Prostate Cancer treatment side effects, risks, medications, surgery, radiation, and danger, adverse effects of medical therapy
 

Cancer is when cells in the body grow out of control. Prostate cancer is a group of abnormal cells in the prostate. Prostate cancer can be aggressive, which means it grows quickly and spreads to other parts of the body. When cancer spreads, doctors say the cancer has "metastasized." Or it may be slow growing and stay in the prostate, causing few if any problems. Three out of four cases of prostate cancer are of the slow-growing type that is relatively harmless. Prostate cancer is the most common type of cancer found in American men, other than skin cancer. The American Cancer Society estimates that there are about 200,000 new cases of prostate cancer in the United States each year, and about 30,000 men will die of this disease.

Natural or alternative Prostate Cancer treatment or prevention
Exercise, maintaining normal body weight, eating fish, legumes, flaxseed, yellow-orange vegetables and cruciferous vegetables lower prostate cancer risk. Increasing the ratio of omega-3 to omega-6 fatty acids in the diet appears to slow the progression of prostate cancer. The so-called Western diet commonly consumed in the US contains mostly omega-6 fatty acids, derived from corn oil and other sources. Omega-3 fatty acids, by contrast, are abundant in cold-water fish, a food source missing in the diets of many Americans. For
   Certain supplements have been found to have an influence on prostate cancer, particularly in laboratory tests. Long term, double blind human studies are not available to confirm these early laboratory findings. Alternative prostate cancer treatment research is still in its infancy, therefore no firm statements can be made made as to how effective these natural supplements would be in your case. However, it is worthwhile to study the following supplements:

Prostate Power Rx

With Saw Palmetto, Pygeum, Stinging Nettle, Gensitein, Quercetin, Phytoestrogens, and several Ingredients for support of normal prostate health and size.

Prostate Power Rx is carefully formulated with important herbs and nutrients to provide optimal prostate health.
 

Prostate Power Rx Supplement Facts
Saw-Palmetto extract
Stinging Nettle extract
Quercetin
Beta Sitosterol
Pygeum extract
Daidzein and Genistein (standardized to contain 40% isoflavones)
(treatment with the isoflavones daidzein and genistein, the estrogen-like compounds found in soy, block prostate growth in rats)
Lycopene

Vitamin supplements and prostate cancer
Effect of nutritional supplement challenge in patients with isolated high-grade prostatic intraepithelial neoplasia.
Urology. 2007 Jun;69(6):1102-6. Department of Urology, University Hospitals Katholieke Universiteit Leuven, Leuven, Belgium.
The researchers wanted to see the effects of selenium, vitamin E, and soy isoflavonoid supplements in men diagnosed with isolated prostate cancer on biopsy. The results showed that taking these supplements for a period of six months led to a decrease in the PSA level which could predict a lower risk of prostate cancer in future biopsies.   
   At the study endpoint, prostate cancer had been found in 24 men (33%), HGPIN in 34 (48%), and no HGPIN or carcinoma in 13 (18%). The prostate cancer risk throughout the study period was 25% in the group with a stable or decreasing PSA level and 52% in the group with an increasing PSA level.

Prostate cancer prevention
Eat a variety of fruits and vegetables, reduce the intake of white bread, high intake of meats and saturated fat, reduce or eliminate smoking, reduce stress, sleep well, exercise, avoid unnecessary hormone use, particularly androgens, eat more flax and fish oil.
   Greater consumption of dark green and cruciferous vegetables, especially broccoli and cauliflower, is associated with a decreased risk of aggressive prostate cancer.

Help Prevent Prostate Cancer by Making Changes to Your Diet
If you think that getting - or not getting - cancer is out of your hands, you are dead wrong. You can help prevent or slow the progression of certain cancers just by making a few simple changes to your lifestyle and diet. Prostate cancer is a good example of how powerful your diet can be when it comes to fighting or staving off a disease. Aside from skin cancer, prostate cancer is the most common type of cancer found in American men. The American Cancer Society estimates that 200,000 men will develop prostate cancer each year. A review of studies done by Australian scientists finds the risk of developing prostate cancer, or slowing its progression, may be possible by reducing intake of bad (ie, omega 6) fats, processed or grilled meats, or dairy products. Men who regularly eat vegetables, including tomatoes and cruciferous vegetables like broccoli, cauliflower, cabbage and Brussels sprouts have a lower risk of developing the cancer. The same appears true of men who consume greater amounts of vitamin E, soy, fish and omega-3 fatty acids -- "good" fats found in oily fish and certain other foods, such as flaxseeds. Improving dietary habits after prostate cancer diagnosis may also improve survival from the disease. On an added note, men who drink heavily raise their risk of developing prostate cancer.


Standard Medical Prostate Cancer Treatment
Many
prostate cancer patients — and their doctors — may be overreacting to the word “cancer.". Of the 234,000 American men expected to be diagnosed with prostate cancer in 2006, most will get surgery or radiation. But in many of those cases, the men might stay healthier without the aggressive treatment.

   Treatment depends on the prostate cancer stage. Prostate cancer surgery and prostate cancer radiation are most common options. A prostate cancer support group would be helpful for many men who do not have a good support system within the family.
   Treatment for prostate cancer depend in part on how big the tumor is or how it has spread - called advanced prostate cancer or if it has spread, metastatic prostate cancer. For tumors that are still inside the prostate, radiation therapy (using x-rays that kill the cancer cells) and a prostate cancer surgery called radical prostatectomy are common treatment options. "Watchful waiting" is also a treatment option. In this approach, no treatment is given until the tumor gets bigger. Watchful waiting may be the best choice for an older man who has a higher risk of dying from something other than his prostate cancer. Generally, tumors that have grown beyond the edge of the prostate can't be cured with either radiation or surgery. They can be treated with hormones that slow the cancer's growth. Side effects of prostate cancer treatment, such as impotence and urinary incontinence, are far more common than most doctors admit. Treatment with anti-testosterone drugs lowers bone density and may lead to a high rate of broken bones. Prostate cancer cure can occur with the right medical and surgical treatment.
   When prostate cancer remains confined to the gland, it's safe to take a conservative approach to treatment. The death rate from localized prostate cancer does not increase sharply 15 years after diagnosis -- which probably makes intensive therapy unnecessary. In  a previous study reported in 2004, a substantial minority of early stage prostate cancers became more aggressive after 15 years of watchful waiting. The authors of that report said their results supported the idea of "early radical treatment for prostate cancer, notably among patients with an estimated life expectancy exceeding 15 years." By contrast, the findings published in May 2005 Journal of the American Medical Association do not show a long-term increase in mortality rates and, therefore, do not support the view of aggressive therapy for localized prostate cancer.

   Men with prostate cancer who are treated with cyproterone acetate face a higher risk of developing venous thromboembolism.

Watchful waiting recommended, The Journal of Urology, April 2009.
Carefully selected men with low-risk prostate cancer can safely delay treatment and choose watchful waiting. With active surveillance, or "watchful waiting," patients with early prostate tumors are evaluated regularly and only treated if their cancer progresses. Dr. Bertrand Guillonneau believes this approach might be a way to differentiate patients with a growing tumor that requires treatment from a benign tumor that will not progress." Dr. Bertrand Guillonneau followed 268 men younger than age 75 years. All of the men had been given multiple treatment options but ultimately chose active surveillance over immediate treatment. The men had early disease, based on their prostate specific antigen (PSA) level and initial biopsy findings. The men had a second "restaging" biopsy immediately before active surveillance began and no treatment in the following 6 months. They later underwent physical exams and PSA tests every six months with biopsies recommended every 1 to 2 years. Of that initial group of men electing active surveillance, 43 eventually chose treatment or had evidence of cancer progression prompting recommendation of treatment by their physician. Following delayed treatment (radiation or surgery,) all but one were cured of their cancer. The remaining 219 patients remained on active surveillance without evidence that their disease had spread. At 2 years the probability of staying on active surveillance was 91 percent. At 5 years, it was 75 percent. the doctor believes that it is likely, for many of these patients, the prostate cancer will not ultimately develop and will not require any kind of active treatment.

