Participants: Allan Handysides, Stoy Proctor
Series Code: WM
Program Code: WM000343
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00:01 The following program presents principles
00:03 designed to promote good health 00:04 and is not intended to take the place of 00:06 personalized professional care. 00:08 The opinions and ideas expressed 00:11 are those of the speaker. Viewers are 00:13 encouraged to draw their own conclusions 00:15 about the information presented. 00:37 Welcome to Wonderfully Made. 00:39 My name is Stoy Proctor and today 00:41 our topic is problems with the prostate. 00:44 I have as my guest Dr. Allan Handysides 00:47 who is a specialist in many areas. 00:50 He has got many degrees and I'm 00:53 certainly happy to have him with us today. 00:56 Dr. Handysides I would like to ask 00:58 you a question. Would you explain 01:01 the Prostate and how prevalent 01:03 is Prostate cancer? Thank you Stoy 01:06 that's a good question and first of all 01:09 the prostate is a gland that sits beneath 01:12 the bladder in the male. It is very beautifully 01:16 and anatomically designed so that 01:18 it wraps around the little tube that drains 01:21 the urine out of the bladder and it has a 01:24 special function, that function is to add fluid 01:28 to the rest of the semen and protect 01:31 and feed the sperm that are in that fluid. 01:35 Unfortunately as you have said 01:37 nearly every male will develop a problem 01:40 with the prostate if he lives long enough. 01:42 So one of the problems that some of our 01:46 older viewers maybe aware of is that 01:48 as the prostate gets older it gets bigger. 01:52 It enlarges. The medical term for this is 01:55 Prostatic Hypertrophy. Now the prostate 01:58 has an outer edge and an area that is where 02:03 predominantly cancer occurs, 02:04 but the innermost portion is where 02:06 this hypertrophy takes place 02:08 and it starts off as clusters of cells 02:11 start to grow and you begin to get 02:13 increasing numbers of these clusters 02:16 and they coil as to form a generally 02:19 enlarge gland which squeezes the little tube 02:23 that comes out of the bladder. 02:24 Consequently males begin to find 02:27 when they pass their urine that the flow 02:29 starts to be a little less powerful, 02:32 a little slower and that is often 02:36 the first sign of prostatic enlargement. 02:39 How many people are affected 02:40 every year by this condition? 02:41 Well if we're talking about 02:43 prostatic hypertrophy I would think probably 02:46 65 to 75% of males will notice some changes 02:50 in their urinary flow. The others will 02:53 probably have changes, but don't notice them. 02:55 It's probable that if we live to the age of 02:59 100 nearly 100% males would be found to have 03:04 at autopsy not in their steady life. 03:07 At autopsy found to have cancer cells 03:09 in their prostate. Now this is a question 03:12 probably people who have a prostatic enlargement 03:16 won't need to answer, but we will need to know 03:19 the answer too, but how do you know 03:21 whether you have got problem 03:22 with the prostate? You have mentioned 03:25 the decreased flow of urine, but any other 03:27 symptoms that you might have? 03:30 Sometimes people can have no symptoms, 03:33 no signs of a problem and in that case 03:36 they can live their lives in blissful 03:38 ignorance and many, many people have 03:40 and for many, many years' people did not 03:42 understand that there were problems. 03:44 But we do recommend that there are 03:46 certain groups people, who should begin 03:49 prostatic surveillance maybe a little earlier. 03:51 For instance, we know that black people 03:55 North America blacks living here on the 03:58 continent particularly because 04:00 we're in the Northern climate seem to have 04:02 increasing risk of prostate cancer 04:04 the further North they go. 04:06 So, Canadian black men living in Canada 04:10 has a greater risk of prostatic cancer 04:12 than those one living in Florida. 04:14 So we have an environmental factor 04:16 that maybe playing a role. Genetic factor 04:20 is probably two, so we recommend that 04:23 American blacks should begin surveillance 04:26 of their prostates maybe around the age of 40. 