Green tea and the prostate problems: prostate cancer, enlarged prostate etc.

For too long the benefits of green tea and its components have been subject of scrutiny by investigators in the medical fraternity.

Many studies have indicated that green tea and its components are helpful in providing treatment for various ailments including prostate cancer and benign prostatic hypertrophy (BPH).

The phytochemicals, chemicals that are biologically active but not nutritive antioxidants in green tea work on growth factors and proteins and act as prostate medicine to restrict the growth of benign and malignant tumors as well.

For men, prostate cancer is the second most common type of cancer after skin cancer. Benign enlargement of the prostate gland, in its worst form, causes several problems with urination and libido. Prostate cancer is reigns since it separated from its origin to distant parts of the body. Moreover, there is no guarantee when a benign condition takes a turn for the worst and develops premalignant and ultimately malignancy.

The green tea is now used as herb for the treatment of enlarged prostate. A study conducted by the UK Tea Council showed that of 32 men who already had pre-cancer lesions, only one prostate cancer development after a year of therapy with green tea. Moreover, nine of 30 men who were not given green tea developed prostate cancer.

The results indicate that antioxidants in green tea help in the caspase-mediated cell death, a process known in medical circles as apoptosis. It is a natural process of cell death in which the cell uses specialized cellular machinery to kill himself. This is basically a mechanism of cell suicide that controls their numbers and eliminates cells that threaten survival. In simple language means that it is the body’s natural process of survival of the fittest cells.

There have been numerous other studies indicating positive effects of green tea in other cancers such as breast cancer. At the same time the FDA has restricted a company from green tea to use advertising the advantages of green tea in reducing risk of prostate cancer and breast cancer.

The fight between the protagonists of conventional and alternative therapies seems endless. There will always be complaints, claims and counter accusations from one to another until the alternative remedies with time are investigated properly and are funded by government and private institutions. Until then, alternative remedies remain poor cousins waiting for their place in the sun.

Green tea is a harmless drink has no known side effects in reasonable quantities. If you can provide some advantages, and there seems no harm in including your drink green tea regularly.

Having accurate, updated information on prostate problems is also very important. If you feel that you need more information on prostate problems, EProstate Problems will take you directly to a Web site that will give you tons of information on prostate problems, Enlarged Prostate Problems, treatments, alternative therapy, specific conditions Prostate and clinical trials.

Mike Jsimon, M.D.
University of Maryland
Kidney and Urologic Diseases Information

Here are some of the bph symptoms. Depending on your age, having some of these symptoms does not mean you need treatment. Most of the following enlarged prostate gland symptoms may also be present in prostate cancer patients.

Signs and symptoms enlarged prostate:

• Diuria
  The need to urinate frequently during the day Normally you shouldn’t have to go more than once every two-three hours during the day unless you drink a lot of liquids such as coffee, tea or beer. But in the cases of prostate enlargement, the prostate gland will press on the bladder and thus diminish it’s capacity, which in turn triggers the need to urinate.
• Nocturia
  Getting up two or more times at night
  Getting up during the night with urging to urinate is not uncommon for most men and a lot of women, especially if they have had a lot to drink in the evening before bed time. But a man who have an enlarged prostate gland symptoms may have to get up several times during the night. Sometimes he only voids a small amount. This provokes general fatigue and thus diminishes the quality of life of the invidual. This is also due to the fact that the swollen prostate is so large that it presses on the bladder.
• Urgency- You have to go to the toilet NOW
  This symptom makes one feel like he can’t wait a second longer, he has to void the bladder.
• Hesitancy or Difficulty in starting the flow of urine
  This is not always a sign of BPH or a prostate enlargement symptom. Many man have trouble urinating in public toilets, or if there are “curious” people around.
• Straining
  You want to urinate but it just won’t come. The urethra is so pressed by the enlarged prostate gland that you may have to strain to force urine through the constricted urethra. Constant straining can have other consequences: it may cause the bladder muscles to simply give up and not work at all. Or this could just cause thickened bladder muscles. Exception: if you wake up in the morning with an erection, and an urge to urinate, this is what is called “a pee hard on”. Straining is almost always necessary to get it started. This is because the bladder sphincter, or valve, is supposed to remain closed in the presence of an erection, so as to prevent any ejaculate that might occur from entering the bladder. After a transurethral resection prostatectomy (TURP) this valve is usually damaged. In this case, quite often when an ejaculation occurs, the semen takes the shorter route into the bladder. This is called retrograde emission.
• Dribbling and difficulty in stopping
  After urination the flow will seem to stop but it may continue to dribble. This is quite embarassing if a meeting follows.
• Decreased strength and force of the stream
• Decreased size or caliber of the stream
  This would be due to the constriction of the prostatic urethra.
• Feeling as though you still have to go
  Even after voiding, you may feel like you still have to go
• Dysuria-Pain or burning during urination
  Any pain or burning sensation could be due to irritation of the urethra. If the patient is unable to completely empty the bladder, it may lead to bacterial infection which may cause pain and burning during urination. Pain and burning could also indicate that you have an inflammation, prostatitis, bladder stones or prostatic stones.
• Dizziness, nausea, unusual sleepiness
  These symptoms may occur if there has been kidney damage due to the urine blockage.

