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North Americas Busiest Chatline
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ESPN is an American global cable television network focusing on sports-related programming including live and recorded event telecasts, sports talk shows, and other original programming. Its name derives from Entertainment and Sports Programming Network.
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Prostate Cancer Treatment Options

Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate.

The prostate is a gland in the male reproductive system located just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland makes fluid that is part of the semen.

Enlarge

Anatomy of the male reproductive and urinary systems, showing the prostate, testicles, bladder, and other organs.

Prostate cancer is found mainly in older men. As men age, the prostate may get bigger and block the urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed to correct it. Thesymptoms of benign prostatic hyperplasia or of other problems in the prostate may be like symptoms of prostate cancer.

Enlarge

Normal prostate and benign prostatic hyperplasia (BPH). A normal prostate does not block the flow of urine from the bladder. An enlarged prostate presses on the bladder and urethra and blocks the flow of urine.

Possible signs of prostate cancer include a weak flow of urine or frequent urination.

These and other symptoms may be caused by prostate cancer. Other conditions may cause the same symptoms. Check with your doctor if you have any of the following problems:

• Weak or interrupted flow of urine.
• Frequent urination (especially at night).
• Trouble urinating.
• Pain or burning during urination.
• Blood in the urine or semen.
• A pain in the back, hips, or pelvis that doesn't go away.
• Painful ejaculation.

Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer.

The following tests and procedures may be used:

• Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormalareas.
  Enlarge
  

  Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal.
  
  
• Prostate-specific antigen (PSA) test : A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection orinflammation of the prostate or BPH (an enlarged, but noncancerous, prostate).
  
• Transrectal ultrasound : A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Transrectal ultrasound may be used during a biopsy procedure.
  Enlarge
  

  Transrectal ultrasound. An ultrasound probe is inserted into the rectum to check the prostate. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the prostate.
  
  
• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by apathologist. The pathologist will check the biopsy sample to see if there are cancer cells and find out the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that atumor will spread. The lower the number, the less likely the tumor is to spread. There are 2 types of biopsy procedures used to diagnose prostate cancer:
  • Transrectal biopsy : The removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide the needle. A pathologist views the tissue under a microscope to look for cancer cells.
    Enlarge
    

    Transrectal biopsy. An ultrasound probe is inserted into the rectum to show where the tumor is. Then a needle is inserted through the rectum into the prostate to remove tissue from the prostate.
    
    
  • Transperineal biopsy : The removal of tissue from the prostate by inserting a thin needle through the skin between the scrotum and rectum and into the prostate. A pathologist views the tissue under a microscope to look for cancer cells.
    
  
  

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• The stage of the cancer (whether it affects part of the prostate, involves the whole prostate, or has spread to other places in the body).
• The patient’s age and health.
• Whether the cancer has just been diagnosed or has recurred (come back).

Prognosis also depends on the Gleason score and the level of PSA.

Holistic Cancer Treatment

Alternative cancer treatments describes alternative and complementary treatments for cancer that have not been approved by the government agencies responsible for the regulation of therapeutic goods. They include diet and exercise, chemicals, herbs, devices, and manual procedures. The treatments may be untested or unsupported by evidence, either because no proper testing has been conducted, or because testing did not demonstrate statistically significant efficacy. Concerns have been raised about the safety of some of them.

Alternative cancer treatments are typically contrasted with experimental cancer treatments, which are treatments for which experimental testing is currently underway. All currently approvedchemotherapeutic cancer treatments were considered experimental cancer treatments before their safety and efficacy testing was completed.

Such therapies can be categorized broadly into three groups: alternative treatments offered as a substitute to standard medical treatment; alternative treatments as an addition to standard treatment; and treatments proposed in the past that have been found in clinical trials to be useless and/or unsafe. Some of these obsolete or disproven treatments continue to be promoted, sold, and used.

Since the 1940s, medical science has developed chemotherapy, radiation therapy, adjuvant therapy and the newer targeted therapies, as well as refining surgical techniques for removing cancer. Before the development of these modern, evidence-based treatments, 90% of cancer patients died within five years.^[1] With modern mainstream treatments, only 34% of cancer patients die within five years.^[2]However, while mainstream forms of cancer treatment generally prolong life or permanently cure cancer, most treatments also have side effects ranging from unpleasant to fatal, such as pain, blood clots, fatigue, and infection,^[3] These side effects and the lack of a guarantee that treatment will be successful create appeal for alternative treatments for cancer, which purport to cause fewer side effects or to increase survival rates.