04:30 But now that's with blacks, 04:31 but with every man at sooner or later 04:34 they probably gonna have problems 04:35 in this area right? Yes, there is a little 04:38 controversy and little argument about just 04:40 how avidly we should screen for 04:42 prostate cancer. I think that with the 04:45 American black we should screen early 04:47 because they tend to have a more aggressive 04:50 prostate cancer than do whites. 04:52 In white males, we suggest that probably 04:55 by the age of 50 they should also begin 04:57 a program of surveillance. 05:00 Now suppose I have been diagnosed 05:03 as having enlarged prostate. 05:04 When does a physician began treatment? 05:07 How do I know whether the treatment 05:10 should start? Let's talk about 05:11 prostatic enlargement. First of all 05:13 not everybody with an enlarged prostate 05:15 is going to require treatment. 05:18 This is because the symptoms maybe a 05:20 slowness in urinary flow, but that's not a 05:23 life threatening problem. Then we say 05:26 well what kinds of treatment 05:27 can be offered. As some of the treatments 05:30 that are offered are medical treatments 05:31 such as giving medications that block 05:35 the conversion of Hydroxy Testosterone 05:38 into the active form. Now that enzyme 05:42 blocking can reduce the amount of testosterone 05:44 and therefore reduce the hypertrophy. 05:47 Another approach is to give a beta-stimulant 05:50 which is a drug that actually causes 05:53 relaxation of the bladder flow 05:56 and let's the urine flow more easily. 05:58 So many people who are having 06:00 a little slowness, little difficulty, 06:02 maybe little dribbling these are all symptoms 06:04 of this problem. They may go to the doctor 06:07 and say can you help me and he may give 06:08 them a medication that relaxes 06:10 the bladder flow. You have, you have 06:12 any names that you could mention? 06:14 Well I don't think that it really, matters, 06:16 goes with, Clonidine is the name, 06:18 but I don't think that matters. 06:19 I would want people to go to see their doctors. 06:21 Sure. One of the natural things that people 06:24 can have, one of the natural remedies 06:26 that has actually been shown with studies 06:30 that are reputable studies is the use of 06:33 Saw Palmetto and the use of Saw Palmetto 06:36 is an herbal remedy that in this situation is 06:40 shown to improve the flow and improve 06:44 the situation without having very 06:45 many side effects. So, medically 06:47 or herbally there are approaches 06:49 that can be made, but if we move from 06:52 the medical we then talking about 06:54 surgical approaches. And what about 06:57 I've heard that some people they go, 06:59 the position goes and reams out? 07:01 Well that's a surgical approach. 07:03 That's a surgical. Oh, this is 07:05 surgical approach. That's a 07:06 surgical approach. In other words, 07:07 surgical approach doesn't always have 07:08 to just be removal of the entire prostate. 07:09 No, it doesn't have to. That's one approach 07:11 right? That is one approach. Yeah okay. 07:13 You see one would prefer to have less 07:16 and invasive procedure as possible. 07:19 So if for all intents and purposes this is a 07:23 Benign Prostatic Hypertrophy 07:26 then you can go and see your doctor 07:30 and the physician can do what's called 07:33 transurethral resection of the prostate. 07:36 Basically they take a very fine tube, 07:38 insert it up through the urethra, 07:40 which is not a very pleasant thought 07:42 to many men, but through that little tube 07:45 they then have a little loop that is electrified 07:47 and by moving the loop up and down 07:49 they can shave off slivers of prostate 07:53 which are then washed and irrigated out. 07:55 Slivers of prostate to widened the opening 07:58 through the prostate gland and that is a 08:00 very successful surgical approach. 08:02 Is there any other approaches? 08:04 Well yes there are many, many innovative 08:07 approaches. I mean successful approaches. 08:08 Successful they have used microwaves 08:11 that they will put a probe up through 08:13 the prostate and then microwave the prostate. 08:16 Sometimes they can put a cold probe up 08:18 through there and they can actually chill 08:21 or freeze sections of prostate 08:23 and then that will die and shrivel back 08:25 and open the pathway. Now sometimes people 08:31 with Prostatic Hypertrophy 08:32 have a blood test done called 08:34 Prostatic Specific Antigen and when they 08:37 get that blood test done. And we know 08:38 that as PSA right? PSA we can get 08:41 that test done. It can be elevated in 08:44 prostatic hypertrophy, but that causes a 08:46 problem because it's also elevated in 08:49 prostatic carcinoma. And then we start 08:53 to have a problem as to what's 08:54 going on in this situation. 08:56 Now you have talked a lot about the 08:58 the enlargement, what about prostate cancer. 09:01 How do I know when if I have got an 09:03 enlarged prostate when do I know, 09:05 when should I maybe get some more tests gonna 09:08 find out if I got cancer. I'm little; 09:10 you know, I could be a little worried about it. 09:12 You see my index finger I'm wagging this finger 09:14 because all doctors know that the 09:18 rectal examination to feel the prostate 09:20 in the male is very important. 09:22 Because the outer wall of the, outer surface of 09:26 the prostate is where cancer usually begins 09:28 and so by feeling across that posterior wall 09:31 of the prostate it's possible sometimes 09:34 to detect a knobbly feeling or a firmness 09:38 to the prostate that is unnatural. 09:40 If you have an elevated PSA and you also feel 09:44 that knobbliness, the doctor is immediately 09:47 going to say I think we should move to a more 09:50 definitive diagnostic procedure in which case 09:52 he will use an ultrasound. 09:53 And then they will then put a 09:56 transrectal ultrasound. The transrectal 09:59 ultrasound goes up behind the prostate. 10:01 It emits these sound waves. 10:03 They are not electromagnetic 10:05 or they are just sound waves. 10:06 It emits the sound waves. The sound waves 10:09 go through the tissue. They meet against 10:12 resistance and bounce back and the computer 10:13 image that is made from all of this very 10:17 modern technology will then show an outline 10:20 of the prostate and they can then see 10:23 if there are indeed nodules or areas in the 10:26 prostate that have an altered texture 10:30 or an altered density to these sound waves. 10:34 If they do find this and if the PSA is elevated 10:37 then we are going to go the definitive step. 10:41 All cancer needs to be definitively diagnosed. 10:45 And how they do that? And the definitive step 10:47 is a biopsy. So a needle will be taken, 10:51 it can be done transperineal, 10:53 it can be done transrectally. 10:54 It doesn't matter how long the needle is. 10:56 Painful. Now for the audience explain 10:58 this trans, what do you mean by trans. 11:01 It can be across. It's across. 11:02 It's across, so the needle can be inserted 11:05 across through the rectum into the 11:07 prostate gland, through the rectum okay. 11:08 Or it maybe come up, through the penis. 11:11 No not through the penis, through the 11:13 perineum, the base of the pelvis there, 11:15 through that into the prostate. 11:17 It's done under an ultrasound so the 11:19 directions they know they putting it exactly 11:21 where they want to put it and then they will 11:23 aspirate cells from that area. 11:26 They may do 10, 16 samples to see 11:30 if there is any prostate cancer cells there. 11:33 Now you have mentioned so far 11:34 first of all we should go see our physician 11:37 if we think we have a problem 11:38 and if we are, for black maybe over 40 or 45 11:41 if we are another ethnic origins we should go 11:44 maybe when we are 50. Yes. 11:45 And may we should go every year. 11:47 At least, once a year probably. 11:48 I think it depends on what's our age is 11:51 and what our risk factors are. If we have 11:52 an enlargement maybe going once every year, 11:54 right. Yes for instance, my father died of 11:56 prostate cancer. Okay. So I know I have a 15% 12:00 greater chance than a man who father 12:04 did not died of prostate cancer. 