Prostate Cancer Treatments

 
After you have read this please, please, please, read my own situation and the steps I have taken to treat my own diagnosed Prostate Cancer see 
MY CANCER 2011 AND MY CANCER 2012.


Cancer Prevention

The PHA have yet to hear from anyone who has had their medic suggest that they change their diet. Such advice would be excellent preventive medicine and it would seem sensible that male members of the family of a man diagnosed with prostate cancer also try a diet change.

Why ? Well, it is now well documented that vegetarians have a lower chance of cancer. In addition it has been shown that Asian men for instance who do not eat so much meat as western man but mainly consume vegetables and soya based foods have an extremely low problem in the prostate area. It seems sensible therefore if you want to lower your chance of all types of prostate disease to change your diet to match those of our Asian brethren.

Jane Plant's book 'Your Life in Your Hands' ISBN1 85227 809 9, accuses milk and dairy products as a prime cause of breast and prostate cancer.

B17 found in seeds has been shown in trials to stop the growth of cancers. For the full story read G E Griffin's book World Without Cancer

ISBN 0 912986 0.

Watchful Waiting

Watchful waiting should not be looked upon as an excuse for doing nothing. The whole point of watchful waiting is that it should only be practiced when it is thought that other treatments would not be in the best interests of the patient. If the cancer cells are few, non-aggressive & contained within the prostate capsule and/or if the patient does not want to have aggressive therapy, i.e. a total prostatectomy for instance; then careful monitoring of the situation with three monthly psa's to ensure that any change in the aggressiveness of the cancer cells are quickly apparent is a suitable alternative for the patient who is aware of the situation and prefers to avoid current radical treatments with their side effects, unless essential. The thinking behind this is that not all prostate cancers will prove fatal and many men die from other causes whilst 'having' prostate cancer.

There is nothing to stop you trying a diet change, as per the prevention detail above. Although there have been no trials etc remember, 'you are what you eat'.

Whatever your medic might say you might not wish to live the rest of your allotted span if you feel there is a likelihood of being impotent or incontinent following radical or hormonal treatment. Your neighbour may not have such a priority in his life and therefore his views would be totally opposite to yours; i.e. he would be content to have a total prostatectomy or hormone treatment regardless of any loss of potency etc., as long as he felt he was controlling the cancer cells. He may also feel that any side effects, hot flushes, tissue damage from radiotherapy etc are acceptable. It is essential that you only make a decision after you have the fullest information on all the tests and treatments together with the various side effects.

The PHA strongly recommend the book 

Vitamin C the Real Story by Steve Hickey and Andrew Saul both PhD’s. 

 

Cancer Surgery

 

Surgery appears to be the favourite route in the USA, whilst here in the UK hormone and radiotherapy make up the bulk of treatments given. By surgery we are talking about the complete removal of the prostate gland. What this means is that the urethra left below the prostate has to be joined to the base of the bladder.

Surgery should only be considered when the cancer cells are known to be contained within the prostate capsule, i.e. have not started to migrate to other parts of the body. Indeed one of the first things a surgeon should do is to check to see if cells have left the prostate by sending off a section of adjoining tissue for analysis before he proceeds to remove the gland. Nerve sparing surgery is always recommended as this performed correctly may spare the nerves which control an erection. It is recommended therefore, that you attempt to ensure, that the surgeon has the expertise in this form of surgical technique and a work load in respect of prostatectomies before you go ahead with the operation. Regrettably the number doing (multiple) such treatments is small, certainly here in the UK.

The removal of the gland can lead to impotence and also to total or partial incontinence; so these possiblities have to be weighed against the chances of the cancer cells becoming more aggressive and moving out from the prostate gland and producing secondaries in other parts of the body. The writer is also concerned about the number of men in the USA who having had radical surgery are now looking around for hormone or radiotherapy treatment as secondary sites are appearing. This either means the cells had left the prostate before the surgery, during the surgery, or the whole theory of early diagnosis, early treatment is flawed.

No randomised trials have been done which show that surgery prolongs the life of a patient over and above any other treatment or watchful waiting.

