Western and Ayurvedic Approaches to the Treatment of Early Stage Prostate Cancer By: Suzanne Mansell
o About 241, 740 new cases of prostate cancer will be diagnosed.
o About 28, 170 men will die of prostate cancer.
o About 1 man in 6 will be diagnosed with prostate cancer during his lifetime.
o About 1 man in 36 will die of prostate cancer.
o The relative 5-year survival rate is nearly 100%.
o The relative 10-year survival rate is 98%.
o The 15-year relative survival rate is 91%.
Western Interpretation and Diagnosis of Prostate Cancer
Western Treatment and Prevention of Early Stage Prostate Cancer
o Radiation therapy. Radiation therapy uses high-powered energy to kill cancer cells. Side effects of radiation therapy can include painful urination, frequent urination and urgent urination, as well as rectal symptoms, such as loose stools or pain when passing stools. Erectile dysfunction can also occur. There is a small risk of radiation causing another form of cancer, such as bladder cancer or rectal cancer, in the future. Radiation therapy is generally an option for early and late stage cancers. [1, 17]
o Hormone therapy. Hormone therapy is treatment to stop the body from producing the male hormone testosterone. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly. Hormone therapy is generally used in men with advanced prostate cancer to shrink the cancer and slow the growth of tumors. In men with early-stage prostate cancer, hormone therapy may be used to shrink tumors before radiation therapy. Side effects of hormone therapy may include erectile dysfunction, hot flashes, loss of bone mass, reduced sex drive and weight gain. Hormone therapy also increases the risk of heart disease and heart attack. [1, 17]
o Surgery to remove the prostate. Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes. [1, 17]
o Freezing prostate tissue. Cryosurgery or cryoablation involves freezing tissue to kill cancer cells. Cryosurgery may be an option for men who have not been helped by radiation therapy. [1,17]
o Heating prostate tissue using ultrasound. High-intensity focused ultrasound treatment uses powerful sound waves to heat prostate tissue, causing cancer cells to die. [1,17]
o Chemotherapy. Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. [1,17]
o Active Surveillance. In active surveillance, regular follow-up blood tests, rectal exams and possibly biopsies may be performed to monitor progression of the cancer in lieu of additional treatment. [1, 17] Note: active surveillance is sometimes called "watchful waiting;" however, some physicians make the distinction that "watchful waiting" is a less intensive form of follow-up that may result in fewer tests and rely more on changes in a man's symptoms. [17, 2]
o Some studies have found that men who are overweight may have a slightly lower risk of prostate cancer overall, but a higher risk of prostate cancers that are likely to be fatal. [1, 17]
o Studies have found that men who get regular physical activity have a slightly lower risk of prostate cancer. Vigorous activity may have a greater effect, especially on the risk of advanced prostate cancer. [1, 17]
o Several studies have suggested that diets high in certain vegetables (including tomatoes, cruciferous vegetables, soy, beans, and other legumes), grains, or fish may be linked with a lower risk of prostate cancer, especially more advanced cancers. [19, 20, 21]
o Studies have shown that men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. However, some studies indicate this may be a result of meat heated at high temperatures. [1,17, 22]
o Studies of men who drink green tea or take green tea extract as a supplement have found a reduced risk of prostate cancer. 
Active Holistic Surveillance: An integrative approach to treatment and prevention:
o Changes in diet, including the reduction or elimination of red meat and dairy.
o Dietary supplements, including herbal anti-inflammatories, omega-three fatty acid supplements, and vitamin D.
o A reasonable exercise program (aerobic exercise at least three times per week).
o Some method of stress reduction (such as yoga or meditation).
o PSA testing every three to four months and a repeat DRE every six months.
o A repeat biopsy at 12 to 24 months, even in cases where the PSA is stable, to ensure the cancer volume has not increased and that the Gleason score does not need to be updated.
o PSA is below 10 and a Gleason score under 7; and
o Disease is at stage I or II; and
o MRI shows no cancer growth outside the prostate gland; and
o Cancer is not palpable in DRE; and
o Biopsy shows fewer than four of at least 12 cores to be positive for cancer; and
o Less than half of any core taken is cancerous.
