By Penelope A. Domogo, MD
The prostate is part of the male reproductive system located in the pelvis just below the urinary bladder and in front of the rectum. It also envelops part of the urethra. The urethra is the tube through which a man urinates and ejaculates. So in men, the urethra is part of both the urinary and reproductive system. Unlike women where the urethra is a part of the urinary system only.
The prostate contains many small glands that produce and secrete a whitish fluid which help in the mobility of the sperms and gives the seminal fluid its whitish appearance. The prostate requires male hormones, also called androgens, to function well. We discussed male hormones in an earlier issue.
Like all other cancers, the occurrence of prostate cancer is increasing. And like all other cancers, it is found more in developed countries like the United States. In the Philippines, it is not as common as lung and liver cancer in men, but it is here. I am sure, though, that it is unheard of in many Igorot villages…. as of now.
Why so? The Physicians Committee on Responsible Medicine (PCRM) says “…several lines of evidence indicate that consumption of dairy products is associated with increased risk of prostate cancer incidence and mortality.” Many studies have been conducted in many different countries and these have consistently shown that the incidence of prostate cancer is more in milk-drinking men than in men who don’t drink milk. For example, scientists have seen that there are more men in America (meaning the USA) who develop prostate cancer compared to men of China and Japan. What they discovered is that the American diet, which we also call the western diet, has a lot of milk and other dairy products which is absent or rare in the Chinese or Japanese diet. Of course, the western diet is also loaded with meat and eggs so that some scientists think the culprit in prostate cancer is the red meat. As of the present, there is enough evidence to show that the risk of getting prostate cancer, along with breast and other reproductive cancers, increases with frequent milk intake. Of course, we are not saying that when you drink milk, you will get prostate cancer. What we are saying is that your risk of getting prostate cancer increases the more you drink milk. Again, when we say milk, it is that thing you buy that did not come from your mother’s breast or from plants. Now, can you see why prostate and breast cancer is unheard of in many Igorot villages? Prostate cancer and all other cancers is a lifestyle disease, like hypertension and diabetes.
How does milk cause cancer? Even the latest technology in the world cannot detect definitely how cancer really sets in but let us take see what the experts say. According to PCRM, “Mechanisms that may explain this association (between milk and prostate cancer) include the deleterious effect of high-calcium foods on vitamin D balance, the tendency of frequent dairy intake to increase serum insulin-like growth factor I (IGF-I) concentrations, and the effect of dairy products on testosterone concentration or activity…. Most dairy products contain substantial amounts of fat and are devoid of fiber, a combination that is likely to increase serum testosterone concentration and activity, with a mitogenic effect on prostate tissue.” Hmm… very technical language. What is important for the general public to know is that there is something in that milk from the store that is not healthy for people. By now, dear reader, you would understand that. We have repeated many times in this column that nature designed that milk in the store for the baby cow not for people.
Researches also show that prostate cancer, just like many other lifestyle diseases, occurs more in older men. I surmise that it is because of the cumulative toxic effects of bad food that people eat and drink.
What are its symptoms? These, of course, would be related to the location and function of the prostate. Early cancers usually don’t present any symptoms. The usual first symptom is a tumor or “bukol” so in the prostate, it presents as enlargement. (Take note, though, that not all “bukol” is cancerous so prostatic enlargement may be non-cancerous.) So the most common symptom of prostate trouble is difficulty in urination because the “bukol” presses on the urethra. Other symptoms can be frequent urination, especially at night, painful urination, painful ejaculation, blood in the urine, or continuing pain or discomfort in the lower back, hips or upper thighs.
Prostate enlargement can be detected through digital rectal examination (DRE) where the examiner inserts a gloved, lubricated finger into the rectum and feel for any prostatic enlargement or abnormal consistency. Although uncomfortable, this procedure is not painful and it takes only a few minutes. There is also a test for prostate-specific antigen (PSA) but there are false-positive and false-negative results. This means that a high PSA result does not always mean there is prostate cancer and that a low result does not necessarily mean there is no cancer. The United States Preventive Services Task Force in 2012 recommended against screening for prostate cancer using PSA testing because of the risk of over-diagnosis and over-treatment. A definite test would be prostate biopsy.
Since prostate cancer is usually slow-growing and patients are usually old, treatment is an option, not a necessity, especially if it is diagnosed by PSA testing. Treatment is major surgery, drugs and radiation therapy and these may cause impotence and urinary incontinence. For patients over 70 years with slow-growing cancer confined to the prostate, watchful waiting is recommended. Studies show that they are more likely to die of other diseases like hypertension or diabetes.
How then will we prevent prostate cancer from getting into our communities? Again, we take advice from worldwide experience. From PCRM- “Evidence from international, case-control and cohort studies suggests that men who avoid dairy products are at lower risk of prostate cancer incidence and mortality, compared to others.” That’s good news for us in the Philippines and other Asian countries who don’t have dairy in our traditional diet. We, Filipinos, were not a milk-drinking or cheese-eating people in the past. So we don’t have to do anything drastic in our diet. We just have to revalue our rice, rice coffee, camote, beans and malunggay and be contented with Mother’s milk. **