12:06 So I take more care of myself in this regard 12:09 so that I go regularly for my screenings 12:11 and checks. Now okay so we go see a physician, 12:14 it takes a PSA test blood test. 12:18 If he finds some problem he might do an 12:21 ultrasound to see what kind of image 12:23 we have on the prostate and then 12:27 he might do a biopsy. Yes. Alright, 12:29 if he finds that the biopsy is clear 12:33 there are no cancer cells then what? 12:35 Then he will put his back to routine 12:37 sequential follow up because it's very 12:40 important and I would like all that people 12:42 who are watching this program to understand 12:44 that you can still have prostate cancer 12:47 even with the normal PSA which means 12:49 that it's not the absolute level, 12:52 but it maybe the trend of the PSA 12:55 which is so important and so we would like 12:58 our listeners and particularly viewers 13:00 if you are out there listening to me 13:01 and you are wondering about this. 13:03 Regularity in plotting and checking 13:06 your PSA level may, because if it goes long 13:10 flat, flat, flat and then suddenly it starts 13:13 to go up that indicates that something needs 13:16 to be done. Investigation needs 13:18 to be made. What's the normal PSA level? 13:20 A normal PSA level is between 1 and 4, 13:24 usually we like it to be less than 1, 13:27 but between 1 and 4 it's normal. 13:29 Though studies have been done that show 13:31 that even at a PSA of 1 there maybe 6 or 7% 13:36 of the male population in an older over 13:39 70 age group that actually do have 13:42 cancer cells in their prostate. 13:43 Now let's take another scenario let's suppose 13:46 someone has a reading of 8 or 10 13:48 and that stay steady for years. 13:50 There is no biopsy, there is no biopsy, 13:54 no cancerous biopsy, there is enlargement. 13:58 What kind of situation? Well then in that case. 14:00 How would you diagnose there 14:01 and what would your prognosis would be? 14:02 In that situation if you have done biopsies, 14:04 you know that you cannot show cancer. 14:06 He has an enlarged prostate then you will 14:08 attribute those elevated levels to the 14:11 prostatic hypertrophy itself. 14:13 So that the benign enlargement is producing 14:16 more of this antigen although it is not 14:18 malignant cells that are producing, 14:20 but still you want to watch that individual 14:22 very closely, on at least a yearly basis, 14:24 at least probably with levels like 14:26 that six monthly. Okay let's suppose 14:28 now we the, by the way what will our 14:32 family doctor be able to care for all this 14:35 or should we go further. You know, family doctors 14:38 are linchpin in healthcare system, 14:41 especially if there is a family doctor 14:43 you know well, you can talk to, 14:45 you can converse with, you feel at ease with 14:48 that doctor is a wonderful confident. 14:51 Now I'm little confused about this linchpin, 14:53 what does that mean? Because he is the key 14:57 in seeing that you get very good. 15:01 He is a gatekeeper. He is the gatekeeper. 15:02 He is the person that is going to look out 15:05 for you. And so if he finds that 15:08 you have an elevated PSA or he is suspicious 15:11 or he has ordered an ultrasound 15:13 and there is something being found. 15:14 He is then going to refer you to an 15:18 urologist in your community, who is 15:20 well versed, well experienced 15:23 and able to take care of you. 15:24 And that's way you trust your family doctor. 15:26 You don't know the urologists in your area, 15:29 but the family doctors get to know 15:31 which practitioners give good service, 15:34 very knowledgeable, very competent 15:36 and capable. So your family doctor 15:38 is a wonderful advisor, but not necessarily 15:40 the one, who is going to give you the 15:42 advanced treatment. Allan, suppose that 15:45 I have done my biopsy and I go back 15:49 to the doctor for the report and he tells me 15:52 you have got cancerous cells. 15:55 What's the next step, I mean besides 15:59 my devastation and having a friend 16:01 that's dying of prostate cancer and others 16:03 that have cancer. This is serious 16:05 and I'm devastated I know as many people 16:09 are there they have cancer, 16:10 but what do a doctrine I do? 16:13 Well you know I'm very pleased that 16:15 you have talked about the devastation 16:17 of diagnosis, because I don't think 16:20 that physicians, no patients really 16:23 understand the enormous weight that suddenly 16:28 falls in an individual who has diagnosis 16:30 of cancer. The good news about prostate cancer 16:33 is that it is usually and I say usually 16:36 not going to be the disease that kills you. 16:40 It's good news. You are going to die 16:41 of other thing. Secondly, this is where 16:44 when we began we said this isn't a disease 16:46 that affects just the individual. 