Different prostate cancer treatments and side effects
More than a third of prostate cancer patients receive treatment that is not the most appropriate for their symptoms and conditions, based on the problems they already have before treatment. Dr. James A. Talcott at Massachusetts General Hospital in Boston followed 438 patients treated for prostate cancer in the Boston area between 1994 and 2000. Prior to prostate cancer treatment and periodically over the next 3 years, the men completed questionnaires about difficulties with urination, bowel function or sexual performance. Before treatment, most of the men reported problems in one or more of these areas; only 11 percent of the patients were free of symptoms. However, treatment of their prostate cancer was often not chosen to minimize the risk of making these problems worse. For example, pre-treatment urinary problems were aggravated for men who received radioactive seed implants or "brachytherapy." Similarly, external beam radiation therapy increased diarrhea, painful bowel movements, bowel urgency, and rectal bleeding in patients with baseline bowel dysfunction. When it comes to surgical removal of the prostate, a more complicated nerve-sparing procedure may avoid subsequent erectile dysfunction but it offers no benefit for men who already have such problems. Cancer, online November 26, 2008.
  
Risks
Androgen-deprivation therapy involves the use of medications or surgery to reduce body levels of testosterone, a hormone that is known to increase the growth of prostate cancer cells.
   Men who undergo hormone therapy for early prostate cancer may experience a modest, short-term decline in their mental capacities. Treatment aimed at suppressing testosterone levels, called LHRH-agonist therapy, in men with prostate cancer may cause subtle changes in cognition.
   Men with advanced prostate cancer may be given therapy to stop their production of testosterone, which may drive tumor growth. However, androgen deprivation therapy, or ADT, appears to trigger a rapid loss of bone mineral density (BMD) making it more likely for men to have osteoporosis and bone fractures. Anti androgen therapy can lead to gynecomastia.
   Men with recurrent or advanced prostate cancer may be put on hormone therapy to block testosterone production in an effort to halt or slow the growth of the tumor. However, this may put them at increased risk for developing insulin resistance and elevated blood sugar levels, which can affect heart health. These complications of what doctors call androgen-deprivation therapy or ADT may contribute to the high rate of heart disease in men with prostate cancer. Roughly half of men who develop prostate cancer die of other, unrelated causes. Heart disease is one of the most common causes of death in men with prostate cancer.
  
The use of androgen deprivation therapy increases the risk of death from cardiovascular disease among men who undergo radical prostatectomy for localized prostate cancer.

Prostate cancer treatment with androgen deprivation therapy increases heart problems, bone fractures
Among men with prostate cancer, treatment with androgen deprivation therapy leads to a higher incidence of heart disease within the first year or two of treatment. Therefore, among men with low-risk prostate cancer, androgen deprivation therapy may actually decrease overall survival, Androgen deprivation therapy  is a type of hormone therapy usually given to men with advanced or difficult to treat cancers. It blocks the production of another male sex hormone, testosterone, which drives tumor growth. Cancer October 1, 2007.

Men who receive hormone deprivation therapy for prostate cancer are at increased risk of fractures and cardiovascular-related death. Men with advanced prostate cancer may be given so-called androgen deprivation therapy, or ADT, to stop their production of testosterone, which may drive tumor growth. Dr. Lockwood G. Taylor, from the University of Texas Health Science Center, Houston, identified 14 articles that included information on ADT side effects with a focus of bone-related and cardiovascular-related outcomes. Dr. Lockwood Taylor found the use of ADT for prostate cancer increased the risk of overall fracture by 23 percent compared with prostate cancer patients who did not receive hormone therapy. Prostate cancer patients treated with ADT were more likely to die from cardiovascular disease than were their peers not treated with this modality. Androgen deprivation therapy use was also linked with an increased risk of diabetes. Cancer, June 1, 2009.

Prostate cancer treatment with androgen deprivation therapy increases risk for diabetes
Androgen deprivation therapy increases the risk of diabetes, particularly in obese men. Treatment of prostate cancer with androgen deprivation therapy is associated with an excess risk of incident diabetes and fractures, but not heart attack or sudden cardiac death, Journal of Clinical Oncology 2009.

