often, because of this, some men
are afraid to seek help. And, often when he does, the physician feels
uncomfortable or is unable to help because many arent aware of
the options. If the truth were known, however, virtually 100% of
impotency problems can be successfully diagnosed and treated, whether
physical or emotional, unless there is permanent injury or severance
of the nerves and or vascular supply necessary in the erectile
Medications taken for hypertension and depression usually inhibit
normal erectile function and can be changed to an alternative which
may allow the return to normal sexual function. In addition, three
drugs may offer hope. Viagra has achieved very good results in men
with psychogenic impotence and also in men with organic impotence.
The intensity of the erection is enhanced as well as overall
performance and there may be major side effects, and a risk of death
for some patients. A doctor will be able to determine if Viagra is
right for you. (This too will be reviewed November 1. For books on
the subject, check "Books" "Issues" "Health-General".) Vasomax has
been used for years as an injectable medication and is now being
tested in pill form. It is another medication which works to dilate
penile blood flow in men with mild vascular problems. Apo-Morphine is
being evaluated for treatment of only psychogenic impotence.
Vacuum erection devices work to create an erection mechanically by
drawing the blood into the penis. While this eliminates the need for
medication, it does require some preparation time which decreases
spontaneity. However, they work for many men and are covered by
Medicare and many insurance companies.
Medical Urethral System for Erection (MUSE) is a cream which is
absorbed through the urethra and dilates the cavernosal spongy tissue
of the erectile chambers. It has about a 66% success rate and
anxiously awaits approval to replace injectable forms of therapy.
Injection Therapies - Papaverine was the first effective medical
treatment for ED. To date, there are two currently approved by the
FDA. Caverject and Edex which are effective in about 85% of patients.
Occasionally, Papaverine by itself or with Regitine and Prostaglandin
E will be used, which is much better than any on eof them used alone.
Some men will have erections lasting a few minutes to 45 minutes.
Dosage determines this. Used immediately after radical prostatectomy
or radiation therapy may prevent atrophy of the smooth muscle
necessary for erection which is associated with non-use of the
Penile Prosthesis, rigid, semi-rigid or inflatable implants, can
very a scary thing for many men. Getting your questions answered is
most important because it is a serious decision. They are only
necessary in about 10% of patients. For men who have become impotent
following radical surgery, radiation or cryosurgery, or have
arthritis and decreased manual dexterity, this procedure may be the
last hope. The success rate is very high and they remain effective at
a 90-95% rate 5 years after implantation.
Im usually more skeptical of Western medicine and chemical
solutions than natural or Eastern methods. With anything, you should
get as much information as possible and know what youre doing.
One place to turn is the Cedars of Sinai Comprehensive Cancer Center,
which publishes a monthly newsletter dealing with cancer advances,
therapies, prevention and support concerns. The February, 1997 issue
included an article titled "Unproven Methods of Cancer Management"
which discussed the potential dangers of various claimed cures such
as macrobiotic diets, psychic surgery, quack drugs such as Prostada,
shark cartilage and biological products, electronic gadgets, and
devices, herbal and fold remedies, dietary approaches, bogus
diagnostic tests, metabolic therapies, mental imagery, faith healing,
homeopathic and many other unproven treatments and modalities. It can
be found at www.csccc.com
is also a newsletter, published by the National Council Against
Health Fraud with short articles about many of the current health
frauds. Write PO Box 1276, Loma Linda, CA 92354. If you encounter a
scam, contact the National Fraud Information Center, 1.800.876.7060
or you may write the Federal Trade Commission, Room 1105, Washington,
D.C. 20580. Do as much checking as possible before you spend good
money, and possibly risk your life, using up-proven methods to cure
prostate cancer or anything else for that matter.
- Eat a healthy, well-balanced diet. Include in the diet pumpkin
seeds, bee pollen, or royal jelly. (Caution: Bee pollen may cause
an allergic reaction in some individuals. Start with a small
amount, and discontinue use if a rash, wheezing, discomfort or
other symptom occurs.
- Avoid alcohol, particularly before sexual encounters.
- Do not consume animal fats, sugar, fried or junk foods.
- Do not smoke. Avoid being around cigarette smoke.
- Avoid stress.
- Consult a urologist for testing to determine whether impotence
is caused by an underlying illness that requires treatment.
- Consider possible psychological factors that may be
contributing to impotence, especially repressed anger or a fear of
intimacy. Exploring psychological issues with a qualified
therapist can help.
