What is it?

Prostate cancer is cancer of the male prostate gland and the most common cancer in men in the UK.

The prostate is found between the bladder and the penis and is involved in sperm production.

Causes

It isn’t known why some men get prostate cancer while others don’t but there are risk factors that make development of the cancer more likely, including:

*   Age – most cases are diagnosed after age 50
*   Ethnic background – cases are more common in men from African-Caribbean or African descent
*   Close family history of prostate cancer – dad or brother
*   Obesity
*   Lack of exercise
*   Diet and nutrition – foods containing lycopene which is in cooked tomatoes, and selenium found in Brazil nuts, may reduce the risk – while eating a higher calcium diet may increase it.

Symptoms

Prostate cancer is not usually an aggressive cancer and is slow to develop over many years. This means symptoms may not be noticed until it is at a more advanced state.

Symptoms can include:

*   More frequent urination – including peeing more at night
*   Having to get to the toilet quickly to pee
*   Finding it harder to start to pee once you get to the toilet or straining to urinate
*   Weaker urine flow and taking longer to finish peeing
*   Having a feeling the bladder isn’t empty after urine has stopped flowing

Later symptoms can include:

*   Lost appetite
*   Testicle pain
*   Unplanned weight loss
*   Back pain
*   Bone pain

If these are noticed it is best to seek medical advice for possible prostate cancer symptoms.

Diagnosis

Unlike some other cancers there is no NHS screening programme for prostate cancer because the blood test used to help detect it can sometimes wrongly suggest that healthy men with no symptoms or risk factors have cancer.

A doctor will begin to diagnose prostate cancer based on the symptoms, family and medical history, and a physical examination.

They will want to rule out other possible causes of symptoms affecting urination, including an enlarged prostate that’s common in older men but isn’t cancerous.

Prostate cancer tests include:

*   Digital rectal examination – the doctor wears a glove to examine the inside of the rectum (bottom) with a finger to check for changes of the prostate
*   Urine test to rule out an infection
*   Blood sample taken for a PSA (prostate-specific antigen) test

If the results of the examination and/or the PSA test suggest possible prostate cancer a referral will be made to a cancer specialist and team of experts – called a multidisciplinary team (MDT). Other tests are used to confirm the diagnosis.

The stages used to define prostate cancers are:

Stage 1 – the cancer is small and still inside the prostate
Stage 2 – the cancer is larger but still within the prostate
Stage 3 – the cancer has spread beyond the prostate, including to nearby tubes for carrying semen
Stage 4 – the cancer has spread to another part of the body – lymph nodes, bladder, rectum, or bones

Treatment

Once the test results are back doctors will recommend treatment – if appropriate.

The decision will depend on how advanced the disease is, and the man’s overall health, age, and circumstances.

The goal of treatment will be to remove the cancer, stop cancer spreading, slow the spread of cancer, or to relieve cancer symptoms.

Treatment can mean being free of cancer but there can be a risk of cancer returning – called recurrence.

The patient may decide the discomfort and side effects from treatment would severely affect his quality of life and may choose not to have treatment.

Watchful waiting or active surveillance

If the cancer is small, low-risk, or slow growing, forms of monitoring called watchful waiting or active surveillance may be recommended.

With active surveillance there are regular tests carried out to monitor the cancer – including PSA tests, biopsies, and MRI scans.

In many cases otherwise healthy men undergoing watchful waiting will outlive their prostate cancer without treatment and will die from another cause or old age. Surveillance rather than treatment may also be recommended if the cancer has spread too far for successful treatment.

Prostate cancer survival

Because prostate cancer is slow growing nearly a third of cases may only be diagnosed at stage 4 once the cancer has spread to other parts of the body.

Like most cancers the earlier it is detected the better the chances of successful treatment and longer survival.

Helpful information:

While there has been no specific research done with regards to bioidentical progesterone usage in men, there have been interesting reports from patients with prostate cancer which has been diagnosed both by blood test and biopsy. These patients have found that, as a result of using natural progesterone for about a year, the levels of PSA (Prostatic Specific Antigen) in their blood have decreased to normal levels.

The mechanism for this apparently beneficial effect of natural progesterone is not clear but may relate to progesterone being a precursor of testosterone. Men as they get older have a tendency to produce less testosterone and more di-hydrotestosterone, which seems to have an over stimulating effect on cells. Progesterone could have the effect of neutralizing the di-hydrotestosterone, which would thus help to maintain testosterone levels. It is also thought that progesterone may have an effect on the genetic coding of some cells, and in this prevents the development of abnormal cells.

Dr Tony Coope, an experienced bioidentical practitioner, has said the following on the use of such creams after cancer treatment and hot flushes in men.

” The physiology behind flushes is in my opinion not completely explained, – my feeling is that it is more to do with hormone imbalance than specifically related to estrogen. As progesterone is so safe, and is believed by some experts to be helpful in prostate cancer (John Lee et al), I think it would be definitely worth trying for a month or two to see how he responds. “

Certainly it seems that men can also suffer from oestrogen dominance but whether supplementing with Serenity (not 20-1) would help proactively against future problems we do not know, but certainly it cannot do any harm.