Articles on prostate

Let’s Not Leave the Men Out: Trends in Prostate Cancer Research

Ms. Samara Mahindra, Dietitian/Nutritionist
The risks of getting prostate cancer depend on a variety of factors. Scientists have been studying the various effects of prostate cancer. Scientists have found that certain foods when included in your diet can significantly lower your risk of developing cancer. Tomatoes and soybeans contain chemical compounds that can help in preventing prostate cancer.Tomatoes contain Lycopenes and soybeans contain Isoflavones. Based on this research some scientists are trying to create compounds synthetically that can be used as nutritional supplements, however supplements should be taken with caution. Other substances that could have beneficial chemical compounds include pomegranate, green tea, broccoli, turmeric, flaxseed, and soy.In the United States, there were 190,000 new prostate cancer cases accounting for 10% of all new cancer cases. The means of detecting prostate cancer are not perfect as many of the tests used for detection are still not very accurate. Prostate cancer is rare among men under the age of 40. As age increases the risk of getting prostate cancer also increases. Some researchers are also working on vaccines for prostate cancer. These vaccines cannot prevent prostate cancer but they can help in the treatment of it. This vaccine enables the patient’s immune system to recognise cancer cells earlier and thereby helps in destroying them. As scientists develop better techniques for the detection and treatment of prostate cancer, the mortality rate for this type of cancer will dramatically come down.

Grave Misconceptions About Prostate Cancer

Dr. Anish Kumar Gupta, Andrologist
Prostate Cancer remains one of the least talked about cancers in general public at-least in India. Hence there remains a great deal of confusion surrounding this disease.Ask any group of men about prostate cancer – some might have few notions of their own unsubstantiated by medical information, other might change the topic and a couple may have few jokes ready too.Most men who have ever heard about a Prostate Specific Antigen (PSA) will say so, that the PSA is the benchmark for Cancer Prostate diagnosis for them and their physicians1. Prostate cancer is an old man’s disease.WRONG!The more likely you are to be diagnosed with prostate cancer (65% of cases are diagnosed in men who are 65 or older)35% men are diagnosed at an early ageAge Wise incidence:   < 40 Years:  1 in 10,000 men      40 – 50 Years: 1 in 40 to 60 men.      60 – 69 Years: 1 in 15 men.There are many risk factors to consider - Your race, family history, physical health  and lifestyle—even geographic location.2. If you don’t have any symptoms, you don’t have prostate cancer.WRONG!Prostate cancer is one of the most asymptomatic cancers in oncology, meaning not all men experience symptoms.Many times symptoms can be mistaken or attributed to something else.Signs of prostate cancer are often first detected by a doctor during a routine check-up. Common symptoms include a need to urinate frequently, difficulty starting or stopping urination, weak or interrupted flow of urination, painful or burning urination, difficulty having an erection, painful ejaculation, blood in the urine or semen, or frequent pain and stiffness in the lower back, hips or upper thighs. If you experience any of these symptoms, be sure to tell your doctor.3. Prostate cancer is a slow growing cancer I don’t need to worry about.The answer to this one is sometimes, yes. Sometimes, no. Aggressiveness can be commented upon ONLY AFTER BIOPSY keeping in mind patient’s age and health status. Patients need to understand the complexity of this disease and make treatment decisions that are right for them in consultation with a trusted Urologist.4. Prostate cancer doesn’t run in my family, so the odds aren’t great that I will get it? WRONG!While a family history of prostate cancer doubles a man’s odds of being diagnosed to 1 in 3. This compares to 1 in 8 women who will be diagnosed with breast cancer.Family history and genetics do, however, play a role in a man’s chances for developing prostate cancer. A man whose father or bother had prostate cancer is twice as likely to develop the disease. The risk is further increased if the cancer was diagnosed in a family member at a younger age (less than 55 years old), or if it affected three or more family members.5. The PSA test is cancer test.WRONG!The PSA tests measures levels of prostate-specific antigen in the prostate, not cancer. PSA is produced by the prostate in response to a number of problems that could be present in the prostate including an inflammation or infection (prostatitis), enlargement of the prostate gland (benign prostatic hyperplasia) or, possibly, cancer. Think of it as a first alert smoke alarm, instead of a fire alarm.  The PSA test may be the first step in the diagnostic process for cancer.  It has made detection of cancer in its early stages, when it is best treated, possible. Experts believe the PSA test saves the life of approximately 1 in 39 men who are tested. The flip side is also the fear of over detection of cancer, which may not affect the patient in his lifetime. This is supported by various Cancer Watchdog Organizations world over.This article is the first of a two part series. Watch out this space for more debunked myths such as-6. A High PSA level means that you have prostate cancer and a Low PSA means you do not have prostate cancer.7. Treatment for prostate cancer always causes impotence or incontinence.8. Sexual activity increases the risk of developing prostate cancer.9. You can pass your cancer to others.10. TURP / Endoscopic Procedure is Adequate treatment for Cancer Prostate 

