Non-Communicable Disease: Prostrate Cancer Essay Example

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Non-Communicable Disease: Prostrate Cancer

Non-Communicable Disease: Prostrate Cancer

Introduction

The World Health Organization, Regional Office for South-East Asia (2007) indicates that non-communicable diseases (NCDs) like cancer, diabetes, asthma, cardiovascular disease, dementia, alcohol and other drug dependency, arthritis, and mental health issues among others are on the rise and increasingly leading to morbidity and mortality globally. There are a wide range of risk factors to these diseases. However, overcoming their threat is subject to use of existing knowledge; and effective employment of preventive and curative interventions. This paper seeks to investigate risk factors to prostate cancer and enhance knowledge on these factors via presenting key issues to facilitate the planning of appropriate responses and interventions.

The Biology of Prostate Cancer

Pathologically, prostate cancer is dependent on the hormone androgen. This is due to the fact that an increased concentration of androgen is a significant risk factor to the growth of tumour on the prostate. Prostate cancer is characterised the growth of tumours on the peripheral Central, and transitional areas of the prostate. The growth of tumours usually occurs on the posterior areas of the prostate. Digital rectal examination (DRE), transrectal ultrasound (TRUS), and prostrate-specific antigen (PSA) testing are the diagnostic examination available for prostate cancer. Other than increased concentration of androgen, the other factors which influence the growth of malignant tumours on the prostate include genetics, chemicals, diet, environmental factors, viral infections, as well as surgical procedures. With regard to genetics, there is a small level of correlation between family history and prostate cancer with approximately 10 per cent of cases being attributed to ancestry (Crawford, 2003, p.4).

Evidence indicates that African American men are more vulnerable to prostate cancer than white men by approximately 60 per cent due to genetical factors. Secondary factors associated to genetics like excessive consumption of red mead as well as phytoestrogens significantly influence prostate cancer cases among cultures. According to Crawford (2003, p.4 and p.5), ageing is a strong risk factor of prostate cancer. World Health Organization, Regional Office for South-East Asia (2007) reiterates that prostate cancer is more prevalent in men above the age of 65 years. The diagnosis of prostate cancer in younger men below this age is very rare. Younger men only develop latent version of prostate cancer which can only be conspicuous in later age. As such, clinical diagnosis for prostate cancer is minimal as compared to historical diagnosis (Crawford, 2003, p.4).

Epidemiology of Prostate Cancer

A worrying aspect of prostate cancer is that it develops absent men experiencing any significant symptoms. Approximately 18,700 and 3,000 Australian men are diagnosed with and die from prostate cancer every year respectively (Australian Government, 2013). In 2012, prostate cancer accounted for approximately 15% of total cancer deaths in Australia making it the second leading cause of death in male cancer patients after lung cancer. Research indicates that almost one man in every eleven men develops cancer in their lifetime. Historically, prostate cancer was considered a disease of the old men due to its high prevalence rate in men above the age of 70 years. However, contemporary trends indicate that men in their 40s, 50s, as well as early 60s are increasing being diagnosed with prostate cancer. In younger men, prostate cancer tends to be more life-threatening due to its aggressive nature (Coory and Baade, 2005). The chance of being diagnosed with prostate cancer is as indicated in the following table. From the table below the chance of being diagnosed with prostate cancer increases as men become older and family history of either father or brother previously diagnosed with prostate cancer.

Chance of diagnosis with prostate cancer

For a man in his 40s

For a man in his 50s

12 in 1000

For a man in his 60s

45 in 1000

For a man in his 70s and above

80 in 1000

(Adopted from: Prostate cancer Foundation of Australia, 2013)

Apart from increases in prevalence with increase in age and family history, there is also a positive association between prostate cancer and diet low in fresh vegetables and fruits and vegetables, as well as high levels of testosterone. Additionally, men with African descent are also at a higher risk of being diagnosed with prostate cancer as compared to their counterparts with European descent (Prostate cancer Foundation of Australia, 2013).

Environmental Conditions Influencing Prostate Cancer Processes and People’s Adaptations to Them

Urban and rural environments, adverse environmental conditions such as pollution, social customs, as well as workplace practices have significant implications on the proliferation of non-communicable diseases (NCDs) such as cancer. Prostate cancer has been described a slower growing cancer which can take a long time before its symptoms are detected. Urban and rural environmental factors especially air pollution with carbon-related gases are significant risk factors to prostate cancer across the world in general. For instance, statistics in Australia indicate that for every 100 deaths resulting from prostate cancer in urban or rather metropolitan areas such as Sydney and Melbourne, 121 deaths resulting from prostate cancer will occur rural Australian setting (Australian Government, 2013; Prostate cancer Foundation of Australia, 2013).

Men in rural settings/environments are at a higher risk of prostate cancer due to lack of education and awareness on the prostate cancer; long distances from quality testing and treatment; minimal or no GP awareness; as well as limited access to professionals and specialists on prostate cancer such as qualified urologists (Coory and Baade, 2005). According to the Australian Vietnam Veterans Association, argues that veterans exhibit a higher mortality rate of approximately 53 per cent as compared to the average population due to the poor working conditions and the nature of their work. Additionally, poor work conditions and work practice significantly influence prostate cancer in men. For instance, research indicates that fire fighters exhibit a higher rate of risk of prostate cancer of approximately 28 per cent. In order to adapt to these adverse environmental factors, people are encouraged to seek regular testing in order to detect prostate cancer in its early stages; ensure safer working environments and prevent environmental pollution (Coory and Baade, 2005; Australian Government, 2013; Prostate cancer Foundation of Australia, 2013).