Alternative cancer treatments have typically not undergone properly conducted, well-designed clinical trials, or the results have not been published due to publication bias (a refusal to publish results showing a treatment does not work). Among those that have been published, the methodology is often poor. A 2006 systematic review of 214 articles covering 198 clinical trials of alternative cancer treatments concluded that almost none conducted dose-ranging studies, which are necessary to ensure that the patients are being given a useful amount of the treatment.^[4] These kinds of treatments appear and vanish frequently, and have throughout history.

Complementary versus alternative treatments

Complementary and alternative cancer treatments are often grouped together, but this grouping is controversial.^[5] Definitions vary, but generally speaking, the same methods that are called "complementary" when given alongside mainstream treatments are "alternative" when they are not.^[6] Thus it is not the specific treatment, per se, that is actually "complementary" or "alternative", but the context in which it is used. Complementary therapies receive more support within the mainstream medical community than alternative treatments.

Complementary treatments are used in conjunction with proven mainstream treatments. They tend to be pleasant for the patient, not involve substances with any pharmacological effects, inexpensive, and intended to treat side effects rather than to kill cancer cells.^[7] Medical massage and self-hypnosis to treat pain are examples of complementary treatments.

Alternative treatments, by contrast, are used in place of mainstream treatments. The most popular alternative cancer therapies are various, generally strict diets, including the macrobiotic diet. Other therapies include mind-body interventions, bioelectromagnetics, nutritional supplements, and herbs^[5] (Anticancer plants^[8]). The popularity and prevalence of different treatments varies widely by region.^[9]

Due to the poor quality of most studies of complementary and alternative medicine in the treatment of cancer pain, it is not possible to recommend these therapies for the management of cancer pain. There is weak evidence for a modest benefit from hypnosis, supportive psychotherapy and cognitive therapy; studies of massage therapy produced mixed results and none found pain relief after 4 weeks; Reiki, and touch therapy results were inconclusive; acupuncture, the most studied such treatment, has demonstrated no benefit as an adjunct analgesic in cancer pain; the evidence for music therapy is equivocal; and some herbal interventions such as PC-SPES, mistletoe, and saw palmetto are known to be toxic to some cancer patients. The most promising evidence, though still weak, is for mind-body interventions such as biofeedback and relaxation techniques.^[10]

People who choose alternative treatments

People who choose alternative treatments tend to believe that evidence-based medicine is ineffective, while still believing that their own health could be improved.^[11] They are impressed by physiological and other scientific-sounding information, prefer a healthcare model that promises to treat the patient as an integrated, whole person, and are loyal to their alternative healthcare providers.^[11]

Cancer patients who choose complementary or alternative treatments in addition to conventional treatments believe themselves less likely to die than patients who choose only conventional treatments.^[12] They feel a greater sense of control over their destinies, and report less anxiety and depression.^[12]

However, patients who use alternative treatments have a poorer survival time, even after controlling for type and stage of disease.^[13] The reason that patients using alternative treatments die sooner may be because patients who accurately perceive that they are likely to survive do not attempt unproven remedies, and patients who accurately perceive that they are unlikely to survive are attracted to unproven remedies.^[13] Among patients who believe their condition to be untreatable by evidence-based medicine, "desperation drives them into the hands of anyone with a promise and a smile."^[14] Con artists have long exploited fear, ignorance, and desperation to strip dying people of their money, comfort, and dignity.

About half the practitioners who dispense complementary or alternative treatments are physicians, although they tend to be generalists rather than oncologists. As many as 60% of physicians have referred their patients to a complementary or alternative practitioner for some purpose.^[5]

 

Examples of alternative treatment

None of the cancer treatments on this list have substantial evidence for their effectiveness in treating cancer. Some have shown some benefits as complementary therapy, to reduce pain. Very few suppliers of alternative medicines have undertaken scientifically controlled clinical trials for their products, although occasional preliminary testing, or testing as adjuvant therapy, has been performed. For this reason, alternative therapies generally rely on testimonial oranecdotal evidence. In the United States, FDA regulations forbid the makers of unproven products from claiming efficacy against cancer.

