Prostate Cancer CCNM Webinar 2023 PDF

 Men’s Health: Prostate Cancer Dr. Terry Vanderheyden, ND, RH Canadian College of Naturopathic Medicine November 20, 2023 2  Men’s Health Focus on Prostate Cancer - Disclosures...

 Men’s Health: Prostate Cancer Dr. Terry Vanderheyden, ND, RH Canadian College of Naturopathic Medicine November 20, 2023 2  Men’s Health Focus on Prostate Cancer - Disclosures 3  Prostate Cancer is a Men’s Health Issue AGENDA Prostate Cancer (PCa) – Anatomy of the male reproductive system – Overview of hormone physiology in men – PCa stats and epidemiology – PCa diagnostics – Speculation and evidence regarding causes Dietary prevention? – Specific nutrients for prevention? Natural approaches and Evidence for same Anatomy of the male reproductive system Anatomy of the male reproductive system Anatomy of the male reproductive system Anatomy of the male reproductive system Anatomy of the male reproductive system Anatomy of the male reproductive system - hormonal Anatomy of the male reproductive system - hormonal Prostate Cancer: A Leading Cancer for Men Stats Prostate cancer is the most common cancer found in men. It is the 3rd leading cause of death from cancer in men in Canada. In 2022, an estimated 24,600 Canadians will be diagnosed, or 20% ​of all new cancers 4,600 men died from prostate cancer. 10% of all cancer deaths in men in 2022 Prostate Cancer: Testing “There is no consistent documentation to show that prostate cancer treatment by radical prostatectomy or radiotherapy reduces mortality or prolongs life. However, both treatment modalities are associated with considerable side effects, the most important being impotence and incontinence.” – Norderhaug et al 2003  Prostate Cancer: Testing “Early detection has not proven to be beneficial, in contrast to some other cancers. PSA may indicate prostate disease but is not a specific marker for prostate cancer. There is no conclusive evidence that treating prostate cancer saves lives. Treatment is associated with bothersome complications. According to current knowledge, no treatment until disease progression (‘‘wait and see’’) is an appropriate alternative for men with prostate cancer without symptoms of disease.” – Norderhaug et al 2003 Prostate Cancer: Testing. “PSA is not a reliable test for early prostate cancer detection.. If you are a healthy man, there is no documented benefit from finding out that you might have prostate cancer.. Treating prostate cancer may cause complications without curing the cancer.. The decision is yours.” – Norderhaug et al 2003 Prostate Cancer: Testing. “…in order to prevent one prostate-cancer death, the number of men who would need to be screened would be 1410 … The additional prostate cancers diagnosed by screening resulted in an increase in cumulative incidence of 34 per 1000 men … 48 additional subjects … would need to be treated to prevent one death from prostate cancer..” – Schröder et al 2009 Prostate Cancer: Testing From 1999 to 2009, 82,429 UK men, 50 and 69 years of age received a PSA test. Localized prostate cancer diagnosed in 2664 men. Of these men, 1643 were enrolled in a trial 545 randomly assigned to receive active monitoring, 553 to undergo prostatectomy, and 545 to undergo radiotherapy. Prostate Cancer: Testing Men were followed until 2020, for an average of 15 years (range, 11 to 21 years) Prostate Cancer: Testing 1/3 had intermediate or high-risk disease at diagnosis. 45 men (2.7%) died from PCa: 17 (3.1%) in the active-monitoring group, 12 (2.2%) in the prostatectomy group, and 16 (2.9%) in the radiotherapy group (P = 0.53 for the overall comparison). Death from any cause occurred in 356 men (21.7%), with similar numbers in all three groups. Prostate Cancer: Testing Metastases developed in: 51 men (9.4%) in the active-monitoring group, in 26 (4.7%) in the prostatectomy group, and in 27 (5.0%) in the radiotherapy group. Prostate Cancer: Testing Conclusions: “After 15 years of follow-up, prostate cancer–specific mortality was low regardless of the treatment assigned. Thus, the choice of therapy involves weighing trade-offs between benefits and harms associated with treatments for localized prostate cancer.” “No treatment complications were reported after the 10-year analysis.” yeah right. Prostate Cancer: Symptoms Changes in bladder habits: Frequent urination, especially at night Urinary urgency Difficulty in initiating or stopping the urine flow Inability to urinate Weak or decreased urine stream Interrupted urine stream A sense of incompletely emptying the bladder Burning or pain during urination Blood in the urine or semen Painful ejaculation Prostate Cancer: Differential Diagnosis Benign prostatic hyperplasia (BPH): Non‐cancerous enlargement of the prostate. A common occurrence as men age Urinary symptoms can be similar between BPH and cancer Treatments: Saw palmetto; Nettle root Prostatitis: Infection or inflammation of the prostate. Prostatitis can cause elevated PSA levels. 25% of men with urinary symptoms have prostatitis. Two forms: acute and chronic Antibiotics are often prescribed Treatments: equal parts goldenrod, Chimaphilla, and mullein Prostate Cancer: PSA PSA level greater than 2.5 are considered suspicious Must be evaluated relative to the size of the prostate. Normal prostate secretes PSA at an average rate of 0.07ng/ml prostate-specific antigen (PSA) For example, a PSA of 4.5 with a prostate of 30ml is worse than a PSA of 7.5 with a Prostate of 110ml (huge). For the 30ml patient, this natural production accounts for 2.1 out of the total score of 4.5 —only half. For the 7.5 patient, however, it accounts for all of the PSA. Prostate Cancer: PSA Doubling Time (PSADT) Baseline PSA level Repeat the PSA at 3- or 6-month intervals ($30 in Ontario) PSADT