Now that you know the enlarged prostate syomptoms, you should also be warned that it doesn’t necessarily mean that is what you have. It could be any of the following disorders:

• Prostatitis
• Prostate cancer
• Urethral strictures
• may be on some sort of medication that is interfering with the muscle fibers in the prostate and with the bladder function

Further investigations will be needed to set the precise diagnosis as being bph/enlarged prostate or other disorder.

If a man has a high PSA reading after radiation or cryosurgery, and it remains high or increases in subsequent tests, then we know that all of the cancer was not killed, or that it had metastasized before treatment. This is a case of Prostate Cancer Recurrence (PSA numbers <>0 indicate this).

Ultra-sensitive PSA Test

Undetectable PSA after prostatectomy is perfect, this is after all the main goal of this radical intervention: no prostate=no PSA. However, if post treatment PSA levels are still there, then we know that the cancer had metastasized, and this is a sign prostate cancer is spreading after treatment. Metastatic cells are the same initial prostate cancer cells, no matter whether they have set up a colony in the lymph nodes or vertebra or lungs or wherever, and this calls for treatment after prostate cancer . So they will continue to pour PSA into the blood stream. Also, if a PSA blood tests shows that the PSA levels are rising after a prostatectomy , then we know that there are cancer cells still in the body somewhere.

The normal PSA test is not very sensitive, and it can detect only down to about 0.2 ng/ml. This is a good accuracy for pre-treatment PSA tests, for these levels can be influenced by many causes. But after treatment/intervention, especially after radical prostatectomy, there should be no PSA in the blood stream.

Dr. Stamey et al at Stanford University devised an ultra-sensitive test that may be ten times more sensitive than the normal Hybritech test. This test can show if the PSA is rising long before it becomes high enough to be detected by the normal PSA test (several months before). If the ultra-sensitive PSA test shows PSA activity, then new treatments options can be considered.

Following is a post from the internet by Charles Clausen about the ultrasensitive PSA tests:

There are two principal manufacturers of “superduper-ultrasensitive” assays, both of which use a chemiluminescent technique:

• Coming/Nichols, 33608 Ortega Hwy., San Juan Capistrano, CA 92690 1-800-642-4657
• Diagnostic Products, 5700 West 96th Street, Los Angeles, CA 90045 1-800-372-1782

The Nichols assay reports values down to 0.02, but can read values as low as 0.007. The Diagnostic Products Immulite assay reports values down to 0.04, but the “Immulite 3rd Generation” assay, which is expected to receive FDA approval, can readvalues down to O.003, and would, I presume, report values equal to or lower than the Nichols assay.

An interesting paper about the Nichols assay by Dr. Stamey of Stanford and the staff of the Nichols Institute can be obtained by phoning the Nichols number above. In this paper, it is stated that the Nichols assay values correlate very closely to those of the Hybritech and Yang assays. They say that their assay should be useful for detecting recurring PCa in post-prostatectomy patients because it allows more lead time in detecting a rising PSA. For this purpose, Dr. Stamey recommends testing every three months, until a PSA >0.07 is detected, then testing should be monthly, “to establish a log linear rise to levels >0.1 ng/mL”.