Cognitive impairment
The majority of men who receive hormone deprivation therapy for prostate cancer will experience some degree of cognitive impairment, such as in the ability to concentrate. Cancer, online July 28, 2008.

Diabetes and Heart Disease Risk from Prostate Cancer Treatment
The main systemic treatment for prostate cancer involves blocking testosterone production. This is done either by removal of the testes (bilateral orchiectomy), or more commonly, by regular injections of a gonadotropin-releasing hormone (GnRH) agonist drug. GnRH agonists are the main treatment for metastatic prostate cancer and may improve survival for some men with locally-advanced cancers. However, little is known about the efficacy of GnRH agonists in treating men with less-advanced local or regional prostate cancer, many of whom receive this therapy. Earlier studies have found GnRH agonists to be associated with obesity and insulin resistance, a precursor to diabetes. "Our study found that men with local or regional prostate cancer receiving a GnRH agonist had a 44 percent higher risk of developing diabetes and a 16 percent higher risk of developing coronary heart disease than men who were not receiving hormone therapy," says Nancy Keating, M.D. who is a physician at Brigham and Women's Hospital. "Doctors should think twice about prescribing GnRH agonists in situations for which studies have not demonstrated improved survival until we better understand the risks of treatment," says co-author Matthew Smith, MD, PhD, associate professor of medicine at Harvard Medical School and a medical oncologist at Massachusetts General Hospital. "For men who do require this prostate cancer treatment, physicians may want to talk with their patients about strategies, such as exercise and weight loss, which may help to lower risk of diabetes and heart disease." Sept. 20, 2006, Journal of Clinical Oncology.

Prostate Cancer treatment is influenced on which type of doctor you consult
The type of prostate cancer treatment a man gets has a lot to do with the kind of specialist he sees first. Prostate cancer can be treated using radiation, radioactive seeds or surgical removal of the prostate. Surgery or drugs to stop production of testosterone, known as hormone therapy, may also be used in high-risk patients. Doctors often also advise close medical observation, also known as watchful waiting. Each treatment is associated with different benefits and side effects. Prostate surgery can cause urinary incontinence and erectile dysfunction; radiation therapy can cause diarrhea and erectile dysfunction; and hormone therapy can cause hot flashes and breast tenderness. Although the 5-year survival rate for men with localized prostate cancer is nearly 100 percent, it is the third most common cause of cancer death in men of all ages, and the most common cause of cancer death in men over 75. If a man's doctor happens to be a urologist, the recommendation for men under 70 most often will be surgery -- 70 percent of the time. For men over 75 who see only a urologist, the choice is watchful waiting or hormone therapy in 90 percent of the patients. But if they see both a urologist and a radiation oncologist, 78 percent of younger men and 85 percent of older men get radiation therapy.

Prostate Cancer treatment with Surgery
If under the age of 65, prostate cancer surgery by removing the prostate gland is a good option, particularly if a person is healthy otherwise. For those over the age of 65, particularly those with a chronic medical problem such as heart disease or diabetes, prostate cancer surgery may not be helpful.
   The time elapsed between a diagnosis of localized prostate cancer and surgery does not appear to have a large effect on the risk of cancer recurrence. There is no clear evidence that an increased time between biopsy and surgery is associated with a significantly poorer outcome. Any effect of a treatment delay is moderate, at least for a time period up to 6 to 12 months after diagnosis.

Prostate Cancer treatment with Radiation - is radiation therapy necessary after removal of the prostate gland?
For men with localized prostate cancer, waiting several months from the time of diagnosis before beginning treatment with external beam radiation therapy does not worsen their odds of survival or other outcomes -- even for high-risk patients.

   Side effects on the lower gastrointestinal (GI) tract after radiation therapy for prostate cancer may be more common than previously reported. Among men treated with radiation for prostate cancer a higher than expected rates of late GI toxicity persists even after several years after the radiation.
  
Men who undergo radiation therapy for prostate cancer have nearly double the risk of developing rectal cancer when compared to men who opt to have surgery to treat prostate cancer.