Prostate Cancer - Risk Factors, Signs And Treatment

Dr. Anish Kumar Gupta, Andrologist
What is Prostate Cancer?Cancer is a disease in which cells in the body grow out of control. When cancer starts in the prostate, it is called prostate cancer. What Is the Prostate?The prostate is a part of the male reproductive system, which includes the penis, prostate, and testicles. The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). It produces fluid that makes up a part of semen. As a man ages, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow. This is called benign prostatic hyperplasia, and it is not the same as prostate cancer. Men may also have other prostate changes that are not cancer.What Are the Risk Factors?Research has found risk factors that increase your chances of getting prostate cancer. These risk factors include:Age: The older a man is, the greater his risk for getting prostate cancer.Family history: Certain genes (the functional and physical units of heredity passed from parent to offspring) that you inherited from your parents may affect your prostate cancer risk. Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself.Race: Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why. Researchers are trying to determine the causes of prostate cancer and whether it can be prevented. They do not yet agree on the factors that can influence a man’s risk of developing the disease, either positively or negatively.Some drugs lower the risk of getting prostate cancer, but whether they can help lower the risk of dying from prostate cancer is still unclear. Regular use of multivitamins has not been proven to increase or decrease the risk of early or localized prostate cancer. Talk to your doctor about multivitamin use.What Are the Symptoms of Prostate Cancer?Different people have different symptoms for prostate cancer. Some men do not have symptoms at all.Some symptoms of prostate cancer are:Difficulty starting urination.Weak or interrupted flow of urine.Frequent urination, especially at night.Difficulty emptying the bladder completely.Pain or burning during urination. Blood in the urine or semen.Pain in the back, hips, or pelvis that doesn’t go away.Painful ejaculation. If you have any symptoms that worry you, be sure to see your doctor right away. Keep in mind that these symptoms may be caused by conditions other than prostate cancer.Should I get screened for Cancer Prostate ?Informed Decision Making - Most urologists support informed decision making. Informed decision making occurs when a man:Understands the nature and risk of prostate cancer.Understands the risks of, benefits of, and alternatives to screening.Participates in the decision to be screened or not at a level he desires.Makes a decision consistent with his preferences and values. We need better ways to screen for and treat prostate cancer. Until we make these discoveries, and even when we do, men and their families will turn to trusted health care professionals to help them make informed decisions.How Is Prostate Cancer Diagnosed?If your prostate specific antigen (PSA) test or digital rectal exam (DRE) is abnormal, doctors may do more tests to find or diagnose prostate cancer. Transrectal ultrasound: A probe the size of a finger is inserted into the rectum, and high-energy sound waves (ultrasound) are bounced off the prostate to create a picture of the prostate called a sonogram. This test may be used during a biopsy.Biopsy: A small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.Gleason score: This score is determined when the biopsy is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2–10. The lower the score, the less likely it is that the cancer will spread.Staging If prostate cancer is diagnosed, other tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. This process is called staging. Whether the cancer is only in the prostate, or has spread outside the prostate, determines your stage of prostate cancer. The stage of prostate cancer tells doctors what kind of treatment you need.How Is Prostate Cancer Treated?Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. Some common treatments are:Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms.Surgery. A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue.Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer. There are two types of radiation therapy—External radiation therapy. A machine outside the body directs radiation at the cancer cells or Internal radiation therapy (brachytherapy). Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells. Brachytherapy is not available in IndiaHormone therapy. Blocks cancer cells from getting the hormones they need to grow.Other therapies used in the treatment of prostate cancer that are still under investigation includeCryotherapy. Placing a special probe inside or near the prostate cancer to freeze and kill the cancer cells. Not available in India.Chemotherapy. Using special drugs to shrink or kill the cancer. The drugs can be pills you take or medicines given through your veins, or, sometimes, both.Biological therapy. Works with your body's immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.High-intensity focused ultrasound. This therapy directs high-energy sound waves (ultrasound) at the cancer to kill cancer cells.Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor before you start any kind of complementary or alternative medicine.Which Treatment Is Right For Me?Choosing the treatment that is right for you may be hard. Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects.Sometimes people get an opinion from more than one cancer doctor. This is called a “second opinion.” Getting a second opinion may help you choose the treatment that is right for you.

