Hormone treatment interferes with the production of male hormones or blocks the action of male hormones that promote prostate tumor growth. It is effective in shrinking the size of the cancer in most patients who are treated and these patients can expect to keep the cancer under control for many years.

Hormonal therapy is not a cure for prostate cancer; its aim is to slow down the growth of hormone dependant prostate cancer cells.

There are three main types of hormonal treatment.

* Surgical removal of the testicles, which produce the testosterone
* Antiandrogen therapy to block the effects of androgens such as testosterone
* Luteinizing Hormone-Releasing Hormone (LH-RH) Agonists

1. Orchiectomy

Orchiectomy used to known as Orchidectomy, and it is the surgical removal of the testicles, or medical castration. A side effect of this rather drastic cure is hot flushes, impotence and a loss of sexual desire. Before this operation is carried out your urologist may require more tests to verify the diagnosis.

A transillumination is the shining of a very bright light through the testicle, which will rule out the possibility of a benign cyst. An ultrasound will also be carried out, whereby; high-frequency sound waves are bounced off tissues inside the body. This is then converted into pictures; the majority of testicular will appear to be solid masses, as opposed to a cyst, which appears as fluid. Whilst ultrasound has a near perfect hundred percent record in detecting tumours, it cannot tell whether they are benign or not. Ninety five percent of tumours in testicles are malignant, and the only way to tell whether or not the cancer is malignant is to look at it under the microscope. However if it is cancer and it is disturbed it can progress through your body.

2. Antiandrogen therapy

Anti- androgens block the production testosterone, so the growth of the cancer is inhibited.
Anti – androgen therapy does not eliminate testosterone and therefore may have fewer or less severe side effects than those associated with surgical and medical castration. Often this treatment is prescribed intermittently with breaks in between.

Bizarrely the body demonstrates an "anti – androgen withdrawal effect." In simple English this means the patient benefits from withdrawing the treatment.

The three most common anti androgen drugs, used for prostate cancer hormone therapy are

* Flutamide,
* Bicalutamide,
* Nilutamide.

They are all oral tablets and it is recommended that they are taken at the same time each day to combat nausea. If there are more serious side effects discuss the matter with your doctor, who may change the medication, or encourage you to continue.

Side effects are usually found not to be too serious, though this can differ depending on whom is receiving the treatment.

Diarrhea is the chief consequence of having this treatment, although queasiness, liver problems, and fatigue can occur in a few patients. The major difference from taking LHRH agonists is anti-androgens have fewer sexual side effects which can only be a good thing for those men who still have an active sex life. When these drugs are used alone libido and potency are normally unaffected.

3. Luteinizing Hormone-Releasing Hormone (LH-RH) Agonists

These drugs are especially formulated to ease the symptoms of advanced prostate cancer. They are not a cure for the prostate cancer but in certain cases they can be as effective in diminishing the level of testosterone produced by the testicles as efficiently as an Orchiectomy. (Surgical removal of the testicles).

One of the reasons that the doctor does not use it as often as surgery is the expense of the drugs and the fact that the treatment needs more supervision from a medical point of view.

Lupron Depot (leuprolide acetate for depot suspension) is an LH-RH agonist used to care for symptoms connected to advanced cases of prostate cancer. Lupron Depot stops the tumor from feeding on the testosterone this slowing down the advance of the cancer.

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Unfortunately it has been noted that many men do not take the subject of prostate cancer seriously. They prefer to bury their head in the sand and ignore the perils. The sad thing is, Prostate cancer is a slow growing cancer and if caught in the early stages, there is a very good chance of recovery. There have been suggestions by some health care specialists that men should have an annual PSA test, however it has been argued that the cost of this combined with the stress caused to many men awaiting the results of these tests would not make it worth it.

Some warning signs of prostate cancer to be aware of are listed below

* A need to urinate more frequently than normal especially at night
* A feeling of needing to rush to urinate
* Difficulty when starting to urinate
* Taking a long time to finish urinating (dribbling towards the end of the flow)
* A feeling your bladder isn't empty when you have finished urinating
* A weaker flow of urine than you would normally have
* Pain upon urinating
* Blood in the urine
* Pain upon ejaculation
* Unable to maintain or get an erection
* Pain felt in the genital area
* Lower back pain
* Pain in the pelvis
* Pain in the hips

Though these symptoms can be indicative of prostate cancer, is should be remembered that other illnesses can also produce these symptoms. Investigations should be carried out to ensure the precise nature of the problem is known.

As many men can suffer from prostate cancer and not realize, there are other symptoms that can arise as the disease progresses. These occur as the disease has spread to other parts of the body

They include
* Pain in the bones of the back, neck, hips and thighs
* Unexplained weight loss
* Extreme fatigue or tiredness
* Anemia

Prostate cancer can run in families though this is fairly uncommon, however if you see a pattern emerging in your own family of prostate cancer, it is a good idea to suggest to other male members of the family to be checked out to ensure they are not susceptible. The risk within families is as follows

If you have a very close male relative such as a brother who has been diagnosed with prostate cancer, then you have a risk of contracting it yourself which is three times higher than the average male. If that brother was under sixty, then unfortunately your risk was just raised to four times higher.

Age is important when discussing prostate cancer, because if the person suffering it is fairly young, it may indicate a faulty gene running through the entire male side of the family. Unfortunately there is no test at the time of writing to distinguish this gene.

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Prostate cancer has become the most common male cancer in most western countries. Most prostate tumors grow slowly and often do not require treatment, whereas other tumors grow much quicker and can spread to the bones causing severe pain.
The most common symptoms likely to be noticed when suffering from prostate cancer is an inability to urinate, difficulty in passing urine, especially at night, weak or interrupted flow of urine, traces of blood in urine and pain or discomfort noticed in the lower back, upper thighs and hips.

Although it is always advisable to seek medical advice if these symptoms are noticed, it is important to remember that they may be caused by other conditions which are not so serious such as benign prostate enlargement.

The exact cause of prostate cancer remains unknown, although exposure to high levels of radiation is one known cause for a very small proportion of cases. Prostate cancer can run in families, so if there is a familial history of prostate cancer, it is advised for other male members to have regular check ups with their doctor.

Prostate cancer is rare in those men under the age of 50 years. However, the risk of development increases following the age of 50 years and nearly half of prostate cancer cases occur in men over the age of 75 years. Again, those men from families with a history of prostate cancer remain at a higher than normal risk.

There is some evidence to suggest a high fat diet can increase the risk of developing prostate cancer and other studies indicate a diet higher in vitamin E, tomatoes and vegetables such as broccoli, cauliflower, cabbage and Brussels sprouts (cruciform vegetables) may also lower the risk, although evidence for this has not yet been submitted.

Although it was once believed that a vasectomy increased the risk of developing cancer, research which has been carried out suggests that there is no difference.

Currently, there is no known way of preventing prostate cancer, although studies have indicated that the consumption of 200 microgram's of selenium daily can reduce the risk of development of this disease.

As mentioned previously, some families have a greater risk of developing prostate cancer and having a close relative with prostate cancer can increase the risk by two or three times.

Prostate cancer that is diagnosed early can be successfully treated. Unfortunately, advanced prostate cancer can be quite difficult to cure. Every man over the age of 50 years should be aware of the symptoms of prostate cancer and if noticed, seek immediate medical advice.

There are many different tests used to diagnose prostate cancer although each one is not conclusive alone.

Rectal Examination – a gloved finger is inserted into the rectum to feel the size of the prostate gland.
PSA Blood Test – if the level of Prostate Specific Antigen is too high, there may be a suggestion of prostate cancer.
Ultrasound – small probe inserted into the rectum to determine the exact size of the prostate.
Biopsey – A tiny tissue sample is taken from the prostate via the rectum by insertion of needle.
X-ray – can reveal any cancer which may have spread to bones.

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There are a number of different tests which are used to detect prostate cancer although each one of them are not conclusive on their own. The following lists will give a brief description of the examinations which are most commonly used:

Rectal Examination

The doctor/surgeon will insert a gloved finger into the back passage to feel the prostate gland. This will help the doctor to determine whether or not the prostate is larger than normal. If enlarged, it does not necessarily mean that it is cancerous.

PSA Test

This involves a blood test which measures the Prostate Specific Antigen (PSA) in the blood. If the PSA is too high, it might be suggested that prostate cancer has developed although there are several other conditions which may have increased the PSA levels in the blood.

Ultrasound

This involved a small probe being inserted into the back passage for the purpose of an ultrasound scan. This will illustrate the exact size of the prostate.

Biopsy

A biopsy involves a small sample of tissue from around the prostate being taken. This is performed by a probe being inserted into the back passage and a small needle jabbing the prostate.

X-rays

X-rays can illustrate the presence of cancer which has spread from the prostate to the nearby bones.

At present, routine screening for cancer of the prostate are not performed in any country due to the fact that the tests are not accurate enough to be used in general. For example, screening every man by PSA test would highlight many men who did not have cancer and on the other hand many men who do have cancer would go undetected. However, those men who have a family history of prostate cancer may benefit from certain screening. This should be discussed with your doctor.

Prostate cancer is detected in more than half of those patients who develop it at an early stage making treatment for successful for nine out of ten cases. The other half of patients are diagnosed after the cancer has been become advanced and spread. Treatment can provide those patients with several extra years of life and prevent pain of the disease, although it does not normally provide a cure.

Some prostate cancers grow fairly slowly, therefore no treatment is required. Where treatment is required, three main methods are used:

Surgery

Surgery known as prostatectomy where the whole of the prostate is removed.

Radiotherapy

During radiation treatment, high energy rays are used to kill the cancerous cells. This also helps to destroy the originating tumour and helps to reduce the pain which have been caused by the cancerous tumour cells which have spread to the bones.

Brachytherapy

This newer type of radiotherapy consists of small radioactive wires or pellets being inserted directly into the tumour, killing it from the inside. This has found to be as effective as other available treatments, sometimes even more so. It has also been found that there are fewer side effects from this type of treatment.

Hormone Therapy

The growth of the cancer cells in the prostate depends on the male hormones, known as androgens. There are certain drugs available which reduce the amount of androgens which are produced by the body. They also work by blocking the effect of androgens on the cancer cells. This then prevents the growth of the tumour or shrinks it. It has been found, however, that most prostate cancers, after approximately five years go on to develop the ability to develop without androgens thus the hormone therapy stops working.

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A TUR is performed by inserting a thin tube into the uretha via the penis. The tube contains a telescope allowing the surgeon to view inside the uretha. Any blockage is removed using an instrument which is attached to the telescope. A patient is expected to spend two to three nights in hospital post surgery.

A TUR is usually performed under a general anaesthetic although some men have a spinal anaestetic, known as an epidural. This means that he remains awake but is unable to feel anything. An epidural may be suggested if the doctor believes that there are any reasons why the man should not have a general anaestetic, for example, unhealthy lungs or heart.
It is advised to begin moving around as much as possible following the operation and most men find that they are up and about within approximately 24 hours.

Many men have an intravenous infusion (drip) to replace the body fluids. This can be removed once normal drinking resumes as it is very important to drink plenty of fluids.

Many patients have a catheter in situ which is a tube going into the bladder to drain urine into a bag. It is perfectly normal to find blood clots in the urine following this type of surgery and bladder irregation is often used to prevent any blood clots blocking the catheter. This involves the passing of fluid into the bladder which is then drained out of the catheter. You will note that the blood in the urine will clear slowly before the catheter can be removed, normally over two or three days post surgery. It is important to advise your doctor/nurse once you pass urine following the removal of the catheter.

Many men find that they are unable to pass urine once their catheter has been removed. This is often due to swelling around the neck of the bladder and the prostate. You may have the catheter reinserted if you are unable to pass urine. Another attempt to urinate without the catheter will be made in a day or two.

Some men have to keep their catheter in situ after they have gone home. Before discharge from hospital, the nurse will show the patient how to maintain the catheter and a district nurse will be arranged to help with any problems at home. If a patient belives he will experience difficulties coping at home, the nurse or a social worker should be notified so help can be arranged.

An appointment will be made to visit the out patient clinic for a check up approximately six weeks later. Problems you may be experiencing can also be discussed.
Pain and discomfort will be experienced for a few days post surgery although there are a number of painkillling drugs available. This should be discussed with the doctor/nurse, especially if the pain continues.

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The function of the prostate

The prostate gland is a complex organ which consists of millions of very small glands which are lined with fluid secreting cells. This fluid flows into thousands of ducts through up to 14-18 exits and end up eventually in the urethra.

Unfortunately if there is a problem with the prostate, it doesn't necessarily mean you have a life threatening disease, there can be a number of problems with the prostate especially as you get older and most of them can be benign. They may certainly be irritating and inconvenient, but not life threatening. However for this article, we will be discussing prostate cancer.

What Exactly Is Cancer?

Cancer is a problem for anyone no matter what their age or sex. Unfortunately even just the word "cancer" tends to strike terror into the hearts of many people who automatically assume if they have contracted it, they have received a death sentence.

Nowadays there are many types of cancer which can be cured as long as it is caught in time. Prostate cancer comes into this category, so it is really important that any man who discovers any problems in this area doesn't bury his head in the sand, but goes to his doctor immediately to have it checked out. Hopefully it will be a problem with a benign source, however if it is prostate cancer then the sooner it is sorted, the better.

It's important that as people who can be prone to cancer that we understand exactly what it actually is.

The human body is made up of trillions of cells which divide and reproduce themselves constantly. This is a process which allows the body to heal itself when it becomes injured. The problem with cancer starts when this process somehow goes haywire. The cells reproduce themselves in an uncontrollable manner. Because these cells are multiplying at an alarming rate, eventually they form a mass which is known as a tumor. These tumors's can be either benign or malignant, but whatever they are, they very often interfere with the body's natural processes. If the tumor is cancerous, there is the risk that small particles can break off and spread to other parts of the body, this is known as metastastic spread.

Prostate cancer is a disease in which abnormal cells have developed in the prostate gland. It usually starts on the outer part of the prostate and a lump can be felt when a rectal examination is performed. Luckily prostate cancer is a slow acting cancer, with many older men only found to be suffering after they have died of other causes. There are occasions however when it can spread quickly, so it is still important that any abnormalities are followed up quickly.

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Whichever way, this disruption to a man's sexual relationship will be difficult to tolerate. Any man who is suffering with prostate cancer should always try to remember that with time, things should change and they will not know how they will be permanently affected until their treatment has finished and things are getting back to normal. It's pointless to contemplate a sexual future until all options have been considered and treatment has been completed.

Most side effects from the treatment of prostate cancer are only temporary. For example, the fatigue and diarrhoea which is a side effect of radiotherapy usually begins to wear off in the weeks following the end of a person's treatment. The effects of this treatment can be wearying, however if it can be tolerated the effects do wear off after the treatment has been completed.

If a man is less interested in sex, it can be due to a number of reasons. These include the effects of an Orchidectomy or hormone treatment. A lowered interest in sex cannot be treated like it usually would be by the use of testosterone injections or patches. This would be counter productive due to some treatments for the prostate cancer being female hormone based. Giving a man the male hormone testosterone would accelerate the growth of the tumor and would negate the effects of the treatment being given.
Changing the treatment itself may be a benefit as a lack of sexual interest is less likely with anti-androgens such as bicalutamide. Therefore any man undergoing treatment should consider discussing their options with their health specialist.

Side effects such as these may be very difficult to live with and how a man looked upon his sex life before diagnosis will play a major role. Whether or not a man has a partner will also determine how he takes to the changes in his sex life.
It is very important that issues such as these are discussed between partners so enable you both to come to terms with the major changes you will face. Its important to remember that a diagnosis of prostate cancer affects a man's partner as well as himself.

Symptoms which might be a side effect of orchidectomy or hormone therapy may include hot flushes and sweats. These symptoms are usually at their worst when a man has just bean hormone treatment or had their testicles removed, although they can get better as the body adjusts.

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The most common type of cancer in men throughout most western countries is prostate cancer. Most tumours are slow growing and often do not require treatment. However, some grow rapidly and can spread to the bones causing considerable pain. There are approximately 30,000 new cases per year within the UK, 215,000 in the USA, 12,000 in Australia and 20,000 in Canada.

There are a number of symptoms associated with prostate cancer such as inability to urinate or difficulty passing urine, especially at night, interrupted or weak urine flow, pain and/or blood during urination, pain in the lower back, upper thighs and hips. It is important, however to bear in mind that other conditions such as benign prostate enlargement can cause these symptoms. A doctor should always be consulted where these symptoms are present.

Although experts have not yet established the exact cause for prostate cancer, it is thought that radiation is a cause for a small proportion of cases. Approximately 5 to 10% of cases are found in families where the patient has inherited a high risk of prostate cancer.

It is very rare to find prostate cancer in men under the age of 50 years. The risk of developing the disease increases after the age of 50 and over half of cases occur in men over the age of 75 years. Those men who have a history of prostate cancer are at an increased risk.

Certain scientific evidence has suggested that eating a low-fat diet can help to reduce the risk of developing prostate cancer. Studies have also suggested that diets which are high in tomatoes, cruciform vegetables such as cabbage, broccoli, brussel sprouts, vitamin E can also reduce a man's risk, although these studies have not yet been confirmed.

Although it was once believed that a vasectomy increased the risk of a man developing prostate cancer, recent research suggests that there is no difference between those who have and have not had a vasectomy.

Experts have not yet found a way of preventing prostate cancer, although research and studies have found that those men who took 200 microgrammes of selenium each day had a reduced risk of producing prostate cancer.

It has been found that some families have an increased risk of developing prostate cancer. The normal risk of developing prostate cancer some time during a man's life is 1 in 13. By having one or more close relative such as a father or brother develop prostate cancer before the age of 70, a man's risk will increase by two or three times.

Early diagnosis can increase the success of treatment. However, when the cancer becomes advanced, it will become more difficult to cure. Men over the age of 50 years should be aware of the symptoms and ensure that they have a medical examination if there are any warning signs.

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