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Prostate Cancer : Treatment
   
Western Medicine
Chinese Medicine

Surgery

If the cancer has been diagnosed early, is still within the prostate gland itself and is of a type considered unlikely to spread rapidly, surgical removal of the entire prostate, an operation known as a radical prostatectomy, may be considered. However, this operation has a high rate of complications, leaving up to up to sixty percent of men impotent and more than ten percent with incontinence (where they cannot control urine flow). This is because the nerves controlling these functions are very close to where the prostate sits under the bladder. The sphincter, a muscle that holds the bladder closed, is located just above the prostate and is also vulnerable to damage during surgery. In expert hands, that is, when done by a surgeon who does many of these procedures at a hospital where the operating theatre and nursing staff are very experienced in prostate surgery, the complication rates are much lower. Some surgeons in top American hospitals report incontinence in only two percent of their patients and impotence in ten percent. For this reason, choosing your surgeon very carefully once you have been diagnosed with operable prostate cancer is essential. It is worth getting several opinions and asking each surgeon for their post-surgery complication rates. If they will not give you this information, ask your usual medical adviser to help you find out who has the lowest complication rates.

Radiotherapy

Those men whose tumours are too advanced for surgery, who are considered unsuitable for surgery, or who would like to avoid the complications of surgery, may be given radiotherapy, where a radiation beam is directed at the prostate to burn away the cancer. This treatment may also be used to burn away secondary prostate cancers in the pelvic bones and spine to stop the pain caused by such tumours. In the right men, who are carefully selected according to the size and stage of their tumour, brachytherapy, a treatment where tiny radioactive implants are inserted into the prostate cancer, has been very successful.

Chemotherapy

Advanced tumours or those thought likely to spread even after surgery may be treated with a combination of drugs able to kill cancer cells, known as chemotherapy. Doses and courses vary according to the oncologist's assessment of which chemical is likely to be most effective but courses are usually given over several months.

Hormone therapy

Because prostate cells are very sensitive to the male hormone testosterone, hormone therapy is given, usually as a long-acting injection, to block the effect of testosterone and delay the spread of advanced prostate cancer. Sometimes both testicles are surgically removed to achieve the same effect without using drugs. Unfortunately, this has marked side effects such as breast development, impotence, loss of sexual desire, and a change from a low to a higher voice, but it can effectively slow down the progression of the disease.

 

There are many ways to treat prostate cancer after a definitive diagnosis has been made. Western treatment methods: hormone therapy, surgery, chemotherapy and radiotherapy are important for curing or arresting disease progression. (See western medicine section.) However, due to the different side effects each option causes (i.e. inability to control urination, impotence and loss of sexual desire), these clinical methods still have limitations.

TCM focuses on holistic healing and creating a harmonious balance in the body. The yin and yang philosophy is central to achieving balance and is used to identify good and evil health influences, distinguish between body excesses & deficiencies and to regulate the functions of the organs, qi, and blood. TCM can complement western medicine by helping to increase therapy efficacy, improve quality of life and in some cases prolong the lifespan.

Surgery is an area in which TCM treatments can be especially useful. The mere act of surgery causes damage to a person's body by exhausting its healthy energy and increasing blood loss causing an imbalance of yin and yang. TCM herbal preparations and other treatments such as acupuncture or qi gong used before and after the operation can reduce the damage from intra and post-operative complications, improve operation tolerance and promote health restoration. Before surgery, TCM preparations that invigorate qi, enrich the blood, strengthen the spleen and nourish the kidney and liver are generally chosen. Afterwards, preparations that tonify qi, nourish yin, promote blood circulation, resolve blood stasis, regulate the function of the spleen and stomach and improve the function the kidney and liver are used to restore the body's health. Herbal prescriptions are adjusted when complicating factors such as a build up of phlegm, dampness, stasis, toxins and heat evils are impeding recovery. Aside from surgery, TCM herbal preparations have been shown in research studies to improve the efficacy of chemotherapy and radiotherapy and reduce their side effects. When deciding what herbal treatments to take, it is always best to consult a qualified TCM physician who can plan follow up visits with you to monitor how successful a particular treatment has been and to ensure the right care is being given.

Below are some examples of selected herbal prescriptions that are used by TCM doctors to treat the different syndromes associated with prostate cancer.

Pathogenic Damp-heat accumulation in lower burner
Therapeutic aim: Clear away damp-heat in the lower burner
Prescription: Sanmiao pellet

cang shu atractylodes root
huang bai amur cork-tree
niu xi twotooth-achyranthes root

Addition for individuals with dribbling after urination:

shi wei shearer's pyrrosia leaf
bi xie dioscorea hypoglauca root
tu fu ling glabrous greenbrier root

Addition for individuals with haematuria: (Blood in urine)

da ji Japanese thistle herb
xiao ji field thistle herb
niu xi twotooth (charred)

Therapy for Kidney-Yin Exhaustion Therapeutic aim: Nourish kidney-yin. Prescription: Zhibai Bawei pellet

zhi mu common anemarrhena root
huang bai amur cork-tree
sheng di rehmannia root
shan yu ru Asiatic cornelian cherry fruit
fu ling Indian bread
ze xie oriental water plantain root
shan yao common yam root

Addition for individuals with severe cases:

gui ban tortoise shell

Therapy for Decline of Kidney-Yang Therapeutic aim: Warm and nourish kidney-yang.
Prescription: Jisheng Shenqi pellet

shu di rehmannia root (processed)
shan yu ru Asiatic cornelian cherry fruit
shan yao common yam root
niu xi twotooth-achyranthes root
che qian zi plantain seed
fu zi prepared common monkshood daughter root
rou gui cassia bark

Addition for individuals with severe cases:

lu jiao shuang (degelatined)deerhorn
or or
lu rong pilose antler
ren shan ginseng

Syndrome differentiation must be accurate when using these medicinal substances for warming and nourishing kidney-yang. They should not be used for those with hyperactivity of excessive ministerial fire.

Therapy for Hyperactivity of Heart-fire Therapeutic aim: Eliminate heart-fire. Prescription: Daochi powder

sheng di rehmannia root
zhu ye bamboo leaf
sheng gan cao unprocessed liquorice root
mu tong vine of clematis armandi

Addition for individuals with urgency or dribbling after urination:

niu xi tan charred twotooth-achyranthes root
ren dong hua honeysuckle flower
tu fu ling glabrous greenbrier root

Therapy for Stagnation of Qi
Therapeutic aim: Regulate the functional activities of vital qi.
Prescription: Chenxiang powder

chen xiang Chinese eaglewood wood
shi wei pyrrosia leaf
chen pi dried tangerine peel
Huang bu liu xing cowherb seed
dong kui zi cluster mallow seed

Addition for individuals with blood stasis:

tao ren peach seed
hong hua safflower