Ayurvedic Interpretation of Prostate Cancer
Cancer According to Ayurveda
o Overexposure to solar radiation (atapa)
o Substances that have irritating properties, like drugs or alcohol (vidahani annapanani)
o Penetrating cytotoxic drugs (tikshnani aushadhani)
o Toxic metabolic waste at the cellular level (cellular ama)
o Incompatible food (viruddha ahara)
o Wrong lifestyle (viruddha vihara)
o Genetic predisposition (bija dosha)
o Parasites or microorganisms in the blood (sukshma krimi)
o Occupational hazards and exposure to toxic substances (vyavasaya)
o Psychological and emotional factors, such as unresolved grief or stress (mano vedana)
o Age, in that people over 65 are more prone to cancer of the prostate or colon (vardhakya)
o Pollution (paryavartanam)
o Overuse of the sexual organs
o Hasty or surreptitious sexual activity without time to relax afterwards
o Holding back the natural urge to ejaculate once at the point of ejaculation
o Excess bicycle riding, or other forms of "bumpy" activity involving sitting astride a saddle
o Exposure to electromagnetic fields, microwave or radiation
o Vata-provoking habits to the entire system (i.e., lack of regular routines, drinking coffee, over-consumption of raw or dry foods, lack of adequate fluid-intake)
o Stress (particularly because vata dosha governs the nervous system).
Ayurvedic Treatment (Chikitsa) and Prevention of Prostate Cancer
o Gokshura is noted to be one of the most important herbs for the urogenital system. Gokshura is tridoshic, diuretic, rejuvenative, nervine, and soothing to the urinary tract. [6, 8, 9]
o Punarnava is another important herb that rejuvenates the urinary tract. It is also useful in the treatment of cancer because it reduces swellings, and its alkaloid has a specific anti- cancer effect. However, it should not be used in cases of dehydration or emaciation. [6, 9]
o Additional herbs that support healthy urination include: white sandalwood, guduchi, shilajit, and pumpkin seeds. [6, 9]
o Herbs that support the shukra dhatu and maintain testosterone production include: gokshura, bala, shilajit, zinc bhasma, and saw palmetto. [7, 9, 10]
o Herbs that specifically support prostate health include:o Guduchi, turmeric, and zinc B=bhasma. They enhance immunity in the prostate area. o The combination of guggul and zinc bhasma. They are a traditional ayurvedic remedy for balancing the size and health of the prostate. Turmeric and guggul are both effective anti-inflammatory herbs, as well. o Ashwaganda. It provides long-term support and nourishment to the prostate gland. o Bala, kapikacchu, and marshmellow. They are effective for enlarged prostate problems. o Kachnar and guggul. They help maintain prostate health and function as both have a specific effect in clearing ama from the blood, muscle, and fat tissue, and help maintain the normal size of the prostate gland by supporting balanced cell production. o Rabdosia. It is one of the active anti-cancer herbs in the formula PC SPES, which has undergone successful clinical trials for prostate cancer. 
o Guduchi, turmeric, and zinc B=bhasma. They enhance immunity in the prostate area. 
o The combination of guggul and zinc bhasma. They are a traditional ayurvedic remedy for balancing the size and health of the prostate. Turmeric and guggul are both effective anti-inflammatory herbs, as well. 
o Ashwaganda. It provides long-term support and nourishment to the prostate gland. 
o Bala, kapikacchu, and marshmellow. They are effective for enlarged prostate problems. 
o Kachnar and guggul. They help maintain prostate health and function as both have a specific effect in clearing ama from the blood, muscle, and fat tissue, and help maintain the normal size of the prostate gland by supporting balanced cell production. 
