Barah Prostat
Name: Mike Strong
Age: 52
Diagnosis: Prostate Cancer
Age: 52
Diagnosis: Prostate Cancer
Strong traveled to the Hope4Cancer Institute, arriving in a wheelchair, and had a catheter. Mike explained: “After a week of treatment, I was playing golf and have not worn a catheter since.” Mike received Sono-Photo Dynamic Therapy and radio-wave hyperthermia, a treatment that heats cancer cells and damages them so they cannot reproduce, without harming normal cells. After two weeks of treatment Mike’s sonogram showed a 50% decrease in tumor size and his blood work was normal. “The treatment was pain-free and had no side effects, and I just kept feeling better and better,” Mike says. “Patients owe it to themselves to look at all their options.”
Prostate Cancer Treatment Offers Good Results
Mike Strong, a health minister for Hallelujah Acres, was only 52 when an annual physical revealed his Prostate Specific Antigen (PSA) was 31 (normal is 4 or under). Although he had no symptoms, a biopsy confirmed that he had cancer. His doctor urged him to have a radical prostectomy to remove his prostate and surrounding tissue. He refused, but did agree to take the testosterone blocker Lupron for one year. The Lupron made him feel extremely tired and he lost all sexual desire. The drug temporarily lowered his PSA, but it jumped to 46 when he stopped it. Mike began researching treatments that would not cause impotence (erectile dysfunction), incontinence (urine leakage) or a host of other side effects. He went on a raw food diet, had his dental amalgams removed and took testosterone blockers, which also eliminated his libido. He joined a clinical trial, but his cancer began to spread and he lost an alarming amount of weight.
While taking part in the clinical trial, Mike met Dr. Antonio Jimenez, Medical Director of the Hope4Cancer Institute in Baja, California. “Dr. Jimenez offered a non-toxic, proven cancer treatment that combined Sono-Photo Dynamic Therapy with radio-wave hyperthermia. Finally, a treatment without side effects!”
As early as age 40, the prostate may begin to increase in size, and by age sixty, 80% of men have an enlarged prostate. This can cause the urethra to narrow, decreasing urine flow. Symptoms include an urgent need to urinate (especially at night), a thin stream, discomfort above the bladder, blood in the urine, low back pain, weak or interrupted flow and pain or burning when urinating. Sometimes, prostate cells begin to grow abnormally, forming a tumor.
Prostate screening normally includes a blood test called PSA, digital rectal exam (DRE) and a Sonogram/Ultrasound. If cancer is suspected, traditional medicine requires a biopsy where a Gleason score (a system of grading tissue/ aggressiveness after biopsy) is obtained, followed by surgery and some combination of radiation, chemotherapy and hormone therapy. Seed radiation or brachytherapy is another invasive procedure where tiny ‘seeds’ are implanted that deliver a time-release dose of radiation. Side effects of these treatments often leave a man with impotence, incontinence, fatigue, hot flashes, rectal irritation or damage, diarrhea and blood in the stool. At least 40% of all surgery patients will experience erectile dysfunction. Side effects may not be apparent immediately; they can begin gradually and increase with time in the years after treatment. According to the National Cancer Institute, 218,890 men were diagnosed with prostate cancer in the United States in 2007. Understandably, men are horrified at the thought of becoming impotent and incontinent. Since virtually all treatments offered in the USA come with a host of undesirable side effects, many patients like Mike Strong are seeking treatments outside the United States. Strong traveled to Baja to the Hope4Cancer Institute, a small ‘boutique’ clinic with 5 patient rooms and 5 physicians on staff. “I arrived in a wheelchair, and I had a catheter,” Mike explained. “After a week of treatment, I was playing golf and have not worn a catheter since.”
According to Dr. Jimenez, after two weeks of treatment Mike’s sonogram showed a 50% decrease in tumor size and his blood work was normal. “In my 20 years of medical practice, Sono-Photo Dynamic Therapy (SPDT) is the most effective treatment for Prostate cancer that I have ever offered. It gives patients improved quality of life while attacking cancer cells and tumors.”
Mike received Sono-Photo Dynamic Therapy (SPDT). During this treatment patients ingest a chlorophyll-like agent that adheres to cancer cells. Then, sound (sono) and light (photo) are pulsed through the body at very precise frequencies that cause the agent to ‘explode’ with free radical oxygen, instantly killing cancer cells, which cannot survive in the presence of oxygen. SPDT has just recently been approved in the US, although it has been used in other countries since the 1800’s.
In addition, he received radio-wave hyperthermia, a treatment that heats cancer cells and damages them so they cannot reproduce , without harming normal cells. Other treatments included natural medicines and therapies to kill cancer cells, detoxify the body and build the immune system.
“The treatment was pain-free and had no side effects, and I just kept feeling better and better,” Mike says. “Patients owe it to themselves to look at all their options.”
By Marla Manhart. Patient name has been changed to protect his privacy. Marla Manhart is a health writer and cancer patient advocate.
ARKIB UTUSAN MALAYSIA : 19/06/2011
Lelaki perlu jalani pemeriksaan prostat
Oleh RABIATUL ADAWIYAH KOH ABDULLAH
adawiyah.koh@utusan.com.my
adawiyah.koh@utusan.com.my
SEMPENA sambutan Hari Bapa hari ini, tentunya pelbagai cara tersendiri dipilih untuk meraikannya.Apa kata pada hari istimewa ini kita mengajak bapa melakukan pemeriksaan kesihatan. Mungkin dalam usianya yang meningkat, dia mempunyai penyakit yang tidak diketahui. Bagi anda yang tidak pernah dengar tentang prostat, hari ini anda perlu memberi kesedaran kepada insan yang bergelar bapa bahawa statistik penyakit tersebut kian meningkat.Prostat sering dipandang remeh dengan alasan bahawa simptom-simptomnya hanya hanya berkaitan orang tua. Sebanyak 98 peratus daripada keseluruhan kes prostat dikesan berlaku pada kaum lelaki yang berusia 55 tahun ke atas. Manakala purata umur kaum lelaki yang kebiasaannya dikenal pasti menghidapi kanser prostat adalah lebih kurang umur 68 tahun.Bagaimanapun, disebabkan kelenjar prostat mengalami pengembangan dan perubahan dari tahap baligh lagi, adalah digalakkan agar lelaki berumur 50 tahun ke atas menjalani pemeriksaan saringan kanser prostat setahun sekali. Bagi kaum lelaki yang mempunyai sejarah kanser prostat di dalam keluarga, mereka dinasihatkan supaya membuat saringan tersebut pada usia 45 tahun.Prostat merupakan kelenjar di pangkal pundi kencing lelaki dan mengelilingi salur kencing yang juga dikenali sebagai urethra.Saiznya sebesar kacang walnut sementara fungsinya adalah menghasilkan cecair yang beralkali untuk air mani.Seperti kelenjar yang lain, beberapa masalah dan penyakit boleh timbul dalam kelenjar prostat . Penyakit dan masalah yang utama adalah Benign Prostatic Hyperplasia - BPH (Pembesaran Kelenjar Prostat ) dan kanser prostat .
Pembesaran Kelenjar Prostat
“BPH adalah pembesaran kelenjar prostat yang disebabkan oleh rangsangan hormon testosterone. Pertambahan saiz prostat sebegini dapat dilihat di kalangan lelaki berumur 50 tahun ke atas. ‘‘Mengikut perangkaan, kelaziman BPH adalah lebih daripada 50 peratus di kalangan lelaki pada umur 60 tahun sementara di kalangan lelaki berumur 85 tahun ke atas, kelaziman BPH adalah lebih daripada 90 peratus,” ujar Ketua Perkhidmatan Urologi dan Jabatan Urologi Hospital Selayang, Datuk Dr. Rohan Malek.Tambah Dr. Rohan, bilangan kes BPH di Malaysia kian meningkat dengan bertambahnya bilangan warga emas. Pada ujian saringan Kempen Kesedaran Prostat Peringkat Kebangsaan 2004, lebih 50 peratus daripada lelaki yang disaring didapati mempunyai gejala ini.Kebiasaannya, saiz kelenjar prostat yang besar daripada normal akan menyebabkan salur kencing yang melalui kelenjar tersebut sempit. Mereka yang mempunyai masalah ini akan kerap mengalami kesukaran membuang air kecil.
Tanda-tanda akibat BPH
* Aliran kencing yang kurang baik (poor stream)
* Kerap membuang air kencing (frequency),
* Tidak dapat mengosongkan pundi kencing selepas membuang air (incomplete emptying)
* Air kencing menitik dari kemaluan selepas selesai membuang air (terminal dribbling).
* Pesakit juga akan mengalami nokturia iaitu perlu bangun dari tidur pada waktu malam untuk membuang air kecil.
Masalah BPH yang tidak dikawal, menurut Dr. Rohan akan menyebabkan salur kencing tersumbat dan pesakit tidak dapat membuang air kencing secara normal. Malah ia boleh menyebabkan risiko buah pinggang menjadi bengkak dan gagal berfungsi (renal failure). Penyakit lain yang sinonim akibat penyakit ini ialah pembentukan batu karang dan hernia. Dr. Rohan berkata demikian pada sidang akhbar mengumumkan kajian epidemiologi cross-sectional untuk mengenal pasti kelaziman (BPH) dan pengesanan kanser prostat baru-baru ini.Menyentuh tentang rawatan BPH, Dr. Rohan memberitahu, pengesahan penyakit memerlukan sejarah kesihatan pesakit dan tanda-tanda penyakit digunakan untuk mengkategorikan sama ada keadaan serius atau tidak.Kebanyakan diagnosis penyakit boleh dilakukan menerusi ujian rektal digital (DRE) atau pemeriksaan darah dengan antigen khusus prostat (PSA).“Kebanyakan kes BPH dapat dirawat dengan kaedah perubatan. Pembedahan diperlukan sekiranya tanda-tanda tidak dapat dikawal lagi dengan ubat atau sekiranya terdapat komplikasi seperti batu karang,’’ katanya. Pembedahan yang biasa dijalankan adalah transurethral resection of prostate (TURP) di mana bahagian prostat yang menyebabkan salur kencing menjadi sempit dibedah untuk membolehkan air kencing mengalir dengan elok semula. Pembedahan ini dijalankan secara endoskopi di mana teropong khas (endoskop) dimasukkan ke dalam salur kencing dan membolehkan kelenjar prostat dibedah dengan hanya menggunakan alat endoskopi. Terdapat komplikasi yang mungkin terjadi akibat pembedahan ini termasuk pendarahan, masalah pancutan air mani (retrograde ejaculation) serta mati pucuk. Dalam pada itu wujud kaedah-kaedah baru rawatan termasuk penggunaan tenaga gelombang mikro untuk memusnahkan tisu prostat (transurethral microwave thermotherapy) serta laser protectonomy tetapi memerlukan kos yang tinggi.
Kanser prostat
Kanser prostat terjadi apabila sel-sel prostat mengalami mutasi dan bertambah tanpa terkawal. Pada peringkat awal, kanser prostat tidak menyebabkan apa-apa tanda yang ketara berbanding BPH. Di Malaysia, barah prostat mewakili 7.4 peratus daripada kes-kes barah di kalangan lelaki . Terdapat sejumlah 735 kes yang dilaporkan dan didaftarkan, menjadikannya jenis barah keempat paling biasa di kalangan kaum lelaki. Lazimnya, barah prostat membesar dengan perlahan. Kajian bedah siasat menunjukkan bahawa ramai lelaki berumur (dan kadangkala lelaki muda juga) yang mati akibat penyakit-penyakit lain, juga menghidapi barah prostat yang tidak pernah mendatangkan masalah semasa hayat mereka .“Kanser prostat dikesan melalui ujian saringan PSA Apabila saiz prostat bertambah, ia akan menyebabkan tanda-tanda yang serupa dengan BPH seperti kesusahan keluar air kencing, aliran kencing yang lemah, kencing kerap serta nokturia. ‘‘Dalam pada itu, mungkin akan terdapat darah yang keluar bersama air kencing pesakit. Pada ketika ini, kanser prostat boleh dikesan secara pemeriksaan dubur kerana ciri-ciri strukturnya yang berbiji-biji kasar serta keras,” ujar Presiden MUA dan Ketua Unit Urologi Pusat Perubatan Universiti Malaya (PPUM), Profesor Azad Hassan Abdul Razack.Pada peringkat akhir, sel-sel kanser prostat boleh merebak melalui aliran darah ke organ-organ lain seperti tulang, terutamanya tulang paha, serta ke paru-paru. Seseorang pesakit akan mengalami sakit pada tulang serta masalah bernafas. Sekiranya tulang belakang juga terlibat, tekanan terhadap saraf tunjang akan menyebabkan seseorang itu lumpuh pada kedua-dua kaki.Tambah Prof. Azad, kanser ini boleh dirawat secara pembedahan dengan mengeluarkan seluruh kelenjar tersebut (radical prostatectomy). Terbaru tentang rawatan ini, pembedahan juga boleh dijalankan dengan bantuan robot.Berdasarkan prosedur ini, radioterapi (sinaran X) juga boleh digunakan untuk merawat kanser prostat dengan memusnahkan sel-sel kanser. Ia juga digunakan untuk merawat mereka yang mempunyai sel-sel kanser yang telah merebak ke tulang paha dan tulang belakang.“Rawatan perlu dilakukan awal sebelum simptom menjadi parah. Justeru itu, pemeriksaan awal tentang kanser ini perlu dilakukan awal khususnya golongan lelaki yang berumur 50 tahun ke atas,” katanya.
Kajian BPH dan barah prostat
Didorong oleh kekurangan data mengenai corak gejala saluran kencing bawahan (lower urinary tract symptoms - LUTS) di kalangan kaum lelaki di Malaysia, kajian tersebut telah dibentuk untuk mengumpul maklumat mengenai BPH dan barah prostat bagi memahami dengan lebih baik mengenai pesakit-pesakit yang mempunyai risiko mendapat penyakit-penyakit ini.Kajian oleh MUA ini telah dilancarkan bagi mengenal pasti kelaziman BPH dan pengesanan barah prostat di kalangan kumpulan pengesanan sasaran dalam masyarakat di Lembah Klang. Populasi sasaran tersebut terdiri daripada bukan sahaja penduduk di Lembah Klang, malah termasuk juga mereka yang berada di Selatan Perak, Pahang Barat dan Negeri Sembilan Utara.Kajian ini akan menganalisis data yang diperoleh daripada lapan pusat pemeriksaan di sekitar Lembah Klang. MUA berharap untuk mendapatkan 3,000 peserta dari kedua-dua latar belakang kota dan luar bandar, serta daripada kumpulan etnik yang berbeza bagi kajian ini. Memandangkan kelaziman penyakit-penyakit prostat adalah lebih tinggi di kalangan lelaki yang lebih tua, kajian tersebut akan tertumpu kepada lelaki berumur 50 tahun ke atas.Mereka yang menepati profil kelayakan digalakkan untuk mengunjungi pusat-pusat pemeriksaan yang berdekatan rumah mereka. Pemeriksaan percuma akan dijalankan setiap hujung minggu dalam bulan Julai di Hospital Selayang, Hospital Tengku Ampuan Rahimah, Pusat Perubatan Universiti Kebangsaan Malaysia, Hospital Serdang, Pusat Perubatan Universiti Malaya, Hospital Angkatan Tentera Tuanku Mizan, Hospital Kuala Lumpur dan Hospital Sungai Buloh.
Vitamin E Supplements Tied to Increased Risk of Prostate Cancer
A new study shows vitamin E supplements are associated with a higher risk of prostate cancer.
Men in a large prostate cancer prevention trial who took vitamin E supplements had a higher risk of developing the disease than men who took a placebo, according to extended follow-up of trial participants. Dr. Eric Klein of the Cleveland Clinic and his colleagues reported the finding October 12 in JAMA.The results are from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), which included more than 35,000 relatively healthy men at average risk for prostate cancer. The trial was stopped early in 2008, when a planned interim analysis indicated that vitamin E and selenium—whether alone or in combination—were unlikely to prevent prostate cancer.
At the time, participants were told to stop taking the supplements, and researchers continued to follow the men. The interim analysis also suggested that vitamin E might be associated with an increased risk of prostate cancer, though the result was not statistically significant at the time.
But with additional follow-up, the researchers detected a 17 percent increased risk of prostate cancer among men who took 400 international units of vitamin E per day (IU/d) compared with men who took a placebo, a difference that was statistically significant.
The Evidence on Vitamin E
In reporting their results, the researchers noted that, by and large, vitamin E has failed to show a benefit for preventing a number of diseases. “The totality of the evidence shows that vitamin E does not prevent other diseases, and we now have evidence that it may increase the risk of prostate cancer,” said Dr. Klein.
Consumers need to be skeptical of health claims for over-the-counter products when strong evidence of a benefit demonstrated by clinical trials is lacking, the study authors stressed.
“Studies like SELECT make us take a step back and realize that any pharmaceutical agent we give has the potential for benefit and, as remote as it may be, also the potential for harm,” said co-author Dr. J. Michael Gaziano of Brigham and Women’s Hospital.
The totality of the evidence shows that vitamin E does not prevent other diseases, and we now have evidence that it may increase the risk of prostate cancer.
—Dr. Eric Klein
“That’s why we engage in these large-scale randomized studies, especially for agents that are in widespread use,” he added.—Dr. Eric Klein
More than half of all men over age 60 in the United States are taking supplements containing vitamin E, and 23 percent are taking the dose used in SELECT, the study authors noted. Therefore, the finding of an increased risk of prostate cancer has “substantial implications.”
The increased risk of prostate cancer emerged only after the men had stopped taking the supplements. “These agents seem to have longer-lasting effects,” said Dr. Klein, noting that researchers who design clinical trials need to consider this possibility.
“This study is yet another cautionary tale about the potential risks of high-dose nutritional supplements,” said Dr. JoAnn Manson of Harvard Medical School, who was not involved in the research. “We’ve seen this before, and it shows why it is so important to have these randomized trials.”
In the early 1980s, she noted, beta-carotene was widely regarded as “a magic bullet for good health” until clinical trials showed that it was harmful to those at elevated risk for lung cancer, particularly smokers.
Another large randomized trial, the Physicians Health Study II, linked vitamin E to an increased risk of bleeding-related strokes.
Although deficiencies in certain nutrients can cause health problems, high doses of supplements may have health risks that outweigh the benefits, noted Dr. Manson, who is leading a large randomized trial
“With many nutrients, there is an optimal range of intake and blood levels, and more is not necessarily better,” she added.
Most Prostate Cancers Found Early
More than 400 sites in the United States, Canada, and Puerto Rico participated in SELECT, which was coordinated by SWOG, a federally funded cancer research cooperative group. Doctors monitored the participants according to contemporary community standards of screening and biopsy. This ensured that, as in general practice, some men had PSA tests and others did not.
During the 7 years of the trial (5.5 years of taking supplements and 1.5 years of not taking them), doctors diagnosed 65 cases of prostate cancer for every 1,000 men in the placebo group. In comparison, doctors diagnosed 76 cases for every 1,000 men in the vitamin E-only group.
Studies like SELECT make us realize that any pharmaceutical agent we give has the potential for benefit and for harm. That's why we engage in these large-scale randomized studies, especially for agents that are in widespread use.
—Dr. J. Michael Gaziano
Most of the detected cancers were found early, and therefore “the risk of a man dying from the disease is not very great,” said co-author Dr. Ian Thompson of the University of Texas Health Science Center at San Antonio.—Dr. J. Michael Gaziano
He pointed out, however, that most men diagnosed with prostate cancer in the United States end up being treated with surgery or radiation, which can impair a man’s sexual and urinary functions.
“If a man is taking vitamin E, he should either stop taking it or talk to his doctor about a reason he should take it,” Dr. Thompson said. “And I can’t think of a reason he should take it.”
It is not clear why SELECT showed an increased risk for prostate cancer when earlier studies that led to the randomized trial showed that vitamin E protected against the disease. The study populations were different, however, and the original results may have been chance findings, the researchers said.
In fact, the prospective randomized trial, the gold standard in medical evidence, was launched precisely because the earlier studies were not definitive and needed to be confirmed.
The SELECT investigators have biological samples from the participants, and they intend to explore questions raised by the trial. For instance, men who took both supplements did not have an increased cancer risk, so there may have been an interaction between selenium and vitamin E.
The current results are an example of “rigorous scientific exploration,” noted Dr. Howard Parnes of NCI’s Division of Cancer Prevention, another co-author. “The idea of science is to put your observations to the test and see if they are correct,” he said. “You often learn the most from the studies that overturn conventional wisdom.”
—Edward R. Winstead
Deadline Extended for Research Proposals Using SELECT and PCPT Samples
With the publication of new data from the Selenium and Vitamin E Cancer Prevention Trial
Researchers interested in using samples from SELECT or PCPT
Together, SELECT and PCPT randomly assigned more than 53,000 men without prostate cancer to intervention or placebo, generating substantial clinical data related to the risk of developing prostate cancer, as well as corresponding biorepositories for molecular, epidemiologic, and other studies.
Information on previously approved studies
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