Societal Responses to Prostate Cancer

Societal responses to prostate cancer is concerned with how both personal and social resources influence the prevention, treatment, rehabilitation as well as self management of prostate cancer. Various drugs are still under investigation/trial for the prevention of prostate cancer some of which include vitamin E and selenium. Other preventive measures include dietary modification to involve eating of low fat foods, fresh fruits and vegetables, and avoidance of red meat. Manipulation of the concentration of certain hormones such as androgen is also a possible prevention method for prostate cancer. Secondary methods of prostate cancer include early diagnosis via prostate-specific antigen (PSA) analysis, prostate biopsy, digital rectal examination (DRE), and transrectal ultrasound (TRUS); and population screening. Treatment of prostate cancer is done through inhibition of androgen production or androgen-receptor blockers; surgical removal of tumours on prostate also known as radical prostatectomy; radiation therapy; and chemotherapy. Additionally, urologists are increasingly using a technique known as nerve-sparing which preserves sexual function and normal bladder (Ho et al., 2011, p.591; Kohli and Tindall, 2010, p.77).

After prostate cancer diagnosis, patients undergo anxiety, stress, depression and maybe mental illnesses. During this time, the emotional support of family members, friends, healthcare providers, church/clergy, and support groups would be of invaluable help to the patient. For instance religious/spiritual resources would enable patients regain self-esteem and sense of hope. With regard to rehabilitation and the management of prostate cancer, self management should involve regular consultation with health professionals; further education on management of the condition; developing/joining support networks; obtaining relief from pain and other symptoms; reorganizing personal schedule as necessary; physical exercise; and setting realistic goals among other endeavours (Ho et al., 2011, p.591).

Factors Determining Approaches to Prostate Cancer Health Intervention

Various factors determine the effectiveness of approaches to prostate cancer health intervention. Some of these factors include health promotion approaches. For instance, the general population should be made aware of the need for dietary modification and healthy eating through health promotion programs (Sonn et al., 2005, p.304). Other health promotion programs should include population screening to facilitate early detection of prostate cancer. This is because research indicates that the detection and treatment of prostate cancer is much easier when the growth of the cancerous tumours is still confined to the prostate areas/glands. Even though prostate cancer tests such as prostate-specific antigen (PSA) analysis and digital rectal examination (DRE) do not provide conclusive diagnosis of the disease, they indicate some level of prostate cancer presence (Kohli and Tindall, 2010, p.77).

The other factors with significant influence on the effectiveness of approaches to prostate cancer health intervention include appropriateness of health intervention legislation and best practice in medical treatment of prostate cancer. Kohli and Tindall (2010, p.77) reiterate that prostate cancer has significant burden on the public health sector globally. Effective legislation and best practice in medical treatment of prostate cancer must be based on the substantial literature and clinical studies which have been conducted in the last five to ten years. Some of these studies are also currently underway. In this way, to prostate cancer health intervention will benefit from ongoing developments and therapeutic advances.

Conclusion

This paper hasinvestigated the risk factors to prostate cancer; and presented key issues to facilitate the planning of appropriate responses and interventions. Prostate cancer is one of the non-communicable diseases (NCDs) that have been on the rise and a significant killer across the world. The implication of prostate cancer on national and global public health sector has significant implications. There are numerous risk factors to prostate cancer. This paper emphasizes various measures for the prevention, treatment and management of the disease among them early diagnosis.

References

Australian Government. (2013). Prostate Cancer Statistics. Available at: http://canceraustralia.gov.au/affected-cancer/cancer-types/prostate-cancer/prostate-cancer-statistics

Coory, M.D. and Baade, P.D. (2005). Urban-rural differences in prostate cancer mortality, radical prostatectomy and prostate-specific antigen testing in Australia. Medical Journal of Australia, 182(3), pp. 112-115.

Crawford, E.D. (2003). Epidemiology of prostate cancer. Urology, 62(6), pp. 3-12.

Ho, S. et al. (2011). Estrogens and prostate Cancer: Etiology, Mediators, prevention, and Management. Endocrinol Medab Clin North Am, 40(3), pp. 591-614.

Kohli, M. and Tindall, D.J. (2010). New development in the Medical Management of Prostate Cancer. Mayo Clin Proc, 85(1), pp. 77-86.

Prostate Cancer Foundation of Australia. (2013). Prostate Cancer Statistics. Available at: http://www.prostate.org.au/articleLive/pages/Prostate-Cancer-Statistics.html

Sonn, G.A. et al. (2005). Impact of Diet on prostate cancer: A Review. Prostate Cancer and Prostatic Disease, 8, pp. 304-310.

World Health Organization, Regional Office for South-East Asia. (2007). Non-communicable diseases. Scaling up prevention and control of non-communicable diseases. The SEANET-NCD meeting, 22–26 October 2007, Phuket, Thailand. Available at:http://www.searo.who.int/en/Section1174/Section1459.htm