The Stanford Medicine Cancer Institute defines cancer as an abnormal growth of cells that rapidly reproduce despite restriction of space, nutrients shared by other cells, or signals sent from the body to stop reproduction.
Cancer cells are often shaped differently from healthy cells, they do not function properly and they can spread to many areas of the body. The term cancer is used when a tumor is malignant, which is to say it has the potential to cause harm, including death.
The Department of Health ranks cancer of the prostate as the fourth leading cause of death among Filipino men. The Philippine Cancer Society reported that one out of 10,000 will suffer from an eventual abnormal enlargement of this small, walnut-sized gland. Speaking of unwanted growth, its increasing incidence in the country and around the globe makes it a prominent health concern.
In prostate cancer, a malignant tumor in elderly men, usually 50 years old and older, invades the bladder, seminal vesicles and peritoneal cavity. It eventually metastasizes (spreads) to the bones, lymph nodes, lungs, liver and kidneys. The disease takes time to develop, usually between two to four years to develop twofold and typically produces little symptoms until it progresses. When prostate cancer symptoms do appear, the cancer usually has progressed and is in a late stage.
This disease has resulted in over 4,000 new cases and 2,000 deaths in the country in 2005. The 2010 statistics from the health department showed about 6 million Filipino men over the age of 50 are susceptible to develop the disease.
The Stanford Medicine also suggest that in general, all men are of risk for prostate cancer and there are specific risk factors that increase the likelihood that certain men will develop the disease, including the following:
Age—Men age 50 and older. Nearly two-thirds of all prostate cancers are diagnosed in men over the age of 65.
Race—Prostate cancer is more common among African-American men than it is among Caucasian American men. Japanese and Chinese men native to their country have the lowest rates of prostate cancer.
Diet—Epidemiological data suggests that the diet consumed in Western industrialized countries may be one of the most important contributory factors for developing prostate cancer.
Obesity—It has been linked with a higher risk of getting a more aggressive type of prostate cancer.
Environmental exposures—Some studies show an increased chance for prostate cancer in men who are farmers, or those exposed to the metal cadmium while making batteries, welding, or electroplating. Additional research is needed in this area to confirm whether this is a true association.
Having a vasectomy, BPH (benign prostatic hyperplasia), or STD (sexually transmitted disease)—Researchers have looked at whether men who have had a vasectomy, BPH, or those who have been exposed to a sexually transmitted disease are at increased risk for prostate cancer. Some studies suggest a link, while others do not support these claims.
Family history—Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. The risk is even higher for men with several affected relatives, particularly if the relatives were young at the time of diagnosis.
genetic factors – Some genes, when altered or mutated, give a higher risk for uncontrolled cell growth, which, in turn, can lead to tumor development. These genes have various names, but overall are referred to as “cancer susceptibility genes.” Approximately 5 percent to 10 percent of all prostate cancers are known to be attributed to an inherited Deoxyribonucleic acid change, such as a cancer susceptibility gene.
However, according to Dr. Dennis Serrano, a urologist, “Majority of men who are diagnosed with prostate cancer will, in fact, not experience any known symptoms. Early detection is the best way to combat this disease. ”
He said there are four stages to prostate cancer describing the extent of involvement or spread of the tumor:
In Stage 1, the tumor is very small, involving one part of the prostate and is usually not detectable or evident during a digital rectal examination (DRE). It is usually only discovered incidentally when a patient undergoes an operation like transurethral resection of the prostate for an initial diagnosis of benign prostate enlargement. This is when the patient gets the best prognosis since the tumor can easily be treated either by surgery, such as radical prostatectomy, or radiation.
Stage 2 is when the tumor is already a bit larger, already felt during a DRE, but is still confined within the prostate. Tumors involve either sides—or lobes—of the prostate. A patient can undergo biopsy for an elevated PSA or prostate specific antigen, a blood test to detect prostate cancer or inflammation. This is also a stage of good prognosis since the patient can still be offered a curative strategy or treatments, such as those for Stage 1.
The tumor in Stage 3 has gone beyond the margins—or the capsule—of the prostate and is what we call locally advanced. At this stage, the tumor has involved the structures adjacent to the prostate and has a somewhat guarded prognosis. Although management can still include curative surgery, the outcomes are not as good as Stages 1 and 2. More often than not, patients will require what we call adjuvant, or additional, treatment with medicines to block testosterone and radiation.
Stage 4 is what we call metastatic prostate cancer where the tumor spreads to other structure adjacent to the prostate like the bladder and the rectum or the muscles around it. It also includes cases wherein there is spread to the lymph nodes and the bones. This has the worst prognosis and is the terminal stage. At this stage, we can only offer palliative—or maintenance, not curative—treatment with medicines blocking testosterone, bone strengthening drugs and pain relievers.
How to lower the risk of prostate cancer
The Philippine Urological Association (PUA) encourages Filipino men to participate in the annual screening for prostate cancer. They recommend the DRE, which is done to check if there are problems with the organs, or other structures in the pelvis or the lower body. A gloved, lubricated finger is inserted into a man’s rectum to feel irregularly or abnormally firm areas, which may be a developing tumor. Dr. Eduardo Gatchalian, former president of the PUA, said that although the process is uncomfortable, it only takes a short time and physicians say that it is an important procedure, because now, it is still the only means that can help detect prostate problems. The PSA test, on the other hand, is a procedure that measures the blood level produced by the cells of the prostate gland. According to the National Cancer Institute, if a man has a higher PSA level, he is most likely prone to prostate cancer. These tests are recommended to men who have a history of prostate cancer in the family, and those who are over 50 years.
In spite the fact that these tests are already available here in the Philippines, many still could not afford the fees for the screening for prostate cancer. The PCSI is a non profit organization that provides emotional and educational support to victims, and their relatives. They also provide medical help to people who are diagnosed with cancer.
A surgery is provided under two important circumstances: (1) How far the cancer has spread in the victim’s body and (2) how malignant the cells are (if a cancer cell is more distorted under the microscope it has the tendency to grow and spread quickly). Radiotherapy is another alternative for curing prostate cancer. It involves high-energy radiation, which can kill cancer cells.
Dr. Eliza Raymundo, a clinical associate professor at the University of the Philippines Manila-Philippine General Hospital suggests that in order to lower the risk of having prostate cancer, men should eat food that are rich in phytoestrogen. These are foods like soybeans. Also there are other high-fiber foods that are rich in phytoestrogen like hops, licorice and thyme. High-fat foods, red meats and processed meats like hot dogs and sausages, should be avoided. Food that are rich in antioxidants also help in preventing the damage to the DNA of the cells in the body.
Further studies and research are being made in order to decrease the dangers of acquiring prostate cancer, and although these advancements are still to soon to disclose to the public, some doctors consider certain drugs containing dutasteride and finasteride, which are both used to rectify a non-cancerous enlarged prostate. Selenium and vitamin E are also believed to lower the chances of having prostate cancer.
It wouldn’t hurt to visit the doctor every once in a while for check-ups. Proper and healthy diet, clean living and a healthy lifestyle would also help in preventing the occurrence of this deadly disease. But most importantly, being aware and knowing the disease will be a big help in preventing the spread or growth of the disease.
But most importantly, being aware and knowing the disease will be a big help in order to