If a “progressive exponential increase” is detected, you know the PCa is back, but if the >0.07 proves to be a one time elevation, it is o.k. to resume testing every three months. The paper states, “serial measurements of serum PSA using an ultrasensitive essay can accelerate detection of recurrence in prostatectomized patients by many months.”

From what I have been able to gather, both of these assays are available at the same cost as conventional assays.

Charles Clausen, SW Oregon cclausen@magick.net

at age 56, 1/94 Dx: PSA 9.9, Gleason 3+4; 3/94 Tx: RP at UCSF, Dx: pT3aNl; thru 7/94 PSA <0.1, 10/94 PSA 0.1 (Abbott IMX); 1/95 to 12/95 Tx: CHT, 2/95 thru 3/96 PSA undetectable (IMX); 6/96 PSA 0.02, 9/96 PSA 0.09 (Immulite 3rd generation) >

Each year, an average of 40,000 American man have their prostate removed, convinced that this is the only hope they have. But is this really true? Statistics show that earlier than five years, 35% will be dealt with again.

The standard treatment choices -surgery, radiation, and hormonal therapy are of limited effectiveness and have major side effects such as incontinence and impotence, which occur in about 80% of cases, although doctors claim the number is closer to 20%.

This site is intended to throw an informative and helping hand to all those seeking to regain their total health; not just the prostate health.

False Positive and False Negative PSA

PSA is indeed a great biomarker for any kind of cancer, but it is not perfect. There are other reasons why prostate PSA test results may be high and in these cases it gives a false indication of cancer; just as there are causes that may hide the PSA and make it appear to be normal even though cancer might be present.

Now it is known that older men with a PSA as high as 5 or 6 most probably don’t have cancer. BPH may also cause a higher PSA. The PSA score for BPH can go up, because of the increased number of cells producing PSA, which can reach levels as high as 10 to 15 ng/ml or more.

However, the fact is this: prostate cancer cells produce 10 times more PSA than BPH cells . In some prostate tumors there is a fairly close correlation between the volume of the cancerous tumor and the PSA.

Diseases such as prostatitis that can also cause a rise in PSA output. Also prostatic massage can cause a temporary change in the PSA. Irritations such as the one produced by a cystoscope (used by doctors to examine the prostate or bladder) can cause a change in the prostate PSA test levels. Because of this, it is sometimes best to wait a few days after one of these procedures in order to get a more accurate PSA reading. Passive Gay men may have a change in PSA levels due to the prostate stimulation.

Some men have been found to have significant cancer with a PSA as low as 2. There are several hormones, drugs and natural medicine alternatives which can alter the PSA levels, e.g. Proscar and Saw Palmetto (both may cause the PSA to be reduced by as much as 50%).

Free PSA and Bound PSA

There seems to be a way to differentiate between the PSA score for BPH and PSA test levels in Prostate cancer.

Here’s the story: there are usually two different forms of PSA in the blood stream, the free PSA and bound PSA. Bound by a proteinase inhibitor that is. Normal PSA tests measure the total PSA. Some companies can now differentiate between free PSA and bound PSA.

Studies done by Dr. W. J. Catalona and others seem to indicate the following:

• if the free PSA is elevated in respect to the bound PSA, then the PSA is probably being produced by BPH.

• if there is a high level of bound PSA, then it is likely to be manufactured by prostate cancer cells.

But in many cases the patient will have BPH and prostate cancer at the same time.

PSA Velocity (PSAV)

PSA velocity is the rate of change in PSA after several tests.

A constant PSA test level after several tests indicates that not much is happening. However, if the the PSA gets higher with each test, this is an indication that the prostate cancer is growing.

Make a chart and carefully follow any change that takes place. Even if the PSA level is fairly low, if the trend is ascendant then you should become concerned. If the PSA test levels double, then you should become very concerned, especially if the doubling interval is short.

Department of Urology of the University of Amsterdam, The Netherlands has done a study concerning bph + psa velocity. The objective was to study the value of PSA velocity (PSAV) in the prediction of benign prostatic hyperplasia (BPH) progression in patients managed with alpha(1)-blockers compared to those in watchful waiting (WW).

PSAV range was -5.24 to 43.06 ng/ml/year in alpha(1)-blocker patients and -6.11 to 19.55 ng/ml/year in watchfull waiting patients. There were no significant differences in retreatment-free survival and the risk of BPH-related invasive therapy between the tertiles (Stable/Decrease/Increase) in both treatment groups.

In conclusion, bph and psa velocity aren’t very strongly related since psa velocity did not predict BPH progression in either alpha(1)-blocker treated patients or WW group.

When a man complains of prostate health symptoms, the first procedure that should be done is a DRE (Digital Rectal Exam). And only if the DRE indicates possible presence of BPH/Prostate Cancer will a PSA test be done.

After you have filled out the many forms and paperwork, a blood sample will be drawn for a prostate specific antigen (PSA) test. The doctor may also ask that a prostate acid phosphatase (PAP) test be done from the same blood draw. Some doctors prefer to draw the blood first, since rough palpations of the prostate gland can cause an increase in PSA levels.

DRE suspicious and PSA test levels above normal, the next procedure may be a biopsy of the prostate. If the results still don’t provide with a clear image of the case, several other tests may be ordered: a bone scan (in case prostate cancer has metastasized), a magnetic resonance imaging (MRI) test, a computerized tomography (CT) scan, a transrectal ultrasound test (TRUS), a ploidy test, a laparoscopic test of lymph nodes, a prostascint test, reverse transcriptase polymerase chain reaction (RT-PCR) test and several others.

With enough information at hand, the doctor can assign a clinical stage. The stage will most likely influence the treatment decision.

PSA Test

With the increased awareness in prostate cancer, there are newer methods to detect it and one of them is Prostate Specific Antigen test. PSA is a protein enzyme that is normally produced by prostate cells. The presence of PSA in the blood stream is normal, and it can be found in high concentrations in the semen.

It’s main purpose is to help liquefy the semen after it has been ejaculated. This liquefaction makes it easier for the sperm to swim in their search for an ovum.

PSA was first used in 1979 to try to identify rapists. Besides being found in the semen, small amounts of PSA is also found in the blood stream. In the mid 1980s it was found that prostate cancer cells also manufacture PSA. Most cancer cells do nothing at all except multiply and expand. The PSA manufactured by these cells is later released into the blood stream and can be measured, considering that the amount of PSA in the blood correlates very closely with the amount of prostate cancer.

The PSA test levels can be used to monitor the progress of the cancer. PSA amount going up indicates that the cancer is actively spreading and growing. However, remember that in cancer there are many exceptions: some prostate cancers become so poorly differentiated that they no longer make PSA. And as a consequence, some men can have metastatic cancer with a very low PSA. But as a general rule, when PSA doubles, then we can be fairly certain that the number of cancer cells have doubled .

This can be a matter of months of weeks. The faster the PSA doubling time, the faster the cancer is growing, so it is very important to have a PSA test done in order to later use it as a starting point.

Significance of PSA test level

Initially, when first discovered, no one knew what “normal” PSA levels were and what high PSA test results were.After statistical evaluations on thousands of men, it was established that the normal PSA should be between 0-4 nanograms per milliliter (ng/ml) of blood . (a nanogram is a billionth of a gram).

What exceptions are there:

• all of us are different. What is normal for one man may not be for another. Some men have had significant cancer with a very low PSA. Conversely, a man may have a PSA as high as 12 ng/ml or more simply because of BPH or a prostatic infection.

• Studies have shown that PSA can be age specific and the 4 ng/ml is not necessarily a good cutoff point for every one. 4 ng/ml may be considered normal for some younger patients, but many significant cancers may be overlooked in older cases. In older men if 4 ng/ml is considered to indicate cancer, then many of them may undergo unnecessary biopsies or even have an unnecessary radical prostatectomy.

  Dr. Joseph E. Oesterling, Editor-in-Chief of Urology, and several other doctors have recommended the following for the age specific PSA test levels cutoff:

  -ages 40-49 = 2.5 ng/ml,

  -ages 50-59 = 3.5 ng/ml,

  -ages 60-70 = 4.5 ng/ml,

  -ages 70-75 = 6.5 ng/ml.

Any PSA greater than that listed for the age should be considered suspicious.

Black people are at a much higher risk for prostate cancer and it is usually more aggressive when detected. Studies show that the age specific PSA levels should be much lower for blacks. But again and again, there are no absolute rules in cancer so these figures are only guidelines.

PSA vs. DRE

Each one has it’s place in the prostate cancer detection process. Drs. Brawer and Lange (The Journal of Urology, September 1993, page 896) investigated a series of 1,249 cancer patients. The prostate cancer was not detected by DRE in 37.5% (468 men) but was detected by the PSA levels.

The study’s lead author Polyxeni Dimitropoulou

A new study finds men who are sexually active in their 20s and 30s are more likely to develop prostate cancer — especially if they masturbate frequently.

The study also found that frequent sexual activity in a man’s 40s appears to have little effect and even small levels of sexual activity in a man’s 50s could offer protection from the disease. Most of the differences were attributed to masturbation rather than sexual intercourse.

However, some previous studies had generated much different findings. The bottom line: More study is needed to settle this one.

The study, led by the University of Nottingham, looked at the sexual practices of more than 431 men who had been diagnosed with prostate cancer before the age of 60, together with 409 controls who do not have prostate cancer.

Among men with prostate cancer, 34 percent had masturbated frequently in their 20s, compared to 24 percent among the control group. A similar spread was found for men in their 30s.

The results, based on questionnaires, are detailed in the journal BJU International (the British Journal of Urology).

The prostate gland secretes a milky fluid that mixes with sperm and seminal vesicle fluid to become semen. Prostate cancer is the second leading cause of cancer deaths among men in the United States, after lung cancer, according to the Centers for Disease Control and Prevention. About 30,000 die from it each year.

In 2004 (the most recent year for which data are available), 189,075 new cases of prostate cancer were diagnosed in the United States, and 29,002 men died of the cancer.

“We were keen to look at the links between sexual activity and younger men as a lot of prostate cancer studies focus on older men as the disease is more prevalent in men over 50,” said lead author Polyxeni Dimitropoulou, who is now at the University of Cambridge.

“Hormones appear to play a key role in prostate cancer and it is very common to treat men with therapy to reduce the hormones thought to stimulate the cancer cells,” Dimitropoulou said. “A man’s sex drive is also regulated by his hormone levels, so this study examined the theory that having a high sex drive affects the risk of prostate cancer.”

Dimitropoulou said more needs to be learned about what’s going on in the body before the results should be seen as conclusive, however.

“There are earlier studies which confirm part of our findings or are inconclusive, besides the ones which disagree with our findings,” Dimitropoulou told LiveScience. “Until the mechanisms are elucidated and are clearly established we cannot be certain about the outcome of any study.”

Other findings:

• 59 percent of the men in both groups said that they had engaged in sexual activity (intercourse or masturbation) 12 times a month or more in their 20s. This fell steadily as they got older, to 48 percent in their 30s, 28 percent in their forties and 13 percent in their 50s.
• 39 percent of the cancer group had had six female partners or more, compared with 31 percent of the control group.
• Men with prostate cancer were more likely to have had a sexually transmitted disease than those without prostate cancer.

“A possible explanation for the protective effect that men in their fifties appear to receive from overall sexual activity, and particularly masturbation, is that the release of accumulated toxins during sexual activity reduces the risk of developing cancer in the prostate area,” Dimitropoulou said. “This theory has, however, not been firmly established and further research is necessary.”

Other possible risks are:

• Inflamation of urethra- as a consequence of Transurethral biopsy.
• Infection- occurring in the case of men with undiagnosed bacterial Prostatitis. In order to prevent such problems, antibiotics are prescribed before the biopsy
• Bleeding from the rectum, in the urine, or hematospermia (blood in the spermatic fluid) for the next 2-3 days. If it lasta longer, you should call your doctor immediately. These are all effects of the needle penetrating living tissue, and the body should soon recover

An anomymous sufferer sais the following

“I developed a severe case of prostatitis following a prostate biopsy. The biopsy was negative for cancer, but left me in severe pain. My PSA was ever so slightly elevated, so my HMO insisted on a biopsy. If I’d known then what I know now about the prostate, I would *never* have let them near me with that needle, at least, not at this time.”

Fortunately, this man found a solution in a strong prostatic massage of a doctor. Already after the first strong prostatic massage, he was feeling better, while no bacterial presence was confirmed. And after the second such massage, his bladder sympthoms and perineal pains were totally gone…

In his book “A Revolutionary Approach to Prostate Cancer”, Aubrey Pilgrim mentions the following:

“Although the patient’s prostate biopsy should be diagnosed by a pathologist who is proficient in interpreting this type of specimen, the patient (and increasingly the urologist) rarely has the opportunity to choose his pathologist. While the urologist may know of a pathologist with special competence in evaluating prostate samples, the insurance company has in most cases already contracted with a specific commercial laboratory to handle the specimen, effectively removing the urologist’s professional opinion from this decision. Nevertheless most general pathologists are well­trained and are competent to read the great majority of prostate needle­biopsy and prostatectomy specimens. If general pathologists see enough prostate specimens to gain familiarity with the subtle variations of normal tissue and the various forms of malignancy, and if they develop a healthy respect for the hard­to­diagnose cases (i.e., those which need to be seen by more experienced eyes), they can provide a valuable service.”

Tissues are graded according to their ability to retain their normal appearance. The more disrupted the normal glandular architecture, the higher the grade of tumor and the poorer the prognosis. But remember: the only way one can be sure of the result of the biopsy is if a radical prostatectomy is performed for cure. Otherwise, if the cancer is missed and you have a negative biopsy, then it could cause a real problem.

A Pathology report will be the result of the pathological exam and you should try your best to grab a copy, thus becoming better informed and able to make the right choices.

Here is what the structure of such a report:
• Your name and associated personal identifiers (age, patient number, etc.)
• The accession number of the case (Usually in the form of “S­year­ number”, e.g., S­96­16258)
• A gross description of the specimen (including the number and size of the tissue cores) received by the laboratory.
• The diagnosis, which reduced to its most basic form is either benign (normal), atypical/suspicious, or malignant (cancer).
• The name and signature of the responsible pathologist along with the name and address of the lab.

All this being said, i wish you a Happy NED (No Evidence of Disease) as a result of your Prostate Biopsy.

So we may conclude that a biopsy of the prostate is necessary if either the PSA or DRE result is abnormal.

Why is prostate biopsy done?

It is performed for two reasons:

1. in order to find the true cause behind the elevated PSA levels.
2. because, as we stated before, the best thing a doctor has when diagnosing his patient, or in the process of staging a cancer, is a portion of living tissue. This is why doctors say that the only time they can be sure aboug the diagnosis and staging is when they have the prostate on the plate, that is in the case of a prostatectomy. The pathologist can only then investigate the prostate in its entirety and draw exact conclusions…

   We can play with PSA levels, blood samples, and joggle with medical concepts and ideas, but until you get the prostate biopsy to the microscope, nothing’s for sure. And even then…

Unless you (or your doctor) are a clairvoyant…

How to get ready

Of course, your medical history is very important: past diseases, past or current intake of medications, any heart diseases, alergies (to anything, be it medications, anesthetics, polen, if you have it and know it, say it) and so on.

Also don’t forget to mention any medications you might be on at the present.

Other preparation steps could involve:

• Signing a consent form in which you assume all risks involved and declare yourself aware of the implications of the procedure (so you should be informed about all details… this document is intended to help a lot here, and your health professional should be able to provide you with specification for things that are unclear)
• If the prostate biopsy involves local anesthesia through the perineum (area between anus and scrotum), no other preparation is needed.
• If done through the rectum, an enema will be done.
• If done under general anesthesia, refrain from eating or drinking anything for 8 to 12 hours before the prostate biopsy.