Prostate Cancer - Prevention, Symptoms, Prevalence and Incidence, Treatment Available, and Prognosis - Research Paper Example

? Research Paper on Pro Cancer ID Number: of School Word Count 795 excluding abstract (194) Research Paper on Prostate Cancer Abstract This paper talks on a disease that is exclusive to males only which is prostate cancer. It is one of the leading causes of death which is usually also undiagnosed because quite often it is the disease that is symptom-free, unlike other cancer ailments. Included in this paper is a description of the disease, its presenting signs and symptoms, its prevalence and incidence, current statistics, how it develops, how it can be detected early, the types of treatment available, how it affects the various body systems, its progress and prognosis and finally, how to prevent or avoid it. Prostate cancer is a second leading cause of death among men after lung cancer, primarily from smoking. The paper also discusses some basic anatomy related to the prostate gland and the cancer itself. The disease is described in greater detail as well as the various symptoms and also the treatments that are available today with the aid of more modern and accurate detection methods. The last part of the paper gives the current state of prostate cancer research which has shown big strides. This paper deals with everything that is related to prostate cancer today. Keywords: cancer, detection, gland, prevention, prostate, research, symptoms, treatment Introduction The human body is an intricate and very complex system of tissues and organs that has an amazing capacity to rejuvenate itself and maintain a dynamic equilibrium called as homeostasis. Entire body systems such as the circulatory, respiratory and reproductive systems are examples of this ability to maintain a stable condition. Ailments are symptoms of something that has gone awry with these body systems such that these were not able to return to equilibrium as expected. This paper talks about a peculiar anatomical part that is present in human males only which is the prostate gland and highlights prostate cancer which is quite common among men. Discussion Prostate Gland – this is a small compound exocrine gland which performs vital functions in the human male anatomy in terms of chemical, physiological and sexual characteristics. It is a small organ that produces and stores a slightly alkaline fluid that constitutes some 20%-30% of the seminal fluid volume during ejaculation. The alkalinity helps the spermatozoa to survive the acidity of the vaginal environment. Prostatic secretions are made up mostly of just simple sugars such as fructose and about one percent of protein. However, it contains a lot of zinc which can be 1,000 times that of the zinc found in human blood. The prostate produces dihydrotestosterone but needs other hormones produced by the testicles to work properly and allow the male to exhibit the male characteristics such as growing a beard or mustache. The average human male prostate gland weighs about 11 grams and is the size of a walnut. It surrounds the first portion of the urethra called prostatic urethra near the base of the bladder (at the neck or its outlet for the drainage of urine). The prostate helps in control of urination and also in the ejaculatory process through the smooth muscles around it. Enlarged Prostate – this is usually just a normal part of the ageing process as men grow older and become less active. The medical term for this condition is benign (harmless) prostatic hyperplasia (over-genesis or over-production of certain cells) or BPH. This is usually a harmless condition caused by changing hormone levels and should not cause too much worry at all. BPH itself is not a symptom of cancer although it causes similar problems (Zorn & Gautam, n.d. p. 1) like reduced urination and sometimes pain as the enlarged prostate squeezes the urethral outlet. Incredibly, a male can survive and manage quite well without the prostate gland like that what happens when it is surgically removed during an operation called radical prostatectomy. Prostate Cancer – this disease occurs when the prostate cells proliferate or reproduce in an uncontrolled manner similar to all other types of cancer growths. Unlike other cancer growth, prostatic cancer does not usually show outward physical symptoms or abnormalities which make it quite difficult to detect unless the physician doing the examination is an expert. Moreover, as it has no initial symptoms, it also gives a false sense of security or perfect health for the man who did not experience