Lower Your Chances of Getting Prostate Cancer

Dr. Anish Kumar Gupta, Andrologist
To understand how to prevent prostate cancer, one must first understand what causes it. There are three major factors that influence one's risk for developing prostate cancer.Age: Prostate Cancer is common after 65 years of age. There is no average age for diagnosis in India but internationally it is proposed to be around 69 years. The incidence increases every year after that age.Race: All over the world, Asian men who live in Asia have the lowest risk; however when they migrate to the west, their risk increases. Family history: A man with a father or brother who developed prostate cancer has a 2 times risk for developing it. This risk is further increased if the cancer was diagnosed at a younger age (less than 55 years of age) or affected three or more family members.The factors above are difficult or cannot be changed, however, there are many things that men can do to reduce or delay their risk of developing prostate cancer.  All things listed below do not have a very high level of evidence at present, but our research associates world over are working hard to find probable environmental and contributory causes. Why is prostate cancer so common in the Western culture and much less so in Asia, and why when Asian men migrate to western countries the risk of prostate cancer increases over time? We believe the major risk factor is diet – foods that produce oxidative damage to DNA. What can you do about it to prevent or delay the onset of the disease?1. Eat lesser calories and exercise more to maintain healthy weight.2. Decrease the amount of fat from non-vegetarian diet and dairy products to a minimum.3. Watch your calcium intake. Do not take supplemental doses far above the recommended daily allowance.4. If you take a mixed diet: Eat more fish – they have "good fat" particularly omega-3 fatty acids. Avoid trans fatty acids (found in ghee / margarine).5. Other antioxidant foods, which may be included, are: Cauliflower, tomatoes cooked in olive oil, soy and green tea are also potential dietary components that may be helpful in moderate amounts.6. Avoid smoking for many reasons. Drink alcohol in moderation, if at all.7. Seek medical treatment for stress, high blood pressure, high cholesterol, and depression. Treating these conditions may save your life and will improve your survivorship with prostate cancer8. What about supplements? Avoid over-supplementation with megavitamins. Too many vitamins, especially folate, may “fuel the cancer”, and while a multivitamin is not likely to be harmful, if you follow a healthy diet with lots of fruits, vegetables, whole grains, fish, and healthy oils you likely do not even need a multivitamin.9. Relax and enjoy life. Reducing stress in the workplace and home will improve your survivorship and lead to a longer, happier life.10. All of these advises together will not take away the risk of having cancer prostate to zero, hence if there are risk factors present, one must talk to his Urologist about screening for Prostate Cancer, its various modalities and risks and benefits.

Prostrate Cancer: Early Detection Can Help Your Chances

Dr. Sandeep Nayak, Surgical Oncologist
In India, prostrate is the second leading site of cancer among males in large cities like Delhi, Kolkata, Pune and Thiruvananthapuram, third leading site of cancer in cities like Bangalore and Mumbai and it is among the top ten leading sites of cancers in the rest of the country. Usually, prostate cancer is a very slow growing cancer and most people do not have major symptoms until the cancer reaches an advanced stage. Most men with prostate cancer die of other unrelated causes, and many never know that they have the disease.Factors that can increase the risk of prostate cancer include:Age: Risk of prostate cancer increases with age. Out of every 10 prostate cancers, 6 are detected in men above 60 years of age.Diet: Consumption of excess calcium through food (especially dairy foods) or supplements has been linked with higher risk of developing prostate cancer.Family history: Prostate cancer seems to run in families which suggest a genetic or inherited factor involved in its causation. Hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome in which large bowel cancer is the most common feature, is caused by inherited gene changes that carry an increased risk for many cancers including prostate cancer.Screening and Early Detection    Early detection of cancer can often be done by testing the amount of prostate-specific antigen (PSA) in a man’s blood sample. Another way to find prostate cancer early is the digital rectal exam (DRE).If the results of either one of these tests are abnormal, further tests are performed to see if there is a cancer. The  prostate cancer found as a result of screening with the PSA test or DRE, will probably be at an earlier, more treatable stage than if no screening were done. However, neither the PSA test nor the DRE is 100% accurate.Treating Prostate CancerNowadays, robot-assisted radical prostatectomy has become the standard of care for prostate cancer throughout the world. In this approach, the laparoscopic surgery is done using a robotic interface (called the da Vinci system). The surgeon sits at a control panel in the operating room and moves robotic arms to operate through several small incisions in the patient’s abdomen.Robotic prostatectomy has advantages over the open approach in terms of less pain, blood loss, and recovery time. For the surgeon, the robotic system provides more maneuverability and more precision when moving the instruments than standard laparoscopic radical prostatectomy (LRP).