- If you suspect impotence may be related to a drug you are
taking, discuss this with your physician. There may be
satisfactory, alternatives that will not cause this problem.
Certain blood pressure medications and tranquilizers often cause
erectile difficulties. The drugs cimetidine (Tagamet) and
ranitidine (Zantac) which are used to treat ulcers and heartburn,
also have significant side effects in some men. (Caution: Do not
stop taking a prescription drug or change the dosage without
consulting your physician.
- Investigate the possibility of heavy metal intoxication. A
hair analysis can reveal possible heavy metal poisoning.
- Keep in mind that sexual function changes with age. As you
age, you may require more stimulation and a longer period of time
to achieve an erection.
- A study done at the Boston University School of Medicine
linked overall health to impotence. Researchers studied the
medical histories of 1300 men aged 40 to 70. They found some
impotence in a total of 52%. Men who were being treated for heart
disease, high blood pressure, or diabetes were one and a half to
four times more likely than the overall group to be completely
impotent later in life. The situation was even worse for men who
had heart disease or hypertension and who smoked.
- Alcohol intake decreases the bodys ability to produce
testosterone. Research at Chicago Medical School revealed that
drinking alcohol may cause the mormonal equivalent of menopause in
men. Alcohol not only affects sexual function, but also helps set
the stage for a heart attack and other dangerous conditions.
- Arteriosclerosis, which restricts blood supply to the penis
and to the nerves that govern sexual arousal, may result in a
"failure to perform." If impotence is related to clogged blood
vessels, a diet low in fats can actually help reverse the
- A study done at Boston University showed that men who smoked
one pack of cigarettes a day for five years were 15 percent more
likely to develop clogging in the arteries that serve the penis, a
situation that can cause impotence. In addition, heavy smoking
decreases sexual capability by damaging the tiny blood vessels in
the penis. The use of marijuana and cocaine also can result in
- Duplex untrasonography, a noninvasive method of measuring
penile blood flow, is a reliable method of determining whether
arterial occlusion plays a role in impotence. If you doctor
believes atherosclerosis to be the underlying problem, he or she
may advise vascular surgey to improve blood flow to the
- According to figures from impotence organizations, only about
5 percent of the estimated 30 million men affected are aware of
- Urologists differ in the types of treatment they recommend for
impotence, but many opt first for nonsurgical treatment.
- Injections of the drugs papaverine (Pavabid) and phentolamine
(Regitine) or prostaglandin E1 (PGE1) into the base of the penis
before intercourse have been shown to be roughly 80% effective in
producing "satisfactory erection" in impotent men who have tried
it. The drug alprostadil also is available in an injection kit
(Caverject). These drugs work by relaxing smooth muscle, causing
the blood vessels in the penis to dilate, promoting an erection
that can last an hour or more. An estimated 300,000 men in the
U.S. use this technique each year. Possible side effects include
priaprism (prolonged, painful erections). Also, although the
injections are done with a tiny needle, and are supposed to be
painless when done properly (proper technique is crucial), this
prospect is unappealing to many men. A less invasive technique,
which involves instilling alprostadil into the urethra with a tiny
plunger, is under development and is expected to become available
in the near future.
- Yohimbine (sold under the brand names Dayto, Yocon, and
Yohimex) is a prescription drug that has been approved by the FDA
for treatment of impotence. Its effectiveness is questionable,
however. Many experts consider it to be, in essence, a placebo.
Yohimbine has an effect on the body similar to that of adrenaline;
it speeds up the heartbeat and elevates blood pressure. Beware of
yohimbine if you have high blood pressure.
- Three drugs may offer hope. Viagra has achieved very good
results in men with psychogenic impotence and also in men with
organic impotence. The intensity of the erection is enhanced as
well as overall performance and there may be major side effects,
and a risk of death for some patients. A doctor will be able to
determine if Viagra is right for you. (For books on the subject,
check "Books" "Issues" "Health-General".) Vasomax has been used
for years as an injectable medication and is now being tested in
pill form. It is another medication which works to dilate penile
blood flow in men with mild vascular problems. Apo-Morphine is
being evaluated for treatment of only psychogenic impotence.
