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Overview
Prostatic Cancer
Prostatic cancer is unfortunately common. It accounts for about 7% of
all cancers in men in the UK. About 750 Scots die for it annually. In
1996, 2027 men were diagnosed as having it. It appears to increase with
age and in the UK 80% of men over 80 years have it, although in most
cases it is dormant.
How do you know if you have this problem? It usually presents as a bladder
obstruction. This is because of the anatomical arrangement of the prostate
to the bladder. As the prostate enlarges as it often does in old age,
a condition known as benign - no cancer prostatic hypertrophy (enlargement)
occurs. The prostate sits at the neck of the bladder and any derangement
caused by any enlargement obstructed to a varying degree, the free flow
of urine from the bladder down the urethra - so it does in a carcinoma
of the prostate.
Investigation as to whether you do or you do not have a cancer prostate
depends upon a rectal examination, whereby the actual prostate can be
felt. In a positive case, the prostate will probably be enlarged, but
will certainly feel much more firm or hard compared to a normal organ.
There is a specific blood test called the PSA test to detect its presence
and this is an accurate test. The problem in the UK is that this test
is not routinely done on the NHS and currently costs - £80. If you were
in the USA it would cost £20.
Currently, trials are being conducted to determine the potential benefits
and draw backs of a screening programme. In September 2000 the Minister
of Health - Alan Milburn announced a new package of £4.2m to research,
training and education in this field - a decision not before time. Currently
there has been much comment in the press about this problem. Any comment
is helpful and those made recently have been clear and concise in their
content and have reported fairly on the public speeches made by prominent
medical men on the subject.
Once such is Professor Myers, Professor of Medicine & Urology who spoke
about the subject at the University of Virginia. He made the point that
he himself had recently been diagnosed as having this type of cancer
and spoke both about his experience as a doctor and a patient. In talking
about the lack of resources and treatment and research, he believes
that there is a change ahead (in the right direction) and that the message
is one of hope. If we applied all our present knowledge, he thought
that the number of cases (in Scotland) could be halved. He advocated
that the blood tes, PSA, should be available and that screening should
be introduced. The critics said that this would cause un-necessary worry
to people who might have the condition but who did not require treatment.
Professor Myers is of the opinion that most people with cancers detected
in this way can be treated and will survive 10 years or more.
How you may be treated
1. AGGRESSIVE TREATMENT:
a. Radioactive seeds (implants into the gland)
b. External beam radiation.
c. Hormonal therapy
In the UK this would probably not be possible as an aggressive xray
therapy machines are not able to safely deliver treatment at the same
level as we are still using older generation instruments.
Other approaches in the UK are radical prostatecomy or radiotherapy
- both result in 80-90% 5 year survival.
If the cancer has spread, metastasis, the treatment could be bilateral
orchidectomy (removal of both testes). The "coalition for prostate cancer"
in London recently - Professor Oliver, Professor of Oncoloy CA at St
Bartholomews Hospital, having just returned from a holiday in the sum
commented that little known research has shown that those who are out
and about in the sun and therefore are often tanned, are less likely
to develop cancer of the prostate. Professor Oliver stresses that he
never burns.
Professor Myers attributed some of his success in the treatment of his
cancer that he followed a healthy Mediterranean diet with supplements
of Vitamins E and C - lycopene (a powerful antioxidant with anti cancer
properties found in omatoes) and selenium.
He ended by commenting "I am 57 years old and for a large part of my
life have been involved in a group of six couples in the USA. Four of
the six men in this group have prostatic cancer. It has to be something
about our particular neighbourhood.
If it is apparent that there is much to be learned about the actiology
of the cause of prostatic carcinoma, Mr Millburn's award is to be commended,
but much more will be required if we are to see the end of carcinoma
of the prostate.
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