In men with prostate cancer, follow-up radiotherapy after complete removal of the prostate (radical prostatectomy) does not improve overall or cancer-specific survival. Dr. Pierre I. Karakiewicz from the University of Montreal, Quebec, Canada, examined overall survival using data from 752 patients treated with radical prostatectomy, 118 of whom underwent adjuvant radiotherapy. Patients who received adjuvant radiotherapy had higher pathological tumor stage, higher pathological tumor cell type, and higher rate of positive surgical margins and received hormonal therapy more frequently than did patients who did not receive adjuvant radiotherapy. In unmatched analyses, they found, patients who received adjuvant radiotherapy had lower probabilities of overall survival and cancer-specific survival after radical prostatectomy than those who did not receive adjuvant radiotherapy. However, in matched analyses, there was no statistically significant difference in overall survival and cancer-specific survival. Dr. Pierre I. Karakiewicz says, "Our analysis showed that adjuvant radiotherapy has no effect on overall survival and cancer-specific survival." BJU International March 2, 2009.

Complications of Prostate Cancer Treatment
For many men a diagnosis of prostate cancer can be frightening not only because of the threat to their lives, but because of the threat to their sexuality. In fact, the possible consequences of treatment — which include bladder control problems and erectile dysfunction or impotence — can be a great concern for some men.
  
Men with more advanced prostate cancer often undergo treatment to reduce levels of testosterone, which drives tumor growth. Androgen deprivation therapy can affect mental performance.

Watchful waiting is an option to aggressive prostate cancer treatment
Men with nonaggressive prostate cancer who are treated with hormones or take no action at all are unlikely to die of the disease even 20 years later. Conversely, the disease is likely to be deadly for men with signs of more aggressive cancer treated with hormones or just observation. A study, with an average follow-up of 24 years, suggests men with low-grade, localized cancers might do well with little or no treatment, avoiding the surgery or radiation that can cause impotence and incontinence. The findings are the latest to support a cautious approach in treating some prostate cancers, although there is still debate about how to define the riskiest cases. Prostate cancer is the most common major cancer, and a man's lifetime odds of getting it are 1 in 6.

The mortality rates for most men diagnosed with prostate cancer in the United States are no higher than those in the general population, a new analysis shows. "The bottom line is that most men diagnosed with the disease today can expect to live as long as, or longer than, men their age without the disease," two editorialists comment. The value of prostate specific antigen (PSA) screening in reducing prostate cancer mortality is still in question, Dr. Hermann Brenner and Dr. Volker Arndt of the German Center for Research on Aging in Heidelberg report in the Journal of Clinical Oncology. Widespread use of the PSA test in the US since the late 1980s means many more men are living with a diagnosis of prostate cancer, the physicians point out. They used "the recently introduced period analysis methodology" to evaluate 5- and 10-year survival rates for 183,484 men diagnosed with prostate cancer between 1990 and 2000 included in the Surveillance, Epidemiology and End Results Program (SEER), a large US database. Overall, relative 5-year survival rates for prostate cancer patients were 99 percent, and 10-year survival rates were 95 percent, Drs. Brenner and Arndt found. "That is, excess mortality compared with the general population was as low as 1 percent and 5 percent within 5 and 10 years following diagnosis, respectively," they explain.  For the two thirds of men with well or moderately differentiated localized or regional prostate cancer, there was no excess mortality at all. The researchers note that it is possible that earlier diagnosis might not in itself mean longer survival. The question of whether PSA screening does in fact reduce mortality from prostate cancer must be answered by large-scale clinical trials.

Prostate cancer treatment questions
Q. I had radical prostate cancer treatment with surgery for prostate removal and when leaving the care provider things worked but poorly. I was using the Caverjet needle but it hurt, and an ED pill that sort of worked, now after 10 years things barley work. Will Passion Rx work for me?
   A. Passion Rx is a potent sexual enhancer but it is impossible to make predictions regarding who will benefit and who won't. We certainly hope it would work in your case but there is no way for us to know for certain. Please have approval by your health care provider.