 

Under investigation

Not to be confused with Experimental cancer treatment.

• Medical cannabis^[15]
• Quercetin^[16]
• Vitamin C megadosage by intravenous infusion^[17] Oral vitamin C, regardless of dose, is disproven.^[13] This is a type of redox therapy.
• Annona - Annomolin taken from the seeds of Annona cherimola was selectively cytotoxic against the human prostate tumour cell

line (PC-3), with a potency of over 10,000 times that of adriamycin. Annocherimolin from this plant possessed cytotoxic potencies

about 10,000 times those of adriamycin in the breast (MCF-7) and colon (HT-29) cancer cell lines.^[18]

Aqueous extrats of Annona squamosa seeds possessed significant antitumor activity in vivo against AD-5 tumor.^[19]

• Medicinal mushrooms^[20][21]
• Selenium (Selenomethionine and Se-methylselenocysteine)^[22][23]
• Mistletoe extracts such as Iscador (may improve patient's quality of life)^[24]
• Nanobees
• Deoxycholic acid
• Dichloroacetic acid
• Curcumin
• Milk thistle
• Proton therapy

• Mixed results

  • Coley's Toxins^[25]
  • Caesium chloride

  [edit]Unknown

  • Budwig diet, a diet emphasizing flaxseed oil, milk, fruits, vegetables, and fiber. More likely to be useful for preventing cancer rather than treating it.
  • Sodium Bicarbonate

  [edit]Disproven or scientifically implausible

  Chemical substances

  • Gonzalez regimen^[26]
  • Homeopathy (disproven), tiny amounts of substances, ritually diluted according to 18th century standards
  • Laetrile (disproven), also known as B-17, is a cyanide-containing extract of crushed apricot pits
  • Di Bella Multitherapy (disproven), a mixture of vitamins, melatonin, and other chemicals.^[13]
  • Emanuel Revici's catabolic/anabolic approach (disproven)^[13]
  • Hoxsey method (disproven), a caustic, escharotic paste of herbs and arsenic that is banned in the US as "worthless", "discredited" and "quackery".^[27]
  • 714X, a water-based solution purported to kill "somatids", which the inventor claims cause disease^[28]
  • Protocel and Cancell (disproven)
  • Krebiozen (disproven), purportedly diluted blood from horses^[29]
  • Hydrazine sulfate, a toxic, synthetic drug^[13]
  • Proteolytic enzyme therapy^[30]
  • William Koch's "glyoxide antitoxin" (fraud), also called "recrystallized synthetic toxin", which proved to be distilled water^[31]
  • Radio-Sulfo Brew, a poultice made of Limburger cheese (fraud)^[32]
  • Livingston-Wheeler, or Virginia Livingston's Progenitor cryptocides treatments, made from the patient's urine, to kill a non-existent bacteria claimed to be the cause of cancer^[13][32]
  • Lawrence Burton's Immuno-Augmentative Therapy, claimed to energize the immune system^[32]
  • Antineoplastons (disproven)^[13]
  • Chaparral^[13]
  • Shark cartilage^[13]
  • Escharotics such as Cansema or "black salve", usually a paste that kills any skin or tissue it is applied to^[33]
  • Essiac tea (disproven)^[34][35]
  • Amygdalin

  Diets

  • Gerson therapy (dangerous and disproven), a combination of diet and enemas^[36]
  • Johanna Brandt's "Grape Cure" (scientifically implausible), a diet of water and grapes^[37]
  • Beverly Hills diet (scientifically implausible), a largely fruitarian diet^[37]
  • Macrobiotic diet (scientifically implausible), a primarily vegetarian diet with no refined or processed foods (may be useful for cancer prevention, but not treatment)^[37]
  • Edgar Cayce's diet (scientifically implausible), which prefers alkaline foods to acidic ones^[37]
  • Juice fasting (scientifically implausible)

