Guys! Check your prostate

Gentlemen, if trips to the restroom require sudden dashes or are marked by difficulty urinating, your prostate may be enlarged.


The prostate gland commonly becomes larger in older men in their mid-life termed benign prostatic hyperplasia (BPH). Even though it can cause problems with passing urine, symptoms are often mild. Without treatment, the condition may not deteriorate and improve over time instead. However, if symptoms become troublesome or distressing, a medical review is necessary. You can determine the severity of the condition by conducting a self-examination as follows:

	Not at all	Less than 1 time in 5	Less than half the time	About half the time	More than half the time	Almost always	Your score
Incomplete emptying Over the past month, how often have you had a sensation of not emptying your bladder completely after you finish urinating?	0	1	2	3	4	5
Frequency Over the past month, how often have you had to urinate again less than two hours after you finished urinating?	0	1	2	3	4	5
Intermittency Over the past month, how often have you found you stopped and started again several times when you urinated?	0	1	2	3	4	5
Urgency Over the last month, how difficult have you found it to postpone urination?	0	1	2	3	4	5
Weak stream Over the past month, how often have you had a weak urinary stream?	0	1	2	3	4	5
Straining Over the past month, how often have you had to push or strain to begin urination?	0	1	2	3	4	5
	None	1 time	2 times	3 times	4 times	5 times or more	Your score
Nocturia Over the past month, how many times did you most typically get up to urinate from the time you went to bed until the time you got up in the morning?	0	1	2	3	4	5
Total IPSS score (see recommendations below)

Basically the signs of any trouble brewing below:

• A frequent and urgent need to urinate. Is common to get up many times a night to go to the bathroom
• Trouble starting a urine stream. Even with an urge, may find it hard to start urinating
• A weak stream of urine
• A small amount of urine each time
• The feeling that you still have to go, even when you have just finished urinating
• Leaking or dribbling urine
• Small amounts of blood in your urine

What is happening under?

The prostate is part of a man’s sex organs. At birth, a boy’s prostate gland is about the size of a pea. It is about the size of a walnut fully developed by age 25 and surrounds the tube called the urethra, located just below the bladder. Its job is to produce fluid that protects and nourishes sperm cells in semen.

 

The urethra has two functions: to carry urine from the bladder when you urinate and to carry semen during a sexual climax or ejaculation.

Prostatitis refers to the condition where the prostate is inflamed or irritated, causing a burning feeling when urinating and with increased frequency. There may also be a fever or extreme fatigue. Like any inflammation, it is usually a sign that the body is fighting germs or repairing an injury. If prostatitis is caused by bacteria, tiny organisms can be seen through a microscope in a sample of your urine. Often an antibiotic or a medicine that kills bacteria is prescribed.


More worrying is prostate enlargement or BPH where an expanding prostate is caused by changes in hormone balance and cell-growth factors. As it grows, it squeezes the urethra. Since urine travels from the bladder through the urethra, the pressure from the enlarged prostate may affect bladder control. With the bladder weakens and loses the ability to empty itself, urine may stay on for too long to cause urinary tract infection, bladder or kidney damage, bladder stones and on continence.

Medical detection and Diagnosis


Men with such problem normally refuse to seek medical treatment due to the embarrassment and misunderstanding that it may affect their sexual life. Take note that you are not alone. The Urology Care Foundation estimates that 50% of men in their 50s are sharing a similar fate. Seek early treatment before the condition worsens. Three tests commonly conducted are:

1. Prostate Specific Antigen (PSA) - This test checks for protein released by the prostate gland with safe range below 4 ng/mL and higher readings evidenced in benign prostate enlargement or inflammation of the prostate.

2. Digital Rectal Exam (DRE) - The doctor feels the texture of the prostate gland with a finger gently placed in the back passage or rectum. Prostate cancer can cause abnormal nodules to form on the wall of the prostate.

3. Prostate therapy - An ultrasound guided biopsy is performed to obtain tissue samples from the prostate performed under local anesthesia before sending to the laboratory for microscopic examination.

How is BPH treated?