anything that might indicate the presence of the cancer. The overgrowth of the prostate cells results into an enlargement of the prostate gland and can expand into local tissues. Aggressive prostate cancer can metastasize (spread farther) to other parts of the body such as the lungs, bones, kidneys and the liver. Symptoms – prostatic cancer is quite appropriately called as the silent cancer because it is not readily apparent, especially in its early stages and is therefore often ignored due to ignorance. Men afflicted with this cancer often exhibit the same symptoms associated with harmless BPH or prostatitis (inflammation of prostate due to bacterial or other causes) such as painful urination. The other common symptoms similar to the three aforementioned conditions are weight loss, lack of appetite, loss of sexual desire, impotence, lower semen volume, weaker erections and the other problems associated with urination such as frequency, hesitancy, urgency and the constant waking up at nights to urinate (nocturia) and low back pains (Hennenfent, 2005, p. 25). BPH and prostatitis also tend to raise the prostate-specific antigen (the PSA is a cancer marker) which can give a false positive, making PSA not a very reliable laboratory test for the cancer. Detection – the most common tests are the digital rectal examination and the PSA test. These two tests are the initial screening done but more detailed laboratory analysis should be done once there is suspicion of cancer present in the prostate. It is called digital because it uses a digit (one finger of the examining doctor to feel the prostate gland through the rectum) and not because in the sense of being electronic or digital (like consumer electronics which are digital). The digital rectal exam or DRE is sometimes called as PPA or palpation per anum (in Latin) as the doctor palpates the gland to detect any abnormal mass, growth or lump (O’Neill, 2006, p. 1). Prostate-specific antigen (PSA) is a chemical substance produced by the prostate and is usually indicative of a cancerous tumor. The normal level of PSA is 4 ng/mL and any figure that is above this is considered a clear sign of cancer already. However, it must be noted that cancer of the prostate may not manifest itself even with a PSA level of below four (Chang, 2010, p. 1). There are several types of PSA tests such as the percent-free PSA (the level or proportion of the PSA that circulates freely in the blood in relation to PSA attached to proteins) and an alternative is the PSA velocity (the pace of change in PSA levels over time) such as an increase greater than 0.75 ng/mL in a single year is usually indicative of cancer (Chang, 2010, p. 2). A newer form of laboratory test that is considered more superior (tentatively, at least) to the PSA test is the EN2 test (Engrailed-2) which is less invasive (no need to draw the blood) as it is performed or detected using urine samples only much like the pregnancy test for women. This was discovered by a team of oncology researchers from the University of Surrey in England and it is a reliable bio-marker that is produced by men with prostate cancer as secreted in their urines (Morgan et al., 2011, p. 1). Although the PSA is not very reliable for its many false positives, it is still credited with the dramatic reduction in prostate cancer deaths because of early detection since introduction of PSA tests in the mid-1980s (Ankerst, Tangen & Thompson, 2009, p. 3). It is highly recommended that an elevated PSA be followed with an ultra-sound guided biopsy to really make sure if cancer is present or not as this is the only way to positively identify cancer. Current Statistics – before the PSA test was invented, the incidence was 119 per 100,000 back in 1986 and then went up to 237 cases per 100,000 in 1992 due to better detection methods (ibid.) but then declined by an amazing 29% because of early treatment. In the United States, the rate is about 186,000 cases detected annually with around 28,600 deaths. It is very common in the US and even more common in Europe. Among American males, it is least common among Asians and most common in African-Americans with the whites in between these statistics. Risk Factors – age is the strongest risk factor for this type of cancer. It is quite rare for a male person to have it before 40 years old while it increases quickly after age 50; it is present in 2 out of 3 prostate cancer patients who are over age 65 (www.acs.org, 2011, p. 1). Other factors include race (most common in African-Americans and less common among Asian-Americans or Hispanics) and