  Electrical or physical treatments

  • Orgone accumulators (fraud), a metal and cardboard box that the client sat in^[38]
  • Magnet therapy (disproven), applying magnets to the body^[39]
  • The Rife Machine (scientifically implausible, fraudulent), a radio frequency energy 'beam ray' tube machine^[40][41]

  Energy and psychological treatments

  • Anti-cancer psychotherapy (disproven),^[42] claiming that a "cancer personality" caused cancer, which could be cured through talk therapy, e.g., that of the Simonton Cancer Center,^[43] Bernie Siegel's "Exceptional Cancer Patients" (ECaP) or Deepak Chopra^[13]
  • Therapeutic touch (scientifically implausible), a type of energy therapy
  • Imagining successful outcomes (scientifically implausible), such as visualizing cancer cells dying, in cancer guided imagery^[44]
  • Psychic surgery, a sleight-of-hand confidence trick in which the practitioner pretends to remove a lump of tissue (typically raw animal entrails bought from a butcher) from a person

  [edit]Examples of complementary therapy

  • Acupuncture may help with nausea but does not treat the disease^[45]
  • Psychotherapy may reduce anxiety and improve quality of life^[13]
  • Massage therapy may temporarily reduce pain^[10]
  • Some cannabinoids may stimulate appetite and reduce symptoms such as pain and nausea related to therapy, which helps reduce weight loss.^[46]

Alternative theories of cancer

Some alternative cancer treatments are based on unproven or disproven theories of how cancer begins or is sustained in the body. Some common concepts are:

• Mind-body connection: This idea says that cancer forms because of, or can be controlled through, the person's mental and emotional state. Treatments based on this idea are mind–body interventions. Proponents say that cancer forms because the person is unhappy or stressed, or that a positive attitude can cure cancer after it has formed. A typical claim is that stress, anger, fear, or sadness depresses the immune system, whereas that love, forgiveness, confidence, and happiness cause the immune system to improve, and that this improved immune system will destroy the cancer. This belief that generally boosting the immune system's activity will kill the cancer cells is not supported by any scientific research.^[47] People with weak immune systems have about the same rate of cancer as people with healthy immune systems.^{[citation needed]} In fact, many cancers require the support of an active immune system (especially through inflammation) to establish the tumor microenvironment necessary for a tumor to grow.^[48]
• Toxin theory of cancer: In this idea, the body's metabolic processes are overwhelmed by normal, everyday byproducts. These byproducts, called "toxins", are said to build up in the cells and cause cancer and other diseases through a process sometimes called autointoxication or autotoxemia. Treatments following this approach are usually aimed at detoxification or body cleansing, such as enemas.
• Low activity by the immune system: This claim asserts that if only the body's immune system were strong enough, it would kill the "invading" or "foreign" cancer. Unfortunately, most cancer cells retain normal cell characteristics, making them appear to the immune system to be a normal part of the body. Cancerous tumors also actively induce immune tolerance, which prevents the immune system from attacking them.^[47] These treatments often focus on substance said to increase the immune system's activity.
• Supposed situations within the body: In this idea, the body is incapable of coping with transient or local differences. For example, proponents will say that a transient lack of oxygen in a small area of the body causes cancer, or that clothing prevents normal circulation and thereby causes cancer.
• Hypothetical microorganisms: While infections are a significant cause of certain kinds of cancer (e.g., Hepatitis B can cause liver cancer, and some human papillomaviruses cause cervical cancer), these stories usually assert that the harmless bacteria and fungi normally present in or on the body cause cancer, or that organisms only detectable by the proponent cause cancer.

[edit]Regulatory action

Government agencies around the world routinely investigate purported alternative cancer treatments in an effort to protect their citizens from fraud and abuse.

In 2008, the United States Federal Trade Commission acted against companies that made unsupported claims that their products, some of which included highly toxic chemicals, could cure cancer.^[49] Targets included Omega Supply, Native Essence Herb Company, Daniel Chapter One, Gemtronics, Inc., Herbs for Cancer, Nu-Gen Nutrition, Inc., Westberry Enterprises, Inc., Jim Clark's All Natural Cancer Therapy, Bioque Technologies, Inc., Cleansing Time Pro, and Premium-essiac-tea-4less.

[edit]See also

• Clinical trial
• Placebo effect
• Pseudoscience