Several treatments are available -

• Watchful waiting. If your symptoms do not bother you too much, you may choose to live with them rather than take pills daily or have surgery. However, monitor closely and go for regular checkups to ensure your condition does not deteriorate. These steps may help you manage mild symptoms:

        ++ Do pelvic-strengthening exercises.
        ++ Stay active.
        ++ Decrease alcohol and caffeine intake.
        ++ Space out how much you drink rather than drinking a lot at once.
        ++ Urinate when the urge strikes — don’t wait.
        ++ Avoid decongestants and antihistamines.

• Drugs. The most common type of medications are called alpha-blockers. This class of medications works by relaxing the bladder neck muscles and the muscle fibers in the prostate. The muscle relaxation makes it easier to urinate. You can expect an increase in urine flow and a less frequent need to urinate within a day or two if you take an alpha blocker for BPH.
• Nonsurgical procedures. For severe condition, where the urethra is totally blocked and the patient cannot urinate or bad urinary tract problem like infection, bladder stones and kidney failure, a more established procedure known as transurethral resection of the prostate (Turp) needs to be performed. It involves inserting thin tubes charged with an electrical current through the urethra to the area where the prostate meets the bladder to scrape out the swollen parts of the prostate around it. With the bladder muscles relaxing, urine can flow out of the bladder easier. A gel may be applied to the urethra to prevent pain or discomfort. You do not need drugs to enable you to sleep. Long-term medication is available but does not always work and has side effects such as decreased libido and enlarged breasts.
• Surgery is the last option in complicated cases of a very enlarged prostate, difficulty in urinating, having a partial blockage in their urethra that causes repeated urinary tract infections, bladder stones or damage, or those who have kidney damage. Such operation involves removing only the portion of the prostate blocking urine flow. Surgery for BPH may have a temporary effect on sexual function. However, most men recover complete sexual function within a year after surgery. The exact length of time depends on how long you had symptoms before surgery was done and on the type of surgery. After the surgery, some men find that semen is not released from the penis during orgasm. Instead, it flows back into the bladder. In some cases, this condition can be treated with a drug that helps keep the bladder closed. A doctor who specializes in fertility problems may be able to help if backwards ejaculation causes a problem for a couple trying to get pregnant. Erection problems and loss of bladder control can be treated, and chances are good if medical help is sought.
• Hormonal therapy - Androgens, such as testosterone, are primarily made by the testes and a small fraction is produced by the adrenal glands (located above the kidneys). These hormones are responsible for the development and function of the male sexual organs and distinct male characteristics. Anti-androgens are prescribed for patients undergoing surgical and chemo treatment to disable the hormone from fueling the growth of abnormal cell growth.

PROSTATE CANCER
 
In recent years, prostate cancer is fast becoming the top cancer killer in the world amongst the male population, after colorectal and lung cancer. The incidence of prostate cancer increases substantially with age above 50 years as can be seen from statistics collected:

Age	Incidence of prostate cancer
<40	1 in 10,000 men
40-59	1 in 38 men
60-69	1 in 14 men

In many cases, multiple factors may be involved, including adopting sedentary lifestyle, genetics and exposure to environmental toxins such as certain chemicals or radiation. Men with diet high in animal fat and low in soya products are vulnerable. There is also evidence that vitamin D deficiency may increase risk for prostate cancer.

Signs and Symptoms

 

+  Trouble passing urine (frequent urination especially at night, painful urination and difficulty starting and maintaining a steady stream of urine)

+ Blood present in the urine or semen

+ General pain or discomfort in the pelvic area, lower back, hips or thighs, as cancer has spread to bones

+  Weakness or numbness in the legs or feet, even loss of bladder or bowel control from cancer pressing on the spinal cord

+ Erectile dysfunction


Treatment options


Mutations in the DNA lead to the growth of cells in the prostate to start growing uncontrollably and abnormally. The cancer can take the form of a benign growth that does not cause any problems throughout one's lifetime or malignant tumor that turns aggressive and invades other parts of the body.











After diagnosis of prostate cancer, additional tests are required to find out if cancer cells are confined to the prostate or have spread to other regions in the body. This is achieved by bone scan or magnetic resonance imaging (MRI).

The decision on the choice of treatment also depends on the profile of the patient and the aggressiveness of the cancer. As signs and symptoms of prostate cancer tend to show up late, it may be already in the advanced stage upon first detection.

+ In patients where prostate cancer is involving other organs and where medical care is not possible, they are prescribed hormonal therapy to control symptoms and improve quality of life.