16:48 The whole family is going to be involved 16:50 in this and that's where a good loving 16:53 supportive wife and family can come around 16:56 and give hope. Hope is such an important 17:00 ingredient when we are talking about cancer. 17:02 Such an essential ingredient and you know 17:06 that's where I'm a Christian physician 17:08 and I'm unabashedly pleased to say so, 17:12 that not only do we have the support 17:14 of the family, but we also have the support 17:17 and the feeling that our Lord 17:19 and Savior Jesus Christ can support us 17:22 and help us go through this very difficult, 17:24 difficult time. It's like Psalm 23 says Yea, 17:28 thou I walk through the valley of the 17:30 shadow of death, I will fear no evil; 17:32 for thou art with me, so it's nice 17:35 if you can have a Christian physician. 17:36 I shall not fear of prostate cancer. 17:38 I will not fear of prostate cancer see, 17:40 now. And what do we do now? 17:43 We got to do something. Right. 17:44 The diagnosis has been made under 17:46 the microscope. Under that microscope, 17:49 they will also look at the sort of cells 17:51 how they dividing, how aggressive they appear 17:53 to be, is this a cancer that is particularly 17:57 aggressive or it is an indolent slow 18:00 looking cancer and they will assign to it 18:02 a score called the Gleason score. 18:06 A Gleason score will tell us 18:09 if it's very aggressive or if it's very indolent 18:12 which maybe important as to how we manage it. 18:15 For instance, if I'm 90-years-old 18:17 and I have got a very lazy indolent cancer. 18:21 I have also got diabetes and I have had 18:24 three heart attacks, my kidneys are failing, 18:27 I have got liver troubles and so forth. 18:29 My prostate cancer is the least of my worries. 18:32 Of your worries, yeah. Seems the 18:33 least one of I have. If I'm a 45-year-old 18:35 and my prostate cancer is a very aggressive 18:38 Gleason you know advanced. I don't wanna 18:42 give the numbers because we don't want to scare 18:43 people, but it's advanced then not only 18:47 myself, but my doctors are going to look 18:49 and say we need to be more aggressive 18:50 in the management of this cancer. 18:53 What's my options if I be diagnosed? Well before 18:56 we do options we have to stage it. Okay. 18:58 What's staging then? Staging is different 19:02 from classifying. Classifying tells us 19:04 how virulent, how aggressive, 19:06 how it's gonna you know go after us, 19:09 but staging tells us how far has it gone. 19:13 Okay, now if it's confined to the prostate 19:17 stage one we are very pleased because 19:19 we know that, that has an excellent, 19:21 excellent prognosis. If on the other hand 19:24 when we detect it and find it we do an x-ray 19:27 and a bone survey and a bone scan as people 19:29 will be asked to do and we find it's already 19:32 in the pelvis, in the femur and something 19:34 like that. We know that this is now 19:35 stage four, this is metastasized a long way. 19:39 We may find in between stages it may just 19:41 metastasize outside the prostate. 19:43 It may have got into the bladder 19:45 or to the rectum. It may have gone 19:46 in the lymph nodes. You know, 19:47 there are degrees of spread, 19:49 so we will stage it 1, 2, 3 or 4. 19:51 And the treatment options depend 19:54 on that stages. Okay let's go through 19:55 those treatment options. First of all stage one? 19:57 Well for stage one, we have a potentially 20:00 curable situation, so how we are 20:03 gonna cure it. Well you could go undergo 20:06 a prostatectomy, a radical prostatectomy 20:09 in which the prostate is taken away, 20:11 surgically, surgically. You remove it, 20:14 you put it in the surgical pot, 20:16 the pathologists looks under it and says 20:17 it looks like its all here, 20:18 all margins are clear of cancer. 20:20 We have got it all in the pot. 20:22 Some people would like that. Would that be 20:23 enough? Well for some it may. 20:25 Some will have a radical prostatectomy 20:28 where there will be dissection of 20:30 lymph nodes, periotics around the pelvis. 