Prostate Gland and Homoeopathy

Introduction:                                                      

The prostate enlarges as a man approaches middle age and will continue to enlarge for the rest of his life. The prostate gland lies just below the bladder in front of the rectum and is found only in men. It surrounds the urethra which is the tube that leads from the bladder through the prostate and penis and transports urine and semen. The main function of the prostate gland is to produce semen which is the fluid that transports sperm during ejaculation.

The prostate gland in an adult man is about the size of a walnut. The prostate enlarges as men approach middle age and will continue to enlarge for the rest of their lives. This enlargement is made up of benign (non-cancerous) tissue and is known as benign prostatic hyperplasia (BPH). BPH is not cancer nor does it lead to cancer, but it can interfere with the normal flow of urine and cause uncomfortable flow of urine and cause uncomfortable urinary outflow symptoms.

Tips for a Healthy Prostate:

Limit consumption of high fat foods, particularly red meat and dairy products.

Eat a lot of fruits and vegetables, especially tomato and cruciferous vegetables like sprouts, cauliflower and others in the cabbage family. Eat fish with a high omega-3 fatty acid content such as salmon, avoid alcohol, be physically active and maintain a healthy weight.

Cancer of the Prostate:

Prostate cancer is the second most common male cancer in the west. The death rates have doubled in the past 20 years and are predicted to overtake lung cancer as the first in the next few years. In india, though no specific statistics are available are available the national registry of cancer does show a steady increase in the incidence over the last few years, that too in relatively younger men, from an overview of the statics from various cancer centers, prostate cancer is roughly estimated to account for 1% of all cancers in the registers. The increasing incidence is not due to any sudden epidemic but largely due to better screening procedure using a reliable tumor marker called prostate specific antigen (PSA), it is estimated that 30%of patients with prostate cancer are in the early stage and hence are curable 

Hither to prostatic malignancy was usually diagnosed in elderly patients and in the advanced stages, even in these men since the disease is quiet, many of them died along with the disease than due to the disease.

Prostate cancer is rare before the age of 40 and the incidence increases with age, though the exact cause of prostate cancer is not yet known, researchers suspect a high fat diet and genetics. However the greatest risk factor is age; most men develop prostate cancer if they live long enough. The likelihood of developing cancer increases after the age of 60. By age 65 most men have enlarged prostates. The first signs are night urination and difficult urination.

Literally 97% of all men will be affected with prostate problems during their lifetime, early stage prostate cancer does not usually cause any symptoms and most such cancers are diagnosed by an ultrasound scan of the prostate and ultrasound guided prostate biopsy. In particular early prostate cancer does not cause typical bladder outflow problems associated with BPH, this is because prostate cancer usually arises in the outer part of the gland. Cancer of the prostate is normally slow growing. A small proportion of prostate cancer can however be very aggressive, spreading quickly to other parts of the body especially the lymph nodes and the bones. Traditionally watchful waiting, palliative radiotherapy and hormonal manipulation are the mainstay of treatment with advanced disease, with the advent of the tumor marker PSA and early screening of men through comprehensive medical checkups there is an increase in the number of younger men being diagnosed with the disease. Brachytherapy for prostate is the latest exciting armamentarium in curing the early disease. Early prostate cancer does not usually causes any symptoms and most such cases are diagnosed by an ultrasound scan prostate cancer diagnosing 

Be on the lookout ;  if prostate cancer can be detected early, proper treatment may result in cure, unfortunately except for occasional difficulty with urination, most men with prostate cancer are men with a family history of the disease. However every man aged 40 and older is at risk, all men aged 40 and older should get a digital rectal examination (DRE) as part of their regular annual physical check up 

1)all men aged 50 and above should get a PSA test done as part of their annual physical, in addition to a DRE 

2) If the DRE or PSA test is not conclusive enough, a trans-rectal ultrasound should be performed 

3) Remember! Prostate cancer often occurs without any symptoms, regular testing can lead to life saving therapy 

PSA-Test

This is a blood test that measures the level of PSA, a protein found in the blood and produced by the prostate. It appears in high concentrations in the blood when the prostate cells are damaged (for instance in prostate cancer, infection benign prostatic hyperplasia ) although the test is not 100% accurate, the PSA test has become an important step in diagnosing prostate cancer and following the course of the disease. A level above 4mgs/dl is thought to be abnormal and will necessitate further investigation. When combined with DRE and trans-rectal ultrasound prostate biopsy, it is highly reliable and currently the most effective means to diagnose prostate. 

