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Prostate Cancer Treatment versus Prostate Cancer Prevention

Posted Dec 05 2009 7:02am

Most forms of prostate cancer treatment are generally effective but can't be used to prevent this disease. This includes ADT - anti-deprivation therapy to suppress testosterone. Yet some individuals confuse prostate cancer treatment and prevention.This came across recently in some misplaced comments I read on another blog. Its author imparted some accurate comments interspersed with some comments that misinform rather than enlighten. 

For instance he wrote that "the prostate gland found under the bladder, that’s necessary for correct sexual function in men, becomes cancerous thanks to a flux in testosterone." He also advocates prostate message, implying this is another way to prevent prostate cancer. I'd like to explain why these are mistaken or imprecise assertions by first restating each one and then offering my comments. 

* Assertion: "The prostate gland ...is necessary for correct sexual function." If by "correct" you mean "normal" sexual functioning, that sounds less judgmental, but is still unclear. It would be more precise to say that the prostate is a gland that helps a man produce and ejaculate semen. After surgery or other treatment, the removal of the prostate and adjacent seminal vesicles makes it impossible for a man to ejaculate. But after treatment men can have dry orgasms. Besides, most prostate cancer patients over time can still have an erection, whether spontaneous or induced by medical prescriptions or devices. 

* Assertion: The prostate gland "becomes cancerous due to a flux in testosterone."  This statement is incorrect. Currently scientists do not know what causes prostate cancer. If is true, though, that suppressing testosterone with ADT (antigen deprivation therapy) is one of several treatment options to prevent cancer of the prostate from spreading further (metastasizing)  in a man's body after he develops prostate cancer. ADT reduces the level of testosterone which is a source of prostate cancer growth. In addition, majority of men (5 out of 6), regardless of whether their testosterone level is in flux (going from low to high and back) will not have to face a prostate cancer diagnosis. 

* Assertion: “Prostate milking” (or "message") is helpful in preventing prostate cancer, especially if a man doesn’t regularly ejaculate. This is not true and remains unproven. However, a prostate message can provide pleasurable sensations that serves as a release and provides physical and emotional relief.

I should add that relatively few men out of the nearly 200,000 newly diagnosed prostate cancer patients each year in the USA, experience symptoms or effects like pain or ED. That's  why I advocate routine annual prostate cancer (PSA) screening from age 40 onward. Despite its inaccuracies, this test, - when augmented by other diagnostic tools like biopsies, will help a man determine if he has prostate cancer. After that it's up to such men and their doctors to determine if any treatment is merited, based on an assessment of each procedure's risks and benefits. 

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