Deadly silence about prostate cancer

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A FORM of cancer affecting the reproductive system kills more than 500 Filipino men each year, according to Global Health Statistics.

Inside the male body, a walnut-shaped gland normally the size of a ping-pong ball sits below the bladder. This gland is called the prostate.

As one of the most important organs involved in male reproduction, it produces fluids that protect the sperm during ejaculation.

As the human body ages, the prostate has a tendency to become enlarged, resulting into a minor condition known as benign prostatic hyperplasia (BPH). BPH is a normal occurrence in the elderly male—caused by hormonal changes during the aging process.

Meanwhile, an abnormal, sudden growth of this gland may lead to cancer dubbed as “the silent killer of men” orprostate cancer.

“Symptoms are not usually that alarming—sa una dedma lang iyong mga pasyente,” Dr. Anita Sangalang, a professor from the Faculty of Pharmacy, said in an interview with the Varsitarian. “They go for check-ups only when the symptoms are serious.”

The first symptom of prostate cancer is difficulty in urination, which is caused by blockage in urine flow due to the enlarged prostate.

Sangalang added that most patients misdiagnose difficulty in urination only as urinary tract infection (UTI).

“If ignored, this may lead to loss of weight and presence of blood in the urine, which are indicative symptoms for middle stage prostate cancer,” she said.

“Lung cancer is reported [more] because the symptoms are cough and difficulty of breathing. Kapag nahihirapan kang huminga mas matatakot ka, as opposed to painful urination in prostate cancer.”

Mysterious causes

“The cause of prostate cancer is usually not well-explained. Nothing has been proven yet,” Sangalang said.“Perhaps the most usual cause would be genetic.”

However, even with a history of prostate cancer in the family, a patient may only exhibit a 5 to10 percent chance of developing it.

Age, diet and race could also contribute to its progression. In a study done by the Philippine General Hospital, it was found that Asians are classified under the low-risk category for developing and dying from prostate cancer.

“This type of cancer is more frequently found in African Americans and in men above the age of 50.” Sangalang added.

She was also skeptical regarding the popular belief that men who ejaculate more in their twenties are less to develop prostate cancer as they grow older.

“I don’t think that’s scientifically backed-up. Wala pa naman akong nababasang ganoon,” she said.

Diagnosis and treatment of the disease

One of the simplest ways to detect the possibility of prostate cancer is to measure prostate specific antigens (PSAs) present in the blood. PSA is a protein produced by the prostate, and an elevation of this antigen could possibly be a sign of prostate damage.

However, an increase of PSAs is not a definitive diagnosis for prostate cancer. “It could also be just BPH or prostatitis,” Sangalang said.

Prostatitis a condition when the prostate gets inflamed due to infection or other causes.

Sangalang added that the next step after PSA measurement is to consult a urologist—a specialist of the urinary tract—and have a digital rectal examination done.

A digital rectal examination is performed by inserting a finger through the anus to assess any abnormal enlargement or hardening of the prostate. If there is evidence of prostate growth, the urologist can request for a biopsy of the prostate tissue for further analysis.

Sangalang, who teaches pharmacology, commented on the different approaches to prostate cancer treatment.

“There are a variety of options for treatment, but it all really depends on the cancer stage,” she said.

During the first and second stage, the tumor is confined only to the prostate and is ideally controllable. Chemotherapy or surgery can be done when cancer is detected in these stages.

If the cancer is already in the late stages—metastasis occurs, and management becomes difficult.

“Metastasis is the spread of the tumor to other organs,” Sangalang said. “During Stage 3, the cancerous cells start to spread to nearby organs. [This] is followed by Stage 4, in which the distant organs are already involved.”

Chemotherapy and radiotherapy are the most common treatments, which aim to eradicate cancer cells from the body.

Radiotherapy reduces tumor sizes by radiation, which presents more side effects. “Adjacent organs that should not be exposed to radiation are exposed during radiotherapy.” Sangalang said.

She also stressed about the role of the physician to lay out all the options of the patient regarding the treatment.

While there is no conclusive way to prevent prostate cancer, lifestyle modifications such as lessening red meat consumption and maintaining a healthy weight may reduce its occurrence.

Sangalang also recommends routine check-ups to monitor a patient’s susceptibility to the disease. “It really is the patient’s responsibility. Regular check-ups are preventive,” she said.

A patient’s survival increases tremendously when prostate cancer is detected and treated at the initial stages. Perhaps then, routine check-ups, together with a healthy lifestyle, may just render the silent killer neither silent, nor a killer.

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