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.

___________________________________________________

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

That Pesky PSA

It is important to understand that the PSA test has one of the highest false-positive rates of any medical test used today. It's bad business. It is very common to score high on the PSA but show no trace of cancer when subjected to a biopsy, and vice versa.

In one of the latest trials, in 78% of the cases, PSA results of men with prostate cancer are negative, assuring those men that they do not have prostate cancer. By failing to detect it, the PSA falsely classifies them as healthy. Consequently, they take no action to protect their prostates, allowing the disease to progress unchecked.

Worse, when you examine correct cancer diagnosis by the PSA, the rate of detection is just over 20%. So, for every one hundred cases of real prostate cancer, the PSA detects only about 20. And, from the study above, for each one of these 20 it also falsely detects a non-existent cancer in a healthy man. Imagine the effect on your life if you were one of those men falsely predicted by the PSA to be suffering from cancer.

In sum, the PSA predicts as many non-existent cancers as it does real cancers, and misses most of the real cancers anyway.

Even If You Have A Tumor

Even if a localized prostate tumor is correctly detected by the PSA, it may not be a big problem. Autopsy studies of old men who die from other causes show that about one man in every three has a malignant tumor of the prostate — a tumor that was not involved in his death, was never treated, and probably did not cause any great health problem during his life.

Prostate tumors are mostly slow growing and can sit there unnoticed and without symptoms for 20 to 30 years. That's probably the reason why there's no controlled evidence showing that PSA detection of cancer has had any effect whatsoever in reducing prostate disease, or in reducing deaths from prostate cancer. As explained above, existing evidence points in exactly the opposite direction.

In sum, the PSA predicts as many non-existent cancers as it does real cancers, and misses most of the real cancers anyway. Despite all this hard evidence, The American Cancer Society (which positions itself as a medical authority, but is not) recommends the PSA, and has been largely responsible for the growth in use of this inaccurate and soul-destroying test. And some uninformed medicine men take it as gospel.

On the other hand, the International Union Against Cancer advises against routine PSA testing. So does the Canadian Task Force on Periodic Health Examinations. The official health authority in the US, the Preventive Services Task Force, came down solidly against the PSA in its Guide to Clinical Preventive Services, and does not recommend its use.

Thumbs down on the PSA, however, doesn't mean you can forget about your prostate. Latest figures show that prostate cancer is the second leading cause of cancer deaths of American men. You definitely don't want BPH progressing into cancer. And there are ways to prevent it. If you have the beginnings of a waterworks problem, or even the anticipation that you will develop one in the future, read on for the details.

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