Are You as Healthy as You Think You Are?

Dr. Vishwas Virmani, Physiotherapist
The best way to eliminate the possibility of getting sick is knowing exactly what you are in for. Here are a few basic health checks that you need to do to check whether you are healthy or not:A mighty heartKeep an eye on your triglyceride levels with blood and blood pressure tests. Get your weight regularly checked to eliminate the possibility of clogged arteries that can hamper the pumping of your heart. Lumps and bumpsWhile a lump in your throat is ok, a lump in your breasts is a definite red light. Do regular self examinations in the shower to make sure there is nothing odd with your breasts and schedule a mammography every two years. Sweet tooth troublesIf you don't deny yourself long walks to the fridge every night, then a test for diabetes is something you cannot ignore. This lifestyle disease has a way of sneaking up on you when you least expect it. Prostate, Yes, we have to talk about itApprehensive as you may be about this one, a prostate check is recommended if you are a man above the age of 45. Prostate cancer is aggressive and difficult to treat, and early detection is key to recovery. Achy jointsAches and pains are classic old age problem. Take a bone density check to see if you are at risk for osteoporosis as this is one condition that is becoming common by the day. Seeing eye to eyeIf you are squinting at your laptop screen chances are that your eyesight is not what it used to be. Diseases such as glaucoma, cataract, and retinopathy are common these days and it is recommended that you get a thorough exam done every year. 

Health Benefits of Pumpkin Seeds

Ms. Ashu Gupta, Dietitian/Nutritionist
1. Heart Healthy MagnesiumOne-quarter cup of pumpkin seeds contains nearly half of the recommended daily amount of magnesium, which participates in a wide range of vitally important physiological functions, including the creation of ATP (adenosine triphosphate, the energy molecules of your body), the synthesis of RNA and DNA, the pumping of your heart, proper bone and tooth formation, relaxation of your blood vessels, and proper bowel function.2. Zinc for Immune SupportPumpkin seeds are a rich source of zinc (one ounce contains more than 2 mg of this beneficial mineral). Zinc is important to your body in many ways, including immunity, cell growth and division, sleep, mood, your senses of taste and smell, eye and skin health, insulin regulation, and male sexual function.3. Prostate HealthPumpkin seeds have long been valued as an important natural food for men's health. This is in part because of their high zinc content, which is important for prostate health (where it is found in the highest concentrations in the body), and also because pumpkin seed extracts and oils may play a role in treating benign prostatic hyperplasia (BPH, or enlarged prostate). Research suggests that both pumpkin seed oil and pumpkin seed may be particularly beneficial in supporting prostate health.4. Anti-Diabetic EffectsAnimal studies suggest that pumpkin seeds may help improve insulin regulation and help prevent diabetic complications by decreasing oxidative stress.5. Heart and Liver HealthPumpkin seeds, rich in healthy fats, antioxidants and fibers, may provide benefits for heart and liver health, particularly when mixed with flax seeds.

Let's Talk About Men's Health!