20:32 They will dissect all those nodes, 20:33 gather all the nodes in them, put those. 20:35 That would probably a stage 2 or 3. 20:37 That will be a stage, well not necessarily. 20:39 No, no because if it's a stage 2 or 3 20:41 we are not gonna be doing this surgery 20:42 because it's too late, but we are gonna go to 20:45 something other, but we are just ensuring 20:46 that we got it all. The problems with surgery 20:51 are that it sometimes difficult to do the 20:54 surgery without damaging nerves. 20:55 What kind of nerves? Well, the pelvic nerves 20:59 that are important for bladder control 21:02 and also sexual function. So now we are 21:06 getting serious. That is one of the problems. 21:08 Bladder. Bladder control is a serious problem, 21:11 but so is impotence to a young man 21:14 and a 40-year-old is a young man. 21:17 So they now have newer surgeries. But a 60 21:19 or 70-year-old doesn't worry about it right. 21:21 Well, I don't know about that, 21:22 are you speak for yourself so. Okay. 21:25 I mean who knows. I'm asking a question. 21:27 Yeah that's right and I'm saying 21:28 it's important. Yes it's important. 21:30 So, in other words, so it's important 21:32 for most all ages. Yeah, all most men, 21:34 who are healthy. Yeah okay. 21:35 So in another words we want a nerve-sparing 21:38 operation and skillful urologists can do 21:40 a procedure which spares the nerves 21:42 and yet removes the cancer. 21:44 But because of this a lot of people look to 21:47 other methods for treating 21:49 prostate cancer. And they are? 21:52 Well you know when it comes treating cancer 21:54 they usually fall into several groups. 21:56 The one important group is a kind of a 21:59 radiotherapy; a radiation therapy. 22:02 But it's not all radiation therapy is not 22:04 all the same because sometimes 22:06 you can put little seeds of radioactive 22:09 substances insert them into the prostate 22:12 and they have this kind of hallow of 22:14 radioactivity which kills of the prostate. 22:16 So that's one method that maybe used. 22:18 The other is the external beam, 22:20 which maybe used to actually irradiate 22:23 the prostate. And if there is evidence 22:26 of spread the beam. Is that same as protein, 22:28 proton. No. That's different okay. This is 22:30 regular radiotherapy. Okay. Proton therapy, 22:33 I'm so glad you have mentioned, 22:34 because proton therapy is an advanced 22:37 that has been brought to the world largely 22:40 by Loma Linda University. Located in 22:44 Southern California. Located in Loma Linda, 22:45 Southern California and proton therapy 22:48 is a most fantastic therapy because 22:51 the proton waves can actually be contoured, 22:55 which you can't do. Radiation goes 22:57 in a straight line. The protons they can 22:59 actually contour to a little bit, 23:01 so that they can actually deliver 23:04 these protons into a given shape. 23:08 Allan, I'm very interested in this 23:10 proton therapy at Loma Linda University. 23:12 You know people today being in the area of 23:14 nutrition, people are concerned about 23:16 microwave ovens. Now how does this proton 23:19 affect the rest of my body? Does it, 23:21 you know, if I just it's designed 23:24 for the prostate, but what about 23:26 other parts of my body, does it affect 23:28 that at all? Well a proton is a sub-atomic 23:31 particle that is put into this very, very 23:36 prescribed place and it's not going to affect 23:41 the rest of your body. It's only going 23:42 to affect that particular portion 23:44 where it's focused and then it's going to 23:45 defuse out and disappear and dissipate. 23:48 Of course it's not just prostate therapy; 23:50 this can be used for many many different 23:53 applications, so it's a wonderful, wonderful 23:55 advance. In fact, MD Anderson is just 23:58 in the process of getting one installed. 24:00 Where is that located? That I don't know, 24:01 I can't give you the location. 24:03 It's in Texas I think? It's in Texas I think 24:06 but I'm not sure yet. And so is at Harvard 24:09 they have one in Boston. They have one of those. 24:12 These things cost millions of dollars. 