nationality (prevalent in some regions only such as North America and Europe). Family history also plays a big part whether a man gets prostate cancer or not. The risk is doubled if a father or brother had it before. Genes can also be a causative factor as normal cells go haywire during reproduction due to damage in their DNA. Some genes linked to the prostate cancer are hereditary prostate cancer gene-1 (HPC1), the PTEN gene and the KAI-1 gene. Diet may be linked to it such as those high in animal fats, red meat or high-fat dairy products. Some lifestyles are prone to prostate cancer such as smoking, obesity, drinking and lack of exercise. Types of Treatment Available – there are a good number of treatments available to the people diagnosed with this dread disease. Among the leading treatments is surgery (without greatly affecting the individual to allow a fairly normal life). Other types of treatment are the radiation therapies which can vary depending on the aggressiveness of the cancer such as the conformal radiation therapy (CRT) or the intensity-modulated radiation therapy (IMRT) or the proton beam radiation which allows for a focused laser-like treatment (ibid.). Another option is hormone therapy by controlling the male hormone testosterone which promotes cancer growth. Most common are the luteinizing hormone-releasing hormones (LH-RH) agonist and the other primary type of hormone treatment are the various androgen-blocking drugs. A new treatment is cryotherapy in which freezing liquid is used to kill the cancer cells (Zorn & Gautam, n.d. p. 11). Prevention – like other types of cancer, prostate cancer has no known specific causes and can therefore not be prevented entirely because of the lack of knowledge about its causes. There are some ways to avoid it such as lifestyle and diet modifications, specifically avoiding red meat and eating more of low-fat foods, tomatoes (lycopenes) and soya products that have isoflavones (reduces testosterone) or selenium which is non-metal trace element (Dennert et al., 2011, p. 1). Conclusion While prostate cancer can be life threatening especially if it is the aggressive type, the many males who are diagnosed with this cancer can live for many years after initial diagnosis without any significant health problems. Prostate cancer can be considered as one of the “kind” forms of cancer as the prognosis is good for those found to have it as long as it is detected early and proper treatment is applied coupled with a good monitoring regime. Ironically, most medical complications of prostate cancer come from the side effects of the selected type of treatment. The patients who cannot be cured can extend their lives by simple hormone treatments. In many cases of prostate cancer, the patient dies from other age-related causes because prostate cancer is slow- growing type of cancer. It is very important to discuss thoroughly if treatment will be used or not once a positive diagnosis from a biopsy indicates the presence of cancer cells because of the risks involved with the various treatments versus minimal benefits obtained from the treatment. References American Cancer Society (2011, May 22). What are the Risk Factors for Prostate Cancer? www.cancer.org Retrieved from http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-risk-factors Ankerst, D. P., Tangen, C. M. & Thompson, I. M. (2009). Prostate Cancer Screening. New York, NY, USA: Humana Press. Chang, L. (2010, April 14). Prostate-specific Antigen (PSA) Blood Test. WebMD Retrieved from http://www.webmd.com/prostate-cancer/guide/psa Dennert, G., Zwahlen, M., Brinkman, M., Vinceti, M., Zeegers, M. P. & Horneber, M. (2011, May 11). Selenium for Preventing Cancer. Cochrane Database of Systematic Reviews. Abstract. Published on-line and retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21563143 Hennenfent, B. (2005). Surviving Prostate Cancer without Surgery. Roseville, IL, USA: Roseville Books. Morgan, R., Boxall, A., Bhatt, A. and et al. (2011, March 1). Engrailed-2 (EN2): A Tumor Specific Urinary Bio-marker for the Early Diagnosis of Prostate Cancer. Clinical Cancer Research, 1-3. Abstract. Published on-line and retrieved from http://clincancerres.aacrjournals.org/search?fulltext=EN2%2C+Engrailed-2&submit=yes&x=16&y=11 O’Neill, P. (2006, December 01). Digital Rectal Examination for Prostate Problems. WebMD. Retrieved from http://www.webmd.com/prostate-cancer/guide/prostate-cancer-digital-rectal-exam Zorn, K. C. & Gautam, G. (no date). Prostate Cancer. MedicineNet.com Retrieved from http://www.medicinenet.com/prostate_cancer/article.htm Read More