Dr. Anish Kumar Gupta, Andrologist
In general, men have poorer health habits, poorer quality of health and shorter life expectancy than women. This may be because they are more likely to engage in unhealthy behaviour, and are at times less likely than women to adopt preventive health measures. But men’s health issues don’t affect only men - they have a significant impact on their family and friends, too.The conditions we will talk about can influence everything from sexual and marital relations to quality and length of life. Unfortunately, a lot of these issues - particularly the ones having to do with sex or masculinity - are very hard for men to talk about.TestosteroneTestosterone is the most important hormone for the normal growth and development of male sex and reproductive organs. it’s possible for the development of male characteristics such as body and facial hair, muscle growth and strength, and deep baritone of voice. Normal levels influence sexual function and production of sperm, and promote a healthy sex drive.Men’s testosterone levels naturally decrease as they age. But if the levels drop below the normal range - whether because of age, injury to the testicles, pituitary gland or hypothalamus, or a genetic disorder - some uncomfortable and often distressing symptoms may develop, including:1.     Diminished interest in sex.2.     Regression of secondary sexual characteristics, such as facial hair and deepening of the voice3.     Impotence or Erectile Dysfunction.4.     Depression5.     FatigueAs many as 50 million men are assumed to be suffering from testosterone deficiency, often associated with a condition called hypogonadism, but less than 1% receive treatment in India. Left unchecked for two long, this condition is linked with significant, long term health problems, such as loss of muscle mass and even osteoporosis.Fortunately, though, testosterone deficiency is usually very treatable.Treatment can take the form of testosterone replacement therapy, which helps provide and maintain normal levels of testosterone. Men should ask their doctors whether testosterone replacement therapy is appropriate for them.Hypogonadism is covered in another article written by me.ProstateThe prostate is a walnut sized gland that manufactures fluid for semen. It’s located just in front of the rectum, an area of the body that men are often embarrassed to talk about.Prostatitis is a significant health concern for men. While the cause of prostatitis are not well understood, it is believed that the condition might be caused by a bacterial infection or a inflammatory autoimmune response similar to that seen with allergies and asthma. Symptoms may include a discharge, discomfort, pain in the prostate or testicles, or frequent urination. A urologist should be consulted for proper treatment.The prostate naturally enlarges as men age. Early affects of this growth ( called BPH for benign prostatic hypertrophy) include painful urination or difficulty starting or stopping the stream of urine. Left untreated, BPH can lead to more serious problems, such as urinary tract infections, bladder and kidney damage, kidney stones or incontinence.Prostate CancerIt is the one of the most common cancer in men. Every year, over 200,000 men are diagnosed with this disease, and approximately 30,000 die. But if caught early, through either a digital rectal examination (DRE) or a prostate specific antigen (PSA) blood test, this disease is often treatable. In the early stages, prostate cancer causes no symptoms. However, as the disease develops, so do the red flags. Men should notify a doctor immediately if they notice any of the following1.     Hip or back pain.2.     Difficulty urinating.3.     Painful or burning urination.4.     Blood in the urine.A man may consider a baseline prostate specific antigen after knowing and understanding the natural history of the disease, complications of treatment and life expectancy. The baseline test can be done at an age of 40 years, though, recommendations vary. Asian population at large is known to have less incidence of prostate cancer as compared to our western counterparts. (Who is fit for Prostate Cancer Screening, would be covered in different article) TreatmentOptions for Cancer Prostate include surgical removal of Prostate, radiation, hormone therapy, immunotherapy and cryosurgery. Men with localised, low risk prostate cancer might choose active surveillance, closely monitoring the cancer to see if it progresses or becomes aggressive, to determine if treatment is needed. Options and possible side effects of treatment should be discussed with a urologist.Prostate cancer - Misconceptions Part 1 has been covered in another article.Testicular CancerCancer of the testicles is the most common cancer in the ages 15 to 35. Although it can’t be prevented, it has a high cure rate if detected early. Early detection is the key to success.Symptoms include:1.     Lumps / enlargement of testis.2.     A feeling of pulling or unusual weight in the scrotum.3.     Pain / discomfort in the testis or scrotum4.     Dull ache in the lower abdomen5.     Enlargement or tenderness of the breasts..The best way to spot testicular cancer is by doing a self examination. Unfortunately, too few boys and young men know that they should examine their testicles monthly, even fewer know how to do these exams, and too many feel uncomfortable touching themselves “down there”. So ask your loved one whether he knows how to do a testicular exam. If he doesn’t, encourage him to talk to his doctor about the proper way to do one. We will be also covering this topic in further articles.Testicular Self Examination has been covered in another article.ERECTILE DYSFUNCTION / IMPOTENCEIt is the inability of a man to get or to maintain an erection sufficient for his sexual needs or the needs of his partner. ED is incredibly common - most men have it briefly at some point in their lives. But for a many as 50 - 60 million men in India, ED is a chronic condition.Although ED becomes more common with age, men of any age can suffer with it. Sadly, they generally refuse to discuss  it with either their partner or their doctors. As a result, men feel embarrassed and women in their life often feel that the man in their life doesn’t find them attractive. So if you want to make love and your husband says he has a headache, pay attention; it might be something far more serious.Although 70% of the time, ED is caused by an underlying health problem, most often diabetes (as many as half of all men with diabetes suffer from ED). ED may also be caused by kidney disease, high blood pressure, high cholesterol, and drug or alcohol abuse or hypogonadism. The remaining 30% of the cases are cause by stress, anxiety, depression, or sometimes the medications used to treat these conditions.In most cases whether ED is caused by a physical or physiological problem, it’s treatable, which means it does not have to be natural or inevitable part of growing older. Treatments include drug therapy, penile implants, vacuum devices that manually create an erection, injections, or other alternatives. Your loved one should talk to his doctor to determine the cause and the most appropriate treatment.Erectile Dysfunction has been covered in detail in another article.