Digital Rectal Examination (DRE)

In this test a gloved finger is inserted in the rectum. The urologist feels for the size, shape and texture of the prostate, cancer feels hard. However more tests will be needed to make sure that cancer is present. It is one of the best methods to screen for malignancy 

Trans-Rectal Ultrasonography (TRUS)

With a probe inserted in the rectum, TRUS shows sound waves bouncing off the prostate and other parts of the body. It is used along with PSA and DRE to diagnose prostate cancer. It is used to help specifically localize tumors for biopsy and give an idea of the local extent of the disease. All men aged 50 and above should get a PSA test and DRE done as part of their annual checkup. Many prostate cancer patients who have been treated may never have problems with their cancer again 

Biopsy 

This is a surgical procedure in which a few cells are removed for microscopic examination. Biopsies are usually done using a local anesthetic.  

The TRUS –guided biopsy allows for an accurate removal of representative tissue from the abnormal areas. Once the diagnosis is made the next process is quantification of the disease and to see its reach and spread using a CT scan of the abdomen pelvis or an MRI scan or a whole body bone scan using tc99 diphosphonate.

The Importance of Early Detection 

Most cancers have a better chance of cure if found and treated at an early stage. Many prostate cancer patients who have been treated may never have problems with their cancer again, on the other hand some men with prostate cancer will not die of the disease even if it remains untreated. It is not possible to say whether early detection of prostate cancer will lower an individual’s chance of eventually dying from that cancer 

Stages of Cancer 

If cancer is found in the prostate, it is important to determine the extent (stage) of the cancer to decide on the best treatment option in addition to PSA and TSU the following may also be used to establish the extent of the disease; CT and/or MRI or a bone scanning 

The pathological staging of prostate cancer is typically divided into 5 stages 

1^st stage 

The tumor is located within the prostate gland and is too small to be detected during a rectal examination, but it may be discovered through other diagnostic procedures such as PSA test. Prostate cancer at this stage generally produces no symptoms 

2^nd stage

The tumor is still located within the prostate gland but it has grown to a point where it can be felt during a rectal examination or imaged by ultrasound or other types of imaging study, there are often no symptoms 

3^rd stage 

The tumor has spread beyond the prostate to other areas near the gland 

4^th stage 

The tumor has spread and become fixed to other adjacent parts of the body, such as the rectum or bladder 

Metastatic 

The tumor has spread to lymph nodes, bones or elsewhere, symptoms such as bone pain, weight loss fatigue are common 

Grading prostate cancer 

In addition to stages, prostate cancer is graded to determine how aggressive or fast growing the tumor is 

The prostate biopsy specimen is graded according to the appearance under a microscope. There are several grading systems but the Gleason grading system is the most common. It ranges from a score of 2 (lowest) to 10(highest).lowest scores 2-4 mean they are usually less aggressive and slower to progress. A score of 5-7 is intermediate and a score of 8-10 means the cancer cells are more likely to be aggressive.

Symptoms and Homoeopathic Medicines:

1. Sabal serrulatha : this medicine has been recommended for various prostatic troubles, but its homoeopathic use seems confined to acute cases of enlarged and inflamed prostate, the gland is hot, swollen and painful, here also come in our regular inflammation polychrests, such as “aconite “ and “belladonna “ and it will not be necessary to go outside of them. Sabal is not altogether useless in senile hypertrophy, the writer has seen a marked palliative action in several cases and avoidance of surgical interference. 
2. Lycopodium: pressure in the perineum near anus while urinating. 
3. Conium: this remedy is useful in chronic hypertrophy of the prostate with difficulty in voiding urine, it stops and starts and there is an accompanying catarrh of the bladder. The suitability of conium to the complaints of the aged should be considered. 
4. China philla: gives occasional good results in relieving the tenesmus of frequent urination and general discomfort due to prostatic hypertrophy, spongia is also a remedy for this condition.
5. Thuja: frequent pressing to urinate with small discharge, patient strains much, stitches from rectum into bladder, discharge of prostatic juice in the morning on waking. 
6. Ferrum picratum: is one of the best medicines for prostate enlargements in the aged. 
7. Conium maculatum: is the stereotype of the elderly man who instead of growing wise, becomes obsessed with sex, he has problems with his prostate, which is enlarged and may even become cancerous. 

                               Medicines shall be taken on the advice of the doctor

Tips for a Healthy Prostate:

1. Limit consumption of high fat foods particularly red meat and dairy products.
2. Eat a lot of fruits and vegetables, especially tomato, and cruciferous vegetables like sprouts, cauliflower and others in the cabbage family 
3. Eat fish with a high omega-3 fatty acid content such as salmon 
4. Avoid alcohol 
5. Be physically active and maintain a healthy weight.

Diet and bowel preparation: the patient is given a bowel laxative to clear the bowels for the procedure, a little Vaseline around the back passage will prevent soreness, and the patient should commence a liquid diet after taking the bowel laxative.

The following clear liquids are allowed ; fruit juices, apple, cranberry, grape, strained orange juice, desserts jellies fruit ices beverages –coffee, tea, lemon/ orange drinks soups ; any strained soups, no alcohol strictly 

Remember to drink as much fluid as possible prior to your examination, the nursing staff will administer an enema.