o Rabdosia. It is one of the active anti-cancer herbs in the formula PC SPES, which has undergone successful clinical trials for prostate cancer. 
o Kutki is a purgative and breaks down fecal matter, thus helping to remove ama from the colon. It tends to break down tumors due to its scraping effect. [6, 9]
o Shilajit's main action is on the urogenital system, and it has a specific effect in reducing both benign and malignant swelling of the prostate. [6, 8, 16]
o Dr. Marc Halpern of the California College of Ayurveda advises mental purification and rejuvenation as part of the healing process. He concludes that, "purifying the mind through periods of silence and a lack of sensory stimulation helps support healing." Meditation and shirodhara can help produce inner silence, while nasya supports mental purification. 
o Dr. Halpern also purports that mental rejuvenation must follow mental purification. Mental rejuvenation can be accomplished through the use of oil therapies, such as shirodara or abhyanga. Daily self-abhyanga is considered an important act of self-love, as it rebuilds ojas in the mind. 
o The patient's relationship with sexuality and procreation can be addressed, as an immature or unintegrated approach to sexuality is viewed as harmful as it sets up a negative energy pattern related to the reproductive system and causes unhealthy behaviors that directly damage the prostate gland. 
o The patient's relationship with creative expression can be addressed, as a life devoid of meaningful creative expression is considered a physically, mentally, and spiritually destructive situation. According to Alakananda Devi, whenever the energy of creation is absent, the energy of destruction (tamas) will take over. This destructive energy will readily find expression within the shukra dhatu, the tissue associated with procreation, generation, and creation. 
o In the Vedic system, cancer is viewed as a psychic disorder, a disruption in the aura allowing the entrance of a negative astral force. Emotional cleansing, mantra, pranayama, and meditation are viewed as important methods to counter this disruption. Gem therapy is considered helpful to balance the aura and protect the life. For example, blue sapphire set in gold is considered the best gem for antitumor properties. Dr. David Frawley states, "Chanting OM is excellent for opening up the aura and clearing the psychic air. The mantra RAM is best to give protection and bring down the Divine healing force. HUM is effective for casting out negative life-energies." 
o Yoga asanas reduce tension and inner restrictions that may be blocking the healing process. 
o Visualization is the process of engaging the imagination in the process of healing. By visualizing a positive outcome, the chances of survival and healing are noted to increase. 
o Sattvic practices, such as spending time in nature, are considered important for keeping the mind clear and supporting the healing process. Sattvic practices assist in the healing of karma. 
o Daily castor oil massage of the prostate using cold-pressed castor oil can be helpful. 
o Daily perineal exercises (the practice of ashvini mudra) can enhance circulation and lymphatic drainage of the prostate. 
o The use of anuvasana and niruha basti can bring herbs close to the location of the prostate gland. A decoction involving dashmoola would be appropriate. These therapies are ideal for pacifying vata dosha; but can be designed so that kapha is not vitiated. [6, 9]
o Yoga asanas that apply perineal pressure can be useful. Examples include: kukutasana, gomukhdsana, padpedandsaan, and salabhasana (locust pose), as well as the inverted poses, sirsasana and sarvangasana. 
o Pacify vata (by creating regular routines around eating and sleeping, slowing down, resting) and apana vayu (through daily abhyanga massages and ensuring regular bowl movements). The classical text, Caraka Samhita, reiterates the importance of pacifying vata in regards to cancerous tumors: "In case of gulma, pacification of vayu should be done properly with all means because after vayu is won over, even the small remedy alleviates the other aggravated dosha." 
o Take short breaks frequently and try to stretch or take a short walk. This will restore the normal flow of energy, blood, and nutrient fluid to the prostate area. 
o Avoid alcohol and caffeine consumption, as both create abnormal urine production and irritate the bladder. Take the necessary time to empty the bladder completely. Drink water throughout the day to prevent the urine from becoming too concentrated. 
o Not suppress the urge to urinate as it can lead to further urogenital complications.