- Medical Urethral System for Erection (MUSE) is a cream which
is absorbed through the urethra and dilates the cavernosal spongy
tissue of the erectile chambers. It has about a 66% success rate
and anxiously awaits approval to replace injectable forms of
- Injection Therapies - Papaverine was the first effective
medical treatment for ED. To date, there are two currently
approved by the FDA. Caverject and Edex which are effective in
about 85% of patients. Occasionally, Papaverine by itself or with
Regitine and Prostaglandin E will be used, which is much better
than any on eof them used alone. Some men will have erections
lasting a few minutes to 45 minutes. Dosage determines this. Used
immediately after radical prostatectomy or radiation therapy may
prevent atrophy of the smooth muscle necessary for erection which
is associated with non-use of the penis.
- If impotence is linked to high levels of the hormone
prolactin, bromocriptine (Parlodel) may be prescribed to correct
- A number of vacuum devised are used to promote erection. With
these devices, a cylinder is placed over the penis and a hand pump
is used to create a vacuum in the cylinder. This in turn causes
blood to flow into the penis, creating an erection. The user then
puts a constriction band around the base of the penis, causing the
erection to last up to thirty minutes. These devices are available
by prescription only. Some 100,000 men in the U.S. choose this
treatment each year. While this eliminates the need for
medication, it does require some preparation time which decreases
spontaneity. However, they work for many men and are covered by
Medicare and many insurance companies. Problems abound with this
- Since the early 1970s, more than 250,000 American men have
turned to inflatable penile implants to mechanically create
erections. Penile implants are surgically installed devices that
are made of silicone or polyurethane. One type is made of two
semi-rigid but bendable rods; another type consists of a pump, a
fluid-filled reservoir, and two cylinders into which the fluid is
pumped to create an erection. Penile implants are now coming under
FDA scrutiny. Since 1984, the FDAs Center for Devices and
Radiological Health has logged more than 6,500 reports of problems
with inflatable devices - a large number for a medical device,
according to the FDA. With the development of more effective
agents, implants are now considered to be a last resort, to be
tried only when all other methods have failed. Penile Prosthesis,
rigid, semi-rigid or inflatable implants, can very a scary thing
for many men. Getting your questions answered is most important
because it is a serious decision. They are only necessary in about
10% of patients. For men who have become impotent following
radical surgery, radiation or cryosurgery, or have arthritis and
decreased manual dexterity, this procedure may be the last hope.
The success rate is very high and they remain effective at a
90-95% rate 5 years after implantation.
- Dr. Robert Frankt of Budapest University in Hungary found a
great increase in sexual vitality and energy in men using a
combination of two herbs, green oats (Avena sativa) and stinging
nettle. "Feeling ones oats" is an expression that originated
centuries ago, and probably with good reason: a study by the
Institute for Advanced Study of Human Sexuality found that men who
suffered from reduced sexual desire and diminished performance
were helped by green oats. Nettle if full of vital minerals and is
good also for hypoglycemia, allergies, depressions, prostate and
urinary tract disorders, and a host of other problems.
- Circumcised men, it is said, have a much higher rate of
impotency than uncircumcised men. We will continue to monitor for
additional information in this area.
This will give you some background on the subject. The important
thing to remember is "Dont wait." The longer you wait, the
greater the worry, the more difficult the treatment and recovery, and
youll miss out on a lot of great evenings in bed, too. So, find
a qualified doctor who is knowledgeable of the latest medical
therapies. If you need help in locating someone, one of the following
organizations can help: Impotence Institute of America &
Impotence Anonymous - 1.800.669.1603 or Male Potency Centers of
America - 1.800.438.7683. The Institute also offers anonymous groups
where men can hear the experiences of other men which usually relates
to what they are going through. And, there is an excellent tape
discussing all of the causes of impotence, diagnostic treatment
options and therapies by Dr. Aubrey Pilgrim for $15 + shipping by
The appropriate treatment for impotence depends upon whether the
cause is physical or psychological. A man whose impotence is
psychologically based generally still has erections during sleep,
whereas an individual whose impotence is physical in origin usually
does to. One easy, inexpensive way to test for nocturnal erections is
with postage stamps. Glue a strip of stamps around the shaft of the
penis before going to bed. If the ring of stamps is broken in the
morning, the cause of the impotence is likely psychological. If the
strip is unbroken, the impotence is likely physiological. You can
also purchase a kit called Snap Gauge from UroHealth Corporation.
This test is designed to detect the measure the rigidity of erections
experienced during sleep. Call 800.328.1103 for more information.
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