24:13 The one at Loma Linda happened to know 24:16 was developed there, Dr. Slater 24:19 was the doctor that put that in his team, 24:22 put that together and it costs many millions 24:24 of dollars to get into place, 24:26 but a very very effective and 24:28 proven therapy for prostate cancer. 24:31 Now very interesting you've first talked 24:33 about options that a person might have, 24:35 that's been diagnosed with prostate cancer. 24:36 First of all was surgery, then it was 24:39 radiotherapy, then it was the proton, 24:42 now is this the order that usually 24:45 you are treated in. Yes. Or a surgery 24:48 the first before for the proton or. 24:51 This depends on the stage. Okay. 24:53 So when we get to more advanced forms 24:55 then prostate cancer is very often 24:58 dependent on testosterone male 25:00 hormone to fuel its fire of cell division 25:03 and so forth. So by blocking testosterone 25:06 production either with the certain medications 25:08 that block it, so there are testosterone 25:11 blockers. There is also a substance called 25:14 a GnRH analog, which is actually a pituitary 25:17 stimulator and it can shut the pituitary 25:20 production of luteinizing hormone 25:22 down, so that we don't get the production 25:25 of testosterone. And that can be 25:28 used things like Lupride and some of those 25:31 medications given by injection or pallets. 25:35 And then of course there is another 25:37 surgical approach which is in a way 25:38 and indirectly a kind of medical therapy 25:43 and that is castration to remove the testicles, 25:46 so that they do not produce a testosterone. 25:48 So, yes we have a full range of treatments. 25:52 Now, there is one you have mentioned though. 25:53 What about drug therapy any, any promise there? 25:57 Yes drugs therapy chemotherapy, 25:59 where there are many agents that will attack 26:02 rapidly dividing cells. But in practice for 26:05 prostate cancer we tend to find that the 26:08 therapies have been more along the lines 26:09 of these hormonal manipulations. 26:12 Occasionally, a person will get severe 26:14 bone pain and that will respond often times 26:17 very well to non-steroidal 26:19 anti-inflammatories and later on it maybe 26:21 more powerful medications will be 26:23 required and on occasion a shot of radiation 26:26 to a lesion in a bone will relieve bone pain. 26:30 And so many many therapies are team 26:33 approach to one's care. And that's why 26:35 yes the second opinion is very important. 26:38 I would like to leave the last minute or two, 26:40 to prevention. Now, there is lot where 26:43 you have mentioned I think of Saw Palmetto, 26:46 but what about prevention or yeah, 26:50 what about prevention. Is there anyway 26:51 we can keep from going through, 26:53 getting this surgery or this proton therapy 26:58 or radical prostatectomy and so on. 27:01 The literature has looked at that 27:03 and the Adventist health study done out 27:04 of Loma Linda University has looked at that 27:06 in great detail and Baldwin presented 27:08 a paper that suggested that the regular 27:11 consumption of tomatoes provides sufficient 27:15 Lycopenes, especially if they are cooked 27:17 tomatoes. Give sufficient Lycopenes 27:20 to reduce the risk. Okay what else quickly? 27:22 Well, I think that's the main one soy products 27:25 are another. Soy milk, a daily glass of soy milk 27:28 maybe very helpful. I think the Loma Linda 27:30 study showed that those who had two or three 27:33 glasses of soy milk had lot less 27:35 with prostate cancer. Yes lot less. 27:36 That's a possibility. But the study 27:38 was not sufficiently abroad though 27:41 we can make a definitive statement 27:42 that if you drink soy milk you won't get 27:44 prostate. Remember with all of these things 27:45 although lifestyle can lower your risk. 27:48 It doesn't always prevent it. 27:52 Allan that's a very good point 27:53 and I would like to thank you 27:55 today for being our guest. It's been a 27:57 pleasure of discussing this topic with you. 27:59 Has been a pleasure for me too 28:00 and a privilege thank you. 28:02 And now with the audience I would like 28:03 to leave one of the points and that is 28:05 if you are diagnosed with prostate cancer, 28:08 it's not your fault and God can be 28:11 with us during this time of need. |
Revised 2014-12-17