 

Radiotherapy

Radiotherapy is the use of high energy rays to kill cancer cells and is thought to extend the life of a patient if treatment is given whilst the cancer is still in the prostate capsule. The target site will not only be the prostate but also the lymph nodes which lie close to the prostate. Cancer cells are more sensitive to the treatment than normal cells so the radiotherapy kills them. You can expect a daily treatment lasting over a period of some six weeks, so you will need to travel daily to your hospital, although you will get breaks at weekends. Show an interest from the beginning. Find out what the ‘dose’ is you will be getting, ask to see how this is set up on the machine.

The treatment is painless. Many men experience virtually no side effects whilst they are having their treatment. Those that do mention tiredness, nausea, some diarrhoea, bladder instability and hair loss in the general area of the treatment. There is also a 25% chance you will become impotent over time and some patients develop radiation cystitis. If you feel tired, plan to take things a little easier for the period of your treatment. If you are still at work see if you can temporarily reduce your work hours.

Some men feel nauseous at the beginning of the treatment, there are many techniques to help you. Physco-therapists can teach you to overcome your feelings, relaxation methods which can allow you to set aside the nausea and of course acupuncture should be given some consideration. If these techniques fail your GP may prescribe a drug to help.

Conformal radiotherapy. This is a method of shaping the rays so that only the prostate is treated. This cuts down on the side effects which can occur with broad beam radiotherapy treatment.

Before you decide on this or any other treatment option you need to ensure that you have all the current information. If you cannot obtain it from another source we suggest you buy the book 'Prostate Cancer' and subscribe to the PHA Newsletters.

Radioactive Seed Implantation. Conventional Radiation Therapy is thought to have a good ‘cure’ rate, however it requires weeks of visits to the centre for daily treatment, there is a high risk of impotence and possible incontinence. The PHA Newsletter has detail of hospitals in the UK which are now using this technique. Send to the PHA for their initial information pack. (Please enclose 2 x 1st class stamps).

Small pellets, (seeds), containing radioactive medication called Iodine-125, are permanently implanted into the prostate; there they radiate low level radiation for approximately one year. The implantation procedure does not require a surgical incision. The seeds which are smaller than a grain of rice are carried into the prostate through the skin between the scrotum and rectum by a thin needle. A transrectal ultra sound machine allows the surgeon to guide the needle to the exact position before he releases each seed. Amersham, the seed manufacturers, claim that of some 450 patients followed for up to six years, show a higher percentage of seed implant patients remained disease free compared to men who have had conventional radiotherapy or a complete removal of the prostate.

The advantage of seed implantation is that it is an outpatient treatment taking approx one hour, and a man can resume his normal activities within several days. Amersham also advise that because the seeds are placed directly next to the cancer cells they can deliver up to three times more radiation to the gland area than external radiation therapy which has to use a lower dose to avoid damaging the healthy body tissue. Although impotence and incontinence can occur using seeds this is considerably lower than with conventional radiotherapy. Urination difficulties are common after the implantation, but these gradually improve and eventually disappear. As can be imagined this minimum invasive method is also well suited to older patients compared to current treatment methods.

 

Hormone Treatment/Orchidectomy

Basically a course of hormone treatment is a chemical castration. The drugs stop the flow of testosterone, which in turn stop the cancer in its tracks and can reverse its growth. In many cases this situation is only good for approx. two years, after which the cancer 'learns' to reproduce regardless of the hormone block and its aggressive growth begins again. Having said that, some cases are reported which have resulted in extended life spans of 10 years or more.

There is argument about :-

MAB, (maximum androgen blockade), additional hormones given to ensure that not a trace of testosterone is in the body. Is it worth the extra cost and does it achieve any worth while benefit ?

Also intermittent or pulse treatment. Here the hormones are taken until the PSA level is down to below 1, or some similar agreed level when the treatment is stopped. This enables the body to regain normality, i.e. sexual drive, no hot flushes etc. Quarterly PSA levels are checked and when they rise to a predetermined level, say 25, the treatment is started again.

The theory here is that by not continually depriving the body of testosterone it can recover from its deprivation and rebuild muscle for instance.  It als gives the patient a rest from hot fluses and any other side effects that the treatment has produced. 

 

Inclusion of links is NOT an endorsement by the Prostate Help Association, nor do we guarantee any information you will find, other than our own.
We would remind everyone that they should discuss with their medical team all aspects of their condition
and then come to a decision in regard to the best treatment for their condition.

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