· incontinence and erectile dysfunctions. Though there are no drugs to prