Prostate Cancer: Straight Talk for Black Men!

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All that is needed for a man to get prostate cancer is having the prostate gland. So without the prostate gland, there is no prostate cancer! We can’t also remove our prostate gland because, it is the priciest asset of a man and without it, and we are in doom as men!

It’s ‘Prostate’ not ‘Prostrate’-Prostate-to stand in front and Prostrate, to lie face Down. I have realized that, men do not know their prostate gland location, let alone what it does!. I got talking with lots of men who know prostate cancer up close and personal. I was struck by the profound impact the diagnosis had had on their view of life.

As a researcher, though, there are many amazing functions of the prostate gland.  I consider the ability of the prostate to acts as a sieve and removes toxins or waste for defense of the sperm, which helps men chances of impregnation and also made sure that men start with the most favorable class of sperm as the most important function. I consider this as the prostate’s most significant function and, at the same time, can be one of the main reasons there is a rising problem of prostate disease and cancer as men in Ghana and the black communities as we deal with more and more toxins or wastes in our food, water and the surroundings!

So the question is, why do men not paid much attention to this prostate gland but later try to regain it after they had lost it? My encounter with men with prostate conditions always leave me wondering as an active researcher in Natural Urology looking for solution for black men! You see, even if black men didn’t need significant ongoing treatment and now had a good long term prognosis, they said the experience had jolted things into perspective.

Day after Day, I heard men talk about making the most of precious time, having more fun, building memories with their families, and doing the things they had always wanted to do. They spoke about the satisfaction they felt from doing things, big and small, which made them and their families proud. They recognized how priceless good health is, and simply couldn’t understand how men would let ignorance, apathy or fear of a simple test or of treatment, get in the way of looking after their health – even though several of them admitted they had done exactly that before they were diagnosed.

According to Angela Culhane of Prostate Cancer UK “The very clear message coming from them to other men was not to stick your head in the sand in a misguided attempt to ignore prostate cancer, but to get informed about it for yourself and to join the fight to beat it for everybody”.

Does Prostate size Matters?

I’m passing that message on and I hope others will too. It’s a life saver. Let alone what it does! You see, Size definitely isn’t everything where the prostate is concerned. This little gland, hidden from sight just below the bladder, is only about the size of a walnut. But when it goes rogue, a man’s life can be over.

Also a large prostate does NOT always cause urinary problems. I think one of the areas conventional urological medicine is behind is assuming that a 60-year-old plus man with urinary problems has a big prostate. A big prostate is not always the problem.  As someone with a background also in Medical Sonography graduated from Radford University with interest in Urological Ultrasound for almost ten years, I often see 100 to 150-gram prostates (normal is roughly 20 to 40grams) with little to no urinary symptoms and smaller prostates with lots of frequency, urgency and nighttime urination.

Benign Prostatic Hyperplasia (also known as BPH or enlarged prostate) is treated with 5-alpha-reductase inhibiting drugs like Finasteride (Proscar, the trade name) or Dutasteride (Avodart). These drugs can marginally make the prostate smaller but do NOT help with urination.   5-alpha reductase drugs can cause feminization, sexual dysfunction and may lead to advanced prostate cancer (Traish et al 2014, published in the Korean Journal of Urology, titled “The Dark Side of 5α-Reductase Inhibitors’ Therapy: Sexual Dysfunction, High Gleason Grade Prostate Cancer and Depression”

That’s bad news!

Trying to reduce the size of the prostate does not always mean urinary problems go away.  The real problem is the area of the prostate called the transitional zone (TZ) that surrounds the urethra (the tube that brings out your urine in your body).  The TZ squeezes the urethra for many reasons, including due to stress. That’s why some men with small prostate have urinary symptoms. Be aware of this fact: “A large prostate does not always cause urinary problems in men, and 5-alpha reductase inhibitors can cause more problems than fix them(Traish et al 2014)

Why men do ignore the Prostate?

Surely men wouldn’t ignore the prostate if they knew what it could do to them. So why do they? Is it because the gland is invisible and out of sight is out of mind? Or that men don’t want to think about any problem below the belt? Or they don’t believe prostate cancer is a real problem because it doesn’t hit the headlines? Or perhaps the myth has taken hold that prostate cancer is a disease that men die with and not from.  But ask the families of some men who die of it every year and they’ll be quick to tell you another story; that prostate cancer doesn’t go away if you stick your head in the sand; that it’s a silent assassin which all too often takes men out in their prime; that it leaves their plans for retirement in tatters and their families grieving.

 

The Diagnosis in Urology

  1. Now we have come to a very important diagnosis in urology– prostate cancer. Prostate cancer is one of the absolutely most common cancers in the whole world. It’s both incident and prevalent.

Prostate cancer is measured mostly and tested for by the test PSA. PSA means prostate specific antigen. And this is an enzyme that leaks out from the prostate in prostate cancer, and also in normal prostates. But it is a very good test– and the best test we have up until now.

This lecture has the aim of giving you the feeling for PSA so you can act and think according to the level of PSA that you have seen in these patients.

I have written a PSA scale here. It starts with number three, which is the normal level. Up until three, that is normal.

And then we have a slight increase of PSA when the patient has between 3 and 10. In a patient with a PSA level between 3 and 10, 30% have prostate cancers. That means that 70% do not have prostate cancer, even though it is increased.

What do these 70% have? Well, they have, for example, an enlargement of the prostate-benign prostatic hyperplasia. A large prostate produces more PSA than a small prostate. So it’s really easy to understand that this can increase the level of PSA slightly.

Other differential diagnosis that can cause an increase in PSA is, for example, urinary tract infections and inflammations of the prostate. These irritative diseases to the prostate will cause the prostate to produce PSA. Therefore, they will also have a slight increase.

So when you have a patient with a slight increase, you might either look from this side– oh, 70% do not have prostate cancer– or you look at it from this side. Oh, 30% have prostate cancer. Here we have to do something.

So how can we make the test better in patients having a slight increase of their PSA? Because this is really where we want to find the prostate cancers in order to cure them from their cancer.

We can use, for example, percent-free PSA. This is the level of the enzyme PSA that travels around in the blood in the body not bound to any proteins. That is the percent-free PSA. It should be as high as possible. The normal level and limit here is 18%. So above 18% is good.

We can also correlate the PSA to the size of the prostate. That is called PSA density. The prostate then has to be measured with ultrasound– in order to find out the size of the prostate.

A very good way of increasing the sensitivity and specificity of the test PSA is to correlate it to the level of increase of PSA in time. That is the PSA velocity. For example, let’s say that PSA doubles in one year. That is alarming. If the PSA doubles in 10 years, that’s really calming down for an urologist.

  1. So now we have some methods of increasing the test’s sensitivity and specificity in these slightly increased levels.

All cancers are classified according to stage and grade. Stage means the growth of the cancer and the spread of the cancer– the metastasis of the cancer. Grade means aggressiveness of the cancer.

Now let’s get back to the PSA level and the PSA scale. Patients having a slight increase their PSA and a cancer in their prostate usually have a cancer called the T1 cancer. This means that somewhere in this prostate, there is a cancer, but you cannot feel it, you cannot see it, you cannot palpate it. It is in there. And it is found only if you take the PSA and biopsies of the prostate.

The next stage in prostate cancer is the T2 stage. The patient then usually has a slightly higher level of their PSA– between 10 and 20. Now the cancer can be palpated, but only within the prostate.

So if you palpate a prostate, and it’s smooth and nice on the surface, but you feel something inside. And it happens to be a cancer. Then it is at T2 cancer. Usually these patients have between 10 and 20 in their PSA.

Above a 20, the cancer is usually a little more extensive. Now the cancer usually is within the prostate, but it also has grown through the capsule. This means that this palpation of these patients– they now have a tumor palpable on the surface of the prostate. That’s called the T3 prostate cancer.

Patients with PSAs over 50 usually have T4 prostate cancer. That means that we have a cancer in the prostate, but the definition is that it has grown over on other organs. For

Example, the rectum. Let’s make a smaller rectum here. That is a T4 cancer. And as you can understand now, it’s more difficult to cure a patient with a T3 and T4 cancer than a T1 and T2 cancer.

Let’s get over to metastasis. The risk for metastasis in patients with PSAs between 3 and 10 is almost zero. It’s a very low risk for metastasis here.

Patients having between 10 and 20 usually do not have prostate cancer metastasis. But some really do. So here we start to look for prostate cancer metastasis.

Patients having over 20 in their PSA have prostate cancer metastasis to such a rate that we have to really look for it in order to cure these patients. But some patients are negative here and do not have metastasis.

Patients with PSA over 50 very often have metastasis and cannot be cured.

Now let’s talk about the grade. That was the aggressiveness of a prostate cancer. Aggressiveness of a prostate cancer is usually measured with a method called the Gleason score method. That is a score between 1 and 10.

And in order to find out the aggressiveness, the higher the number, the worse aggressiveness of the cancer. So the grades can be anywhere from slightly aggressive to very aggressive malignancies in all the different PSA levels. So we have to take notice of the grade in these patients. Hope you get the simple concept of prostate cancer? Thank you! Stay blessed!

Dr. Raphael NyarkoteyObu, RND, PhD is a renowned prostate cancer and Natural Medicine Researcher, Member of the Prostate Cancer Transatlantic Consortium(CaPTC Scientist), University of Florida, National President of Alternative Medical Association of Ghana(AMAG), President of Nyarkotey College of Holistic Medicine, Tema Community, 7, Post office and RNG Medicine Research Lab, Tema community 18. He is the chief editor and founder of the Ghana Alternative Medicine Journal (GAM J). Dr. Nyarkotey love for prostate cancer started as an MSc Prostate Cancer care student-Sheffield Hallam University, UK. His research interest centered on Naturopathic Urology and a practitioner of Integrative Medicine with multiple awards. He is the formulator and developer of the FDA certified Men’s Formula for Prostate Health & Immune Booster, Women’s Formula for wellness and Nyarkotey Tea for Cardiovascular and General Wellbeing. Enquiries: 0208244716/0541234556

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