Health Guide

Prostate Cancer

Information on the prostate men should know to protect there health and stay alive.

Prostate Cancer is an increasingly common diagnosis in Western societies and in
those emulating Western lifestyles and diets. In the year 2001 there were estimated
to be 198,100 new cases and almost 31,900 deaths attributable to this condition in the
United States (1). Approximately one in seven American men will be diagnosed with
prostate cancer during their lifetime, making it the most common solid tissue cancer
in the United States.

Despite advances in prevention and early detection, refinements in surgical technique
and improvements in adjuvant radio-therapy and chemotherapy, the ability
to cure many patients with prostate cancer remains elusive. However, mortality rates
are changing. Baade et al recently reviewed international trends in prostate cancer
mortality and reported significant reductions in prostate-cancer mortality in the UK,
USA, Austria, Canada, Italy, France, Germany, Australia and Spain with downward
trends in the Netherlands, Ireland and Sweden (2).

Detection of this disease earlier, as a consequence of introduction of the prostate specific
antigen (PSA) blood test, has been acknowledged by the NCI as one factor contributing
to lowering the mortality rate over the past few years (3-6). The use of PSA
testing has been estimated to provide a diagnostic lead-time of up to 10 years (7-11).
In the mid to late 1980s only one third of prostate cancers were diagnosed at curable
stages compared with today when 80% are staged clinically as organ-confined
and potentially curable (12-14). Unfortunately, however, even when the tumour is
thought to be localized, up to 25% of men have non-localised disease which declares
itself subsequently (15).

Since curative therapies are directed to localised tumours (3,4,7,16), extending effective
but non-invasive treatments to include both primary and secondary lesions
remains a major goal and challenge. Once prostate cancer metastasizes, apart from
causing loss of life, its toll is often considerable with regard to morbidity from both
the disease itself and administered therapies.
As a result of increasing numbers of men having their prostate cancers diagnosed
earlier, more patients are now eligible for treatment with curative intent. Improved
surgical and radiation-based treatments have been developed so that the prognosis
of a man diagnosed today with prostate cancer is better than ever before.

II. ANATOMY AND PHYSIOLOGY

The term "prostate", originally derived from the Greek word prohistani which means
"to stand in front of," has been attributed to Herophilus of Alexandria who used
the term in 355 B.C.E. to describe the small organ located in front of the bladder
(17). The prostate gland is a small firm organ, about the size of a chestnut, located
below the bladder and in front of the rectum. The urethra, the channel through which
urine is voided, passes from the bladder and through the prostate and penis. The
primary function of the prostate gland, which contracts with ejaculation, is to provide
enzymes to maintain the fluid nature of seminal fluid and to nourish sperm as they
pass through the the prostatic and penile urethra to outside the body.