Tuesday, September 8, 2009

The Changing Face Of Prostate Care

Most men do nothing to look after their prostates. They spend more time looking after their hair or teeth. Baldness or rotten choppers are seldom life-threatening, but a rotten prostate will kill you quick. As the second leading cause of cancer death in American men, prostate cancer carries a lifetime risk nearly double that of breast cancer.Whether you are 20 or 50, you should start taking care of that pesky little gland today.

Twenty years ago, the standard treatment for BPH and early stages of prostate disease was transurethral resection of the-prostate (TURP). In other words, whip it out. But the high rates of impotence, incontinence and other side-effects of this arcane little surgery, have prompted most urologists to seek other ways to remove chunks of overgrown prostate tissue.

Less invasive surgeries include transurethral incision (TUIP), electroevaporation, transurethral needle ablation, ultrasound destruction and laser prostatectomy. Surgeons today can even burn out bits of your prostate by microwaving. All these procedures are less effective than TURP and have almost as high rates of side-effects. Whether or not you are still able to have erections on command, sex without pain, and urinate only when you want to, depends on the skill of the surgeon wielding the instruments. And prostate surgery is not reversible.


The Move To Drugs

In contrast, non-surgical drug therapies for BPH are both controllable and reversible. It is not surprising then that prostate medicine has moved in that direction. There are still many older physicians who were trained long ago to whip out the prostate at the first sign of trouble. If you run into one, get a second opinion. Chemo-control is a much better way to go.

Androgen-blockers, which eliminate bodily production of testosterone and dihydrotestosterone, cause rapid prostate shrinkage and rapid reduction of the prostate specific antigen (PSA) score. But they also cause almost 100% impotence. In addition, they carry a high rate of depression, because, as I have documented elsewhere, normal testosterone levels are essential for emotional well-being. The only consolation is that the course of therapy is usually less than one year, and the side-effects are reversible.

Alpha-adrenoceptor antagonists block testosterone and dihydrotestosterone receptor sites on prostate cells (and other body cells). They cause relaxation of the smooth muscle of the prostate, with consequent improved urination, ejaculation and reduction of symptoms of BPH. These drugs work quickly to relieve symptoms, but do nothing to reduce prostate size. Also, the symptom reduction is moderate, overall about 20%.

The main culprit in prostate overgrowth is dihydrotestosterone . The most effective drugs for prostate problems are those that block the enzyme alpha-5-reductase, which converts testosterone to dihydrotestosterone. And the best news from studies on these drugs' effects is that men with the largest prostates benefited the most.

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For more information on prostate disorders and their treatment options go to: Prostate Health Supplements