+  As the male sex hormone testosterone fuels the growth of prostate cancer cells, removing it will result in tumor cells not being able to survive. For those with severe cancer profile and in good health, surgical procedure may necessitate the removal of prostate, both testes, surrounding tissue and seminal vesicles. In some instances, the pelvic lymph nodes around the prostate gland may also be removed. Usually a 15cm incision below the navel in the midline of the abdomen is performed.

+ Radiation therapy entails the use of high energy X-rays to kill cancer cells. Hormonal therapy is usually applied at the same time.

+ Chemotherapy therapy is usually given to patients with advanced cancer not responsive to hormonal treatment. This modality involves drugs used to stop the growth of cancer cells, either by killing or stopping them from dividing.

+ In more advanced stage, highly potent drugs have to be prescribed when conventional treatment like chemotherapy and hormonal therapy are no longer effective.

+  Vaccine therapy and bone-directed therapies may also be necessary for some patients.

For all the above treatment options be prepared to endure discomfort and pain from complications.

The Natural Way to Solve Prostate Problem

Recent study from a German medical team shows that men who subject themselves to repeated biopsies to diagnose prostate cancer could suffer from temporary erectile dysfunction (side effect decreases with time) and in some cases, lingering problems with urination, such as straining to pass urine and frequent night-time trips to the toilet.

Taking more samples during the biopsy should increase the chances of finding any tumor. However, all those needle sticks may come with a cost due to the damage to the "neurovascular bundle" a maze of nerves and blood vessels close to the prostate.

There are a number of well-controlled clinical studies that confirm the safe and effective use of saw palmetto for the treatment of BPH. Saw palmetto extracts can reduce the activity of 5-alpha-reductase by about 40%, and hence reduce the uptake of dihydrotestosterone by the prostate gland. The active substances in saw palmetto berries, such as the phytosterols, provide beneficial effects such as increased urinary flow, increased ease in commencing urination, reduced post-voiding residual volume, decreased frequency of urination, and a decreased urge to void during the night. While saw palmetto effectively diminishes the symptoms of BPH, it appears to act without reducing the size of the prostate.

Experiments have shown that men with an enlarged prostate who received an extract of saw palmetto for 30 days experienced 45% less nocturnal trips to the bathroom, a 50% increase in urinary flow rates, diminished residual urinary volume, and less pain during urination. After three months 90% of the patients reported much lesser problems with no side effects.

Our comments

Making dietary changes and regular exercises may slow the progress of prostate disorders. Men should increase the intake of vitamins and minerals from whole food, such as flaxseed, tomato and soybean. Low fat and high fiber diet are no longer important to just women, but also men. Beside, health authorities should educate public on the importance of healthy prostate and encourage them to be brave when faced with such 'embarrassing' issue.

Scoring & VIVA Recommendations

Total Score	Severity	ProsmettTM
0 - 7	Mild or no symptoms	1 capsule twice daily after meal (Preventive dosage)
8 - 19	Moderate	2 capsules twice daily after meal
20 - 35	Severe	3 capsules twice daily after meal

It is recommended that all adults men especially those above 40 years old to take preventive dosage of VIVA Prosmett even without any symptoms. It contains natural bioactive botanical and herbal compounds like saw palmetto extract, pygeum bark extract, tomato extracts, wheat germ powder that are widely recognised to exert protective effects within the prostrate gland and urinary system. Other ingredients include:

Beta-sitosterol (found in soybean) naturally inhibits the production of DHT (dihydrotestosterone), a hormone which stimulates enlargement of the prostate

Pumpkin seed extract inhibits production of testosterone, a hormone which contributes to an enlarged prostate

Red clover extract helps decrease total prostate-specific antigen (PSA), a protein produced by the cells of the prostate gland that is often elevated in the presence of prostate disorders

Green tea extract reduces oxidative DNA damage and inflammation  

Antioxidant vitamins A and E, and trace minerals selenium and zinc fight against free radicals and maintain proper functioning of the prostate.

Phytonutrients such as tomato lycopene have high antioxidant activity and supports healthy PSA levels.

For prostate cancer, viva products to consider - germanium, selguard, vivashield, oxypower, dailyguard, floraguard, greem barley, Omega 3.