Prostate cancer: how pharmacies can help

The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer. In Australia, around 20,000 new cases of prostate cancer are diagnosed each year, meaning one in nine men will develop the disease.

Risk factors¹

• Age. It is most common in men over the age of 50 and the risk increases with age.
• Family history. Men with a family history are more likely to develop the disease. Regular testing is advised from the age of 40 if there is at least one first-degree relative diagnosed with prostate cancer.
• Ethnicity. For example, European men have a much higher chance of developing prostate cancer than Asian men.
• High levels of testosterone. Testosterone naturally stimulates the growth of the prostate.
• Diet. A high-fat diet and obesity may increase the risk of prostate cancer.

Prostate cancer may cause no signs or symptoms in its early stages but in more advanced cases it may cause signs and symptoms such as:

• Trouble urinating.
• Decreased force in the stream of urine.
• Blood in the urine.
• Blood in the semen.
• Bone pain.
• Losing weight without trying.
• Erectile dysfunction.

Detection 

Regular check-ups and examinations can result in early detection and treatment.

A digital rectal examination is recommended in order to detect any irregularities in the prostate. This may be an uncomfortable examination but is rarely painful. An enlarged gland will feel hard and possibly irregular in shape.

A prostate-specific antigen test may be requested if any abnormality is found. This measures a protein in the blood that rises in concentration when there are prostate problems. These two tests cannot distinguish between cancer or a benign enlarged prostate, and so, if an abnormality is found, an ultrasound scan will be carried out. A biopsy will then determine if the prostate is cancerous or benign.

Prevention 

Healthy diet and lifestyle actions advised include:

• Choose a healthy diet full of fruit and vegetables. Eat a variety of fruit, vegetables and whole grains. Fruit and vegetables contain many vitamins and nutrients that can contribute to your health. Whether you can prevent prostate cancer through diet has yet to be conclusively proven. But eating a healthy diet with a variety of fruit and vegetables can improve your overall health.
• Choose healthy foods over supplements. No studies have shown that supplements play a role in reducing your risk of prostate cancer. Instead, choose foods that are rich in vitamins and minerals to maintain healthy levels of these organic compounds in your body.
• Exercise most days of the week. Exercise improves overall health, helps to maintain a healthy weight and improves mood. Try to exercise most days of the week. If just beginning an exercise program, start slowly and work up to more exercise time each day.
• Maintain a healthy weight. Work to maintain a healthy weight by choosing a healthy diet and exercising most days of the week. To lose weight, add more exercise and reduce the number of calories you eat each day
• Talk to your doctor about the increased risk of prostate cancer. If a high risk of prostate cancer is evident, the doctor may consider medications or other treatments to reduce the risk.

Some studies have suggested that some foods can help in recovery or prevent prostate cancer relapse. These include:

• Foods containing lycopene. Lycopene is a bright red compound found in tomatoes and other fruit and vegetables, including red carrots, papayas, watermelons, pink grapefruits and guavas. Although lacking sufficient evidence, some studies suggest that the antioxidant and immune-boosting properties of lycopene may help fight cancer cells.
• Plant-origin protein sources. These include soybeans, kidney beans, chickpeas, lentils and other pulses. These foods are rich in protein and low in fat and cholesterol. They help promote overall health and may hasten recovery from prostate cancer.
• Green tea. This tea is rich in antioxidants that boost immunity and well-being. A decaffeinated green tea provides the same cancer-protection benefits without the urinary side effects.
• Cruciferous vegetables. These include broccoli, cauliflower, cabbage, kale, Brussels sprouts and mustard greens. They help provide the essential vitamins and minerals that aid in recovery from prostate cancer.
• Fruit. Various fruits, especially cranberries, blueberries, strawberries and pomegranates, are popular for their potential cancer-killing properties.

A balanced diet that includes these foods may promote an overall sense of well-being and help limit prostate cancer. A high-fat diet and obesity may increase your risk of prostate cancer.

Drinking plenty of water helps to flush out the wastes and toxins from the body and keep the metabolism at optimum levels. Sugary drinks and foods, red meat, barbecued or deep-`fried foods and processed foods (such as chips and cookies) should be avoided. Get ample rest and perform regular physical activities as per the doctor’s advice.

Cancer treatment side effects

Current research suggests that the management of chemotherapy-induced nausea should focus on treating the symptoms before they occur rather than after they develop. Cancer patients rate nausea as the most distressing side effect of chemotherapy. Despite the extensive use of antiemetics, chemotherapy-induced nausea continues to be reported by up to 70 per cent of adult patients.

Despite the fact that many patients use ginger for the prevention or treatment of nausea and vomiting caused by chemotherapy for cancer, only seven studies were found that assessed the efficacy of ginger for chemotherapy-induced nausea and vomiting.³

Acupressure can also be used. Although its overall effect suggests effectiveness against acute and delayed chemotherapy-induced nausea, the data is not conclusive.²

General advice relating to chemotherapy-induced nausea includes drinking a variety of fluids all day to avoid becoming dehydrated. Try drinks and foods with ginger, including ginger tea, non-alcoholic ginger beer and ginger biscuits. Avoid foods that are too sweet, fatty, fried or spicy, or that have strong smells. Brush teeth regularly to help reduce tastes that may make someone feel nauseated. There’s no substitute for good food but it may be necessary to recommend an additional nutritional supplement, such as Ensure.

Pharmacies have a role in encouraging all their customers to have regular health checks for prevention and early detection of any cancer. They should encourage a healthy diet and lifestyle. But if their customer is diagnosed with cancer, careful and continued counselling regarding their medication is essential. Gentle questioning may encourage customers to talk about their concerns, treatment and possible drug side effects. Reassure them about what is to be expected and refer to when it is abnormal.

References 

1. org.au/research/diseases/cancer-prostate
2. Ryan JL, PhD, MPH, Assistant Professor. ‘Treatment of chemotherapy-induced nausea in cancer patients’. nlm.nih.gov/pmc/articles/PMC3188425/
3. Quimby EL. ‘The use of herbal therapies in paediatric oncology patients: Treating symptoms of cancer and side effects of standard therapies. J Pediatr Oncol Nurs. 2007 Jan-Feb; 24 (1): 35–40.

Written by Sue Holzberger. 

This feature was originally published in the June issue of RPA e-magazine.