Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. It occurs when cells of the prostate mutate and begin to multiply out of control. These cells may spread (metastasize) from the prostate to other parts of the body, especially the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during segxwal intercourse, erectile dysfunction and other symptoms.

The incidence and mortality from prostate cancer is particularly high in the western world. Prostate cancer is, for example, the commonest male cancer in Nigeria.

Studies have shown that apart from cases of diagnosed prostate cancer, many more men still develop cancer in their prostate but die with it rather than of it. By about age 70, the presence of cancer cells is inevitable in the prostate. It is for these and other reasons that the prostate has been referred to as “a time tomb ticking in men’s plumbing”.

ANATOMICAL LOCATION AND THE FUNCTIONS OF THE PROSTATE
The prostate is strategically located in a man’s body. As can be seen in the diagram below, the prostate gland surrounds the first part of the urethra, the channel through which urine passes from the bladder, through the penis when a man urinates.

In the course of segxwal intercourse, the flow of sperm from the testicles goes through another channel in the prostate which also empties into the urethra. During ********, the prostate itself produces a fluid called “seminal fluid” which is needed to transport and nourish the sperm. Ninety-five percent of the fluid ejaculated during intercourse is contributed by the prostate.

The prostate, therefore, plays a central role in a man’s segxwal and urinary functions and these can therefore be adversely affected by the various diseases of the prostate.

WHAT CAN GO WRONG WITH THE PROSTATE AND WHY?
 The major diseases that commonly arise in the prostate are:
1. Prostatitis (infection or inflammation of the prostate)
2. Benign Prostate Hypertrophy (BPH) - a non-cancerous enlargement of the prostate
3. Prostate Cancer

PROTATITIS: Experts estimate that at some point in their lives, half of all men will experience symptoms of prostatitis, such as urinary burning or irritation, discharge through the penis, pain in the pelvis (the part of the body where the prostate and bladder are located) or in the rectum (the end part of the large intestine that opens to the outside through the anus).

Men who have any of the symptoms mentioned above should have themselves investigated by a doctor who will provide appropriate treatment.

BENIGN PROSTATE HYPERTROPHY: This condition is even more common than prostate cancer. It is caused by a second spurt of growth of the prostate gland taking place in middle age. It develops as a result of hormonal changes that occur with age.

There is an enzyme, 5-alpha-reductase, that converts the male hormone (testosterone) to dihydrotestosterone. At about age 40, this enzyme goes into overdrive, increasing the amount of dihydrotestosterone produced whilst decreasing the level of testosterone in the process. This change of hormone balance is what causes BPH along with other concomitant changes that tend to occur with age e.g. loss of hair.

When the prostate enlarges,   it squeezes the channels for the passage of urine and sperm that pass through it.  As a result, BPH can give rise to BATHROOM TROUBLES as well as BEDROOM TROUBLES.

BATHROOM TROUBLES: These include the following: Need to urinate frequently, especially at night, sudden uncontrollable urges to urinate, difficulty starting urination, weak or interrupted urine flow, burning sensation or pain when urinating and sometimes blood in urine

BPH can also lead to total obstruction of the outflow of urine which would call for urgent medical intervention. Chronic partial obstruction to the flow of urine can also cause damage to the kidneys and even kidney failure eventually.

BEDROOM TROUBLES: These include the following: Reduced segxwal ability, discomfort during intercourse such as painful orgasm, for example.

  Men who suspect that they may have BPH should see a doctor for proper evaluation. The doctor may do some investigations to make a diagnosis and would also want to exclude the presence of cancer.

PROSTATE CANCER: I have already pointed to how very common prostate cancer is. I also stated that prostate cancer may be present in many men without their being aware of it i.e. without their having any complaints whatsoever.

This again underscores the importance of regular medical check-up. When a man with prostate cancer has complaints, many of his symptoms could be similar to that caused by BPH. However, sometimes the complaint that brings some patients with prostate cancer to the doctor is bone pain resulting from the cancer having already spread to the bones. Bone pain that won't go away should therefore be taken seriously in the older age group (50 years and above) as it could be due to prostate cancer already spread to the bones.

RISK FACTORS (PROSTATE CANCER)

GENDER AND HORMONES:
Prostate cancer does not   develop in the absence of male hormones. Men who are castrated before puberty and those born with a severe deficiency of male hormones are not at risk.

RACE AND NATIONALITY: As has been stated, prostate cancer is the commonest male cancer in Nigeria. African-Americans have the highest prostate cancer incidence in the world. They are seven times more likely to have prostate cancer than Asians who have the lowest rate.

In Japan, where the diet is low in fat and rich in soy, prostate cancer incidence is low, like among other Asians. When Japanese adopt a typical western diet, however, their risk of prostate cancer soon increases.

FAMILY HISTORY: Those whose relatives have prostate cancer have a higher risk of developing the disease. The closer the degree of the relationship and the more the number of a man’s relatives who have prostate cancer, the higher the risk of the disease in the individual concerned. 

AGE: Although prostate cancer can occasionally occur in people in their thirties, it is after the age of fifty that the incidence rises sharply and then skyrockets after the age of seventy. Among blacks, prostate cancer tends to develop at a relatively earlier age.

DIET: Diet that is high in saturated fat is linked with increased incidence of prostate cancer. Diet that is low in fruits and vegetables is also linked with increased risk of prostate cancer. There is evidence that a diet low in vitamin E and selenium may increase prostate cancer risk. The prostate needs ten times more zinc than any other organ in the body. Men also lose zinc during ********. Thus, it is vital for prostate health to have adequate zinc intake.

A four-year study at Harvard University, involving 50,000 men, showed that eating ten servings of tomatoes or tomato-based food per week reduced the chances of the development of prostate cancer by 33%. The active ingredient thought to be responsible for this effect is lycopene.

LIFESTYLE: A sedentary lifestyle can lead to increased body mass and this increases the risk of prostate cancer and also the risk of dying from it.

EXPOSURE TO TOXINS: There are pointers to the increased risk of prostate cancer in people who have been exposed to cadmium (in nickel cadmium battery manufacturing plants) or to anabolic steroids.

MAINTENANCE OF PROSTATE HEALTH

DIET AND LIFESTYLE: Against the background of all that is known about prostate-related problems, certain lifestyle and dietary measures would contribute to making the prostate healthy.

Whole–food diet,  with plenty of whole grains, raw nuts and seeds, vegetables, including tomatoes. Food rich in zinc should be consumed e.g. mushrooms, seafood, spinach and whole grains. Fish should be eaten for its omega-3 fatty acids.

Dairy products should be minimized. Red meat should be reduced or avoided. There is a definite correlation between high red meat consumption and prostate cancer.  Saturated fats, junk food, refined sugars, processed foods and food additives should be avoided.
Adequate exercise, regular and effective bowel evacuation and body detoxification are also recommended.

NUTRITIONAL SUPPLEMENTS:
In addition to lifestyle and  dietary supplements, there are also nutritional supplements and herbs which have been shown, through scientific studies, to enhance prostate health and also useful in reversing its disease in some cases.

These nutritional supplements and herbs include:Pro 6, zinc, selenium, Vitamins A (beta carotene), B6, C, E. Also included are: saw palmetto, pygeum africanum, lycopene, amino acids (glycine, alanine and glutamic acid), panax ginseng, Bee pollen, beta sitosterol, essential fatty acids and cranberry and Aloe Vera.

What will be helpful and appropriate in each individual case has to be recommended by the healthcare provider.

RECOMMENDATIONS:
All men, as from about age forty, should have a PSA (Prostate-Specific Antigen) test done on themselves yearly. Also, they should have their prostates examined by the doctor yearly.

A combination of the PSA test result and the physical examination should give a good idea of whether or not BPH or cancer is present or likely to be present and to help in determining if further tests need to be done.  Men should also be alert to the symptoms of prostate disease so that they could be looked into as early as possible.

Necessary measures should also be taken concerning diet, lifestyle and the use of nutritional supplements to help in keeping or correct prostate diseases ........ for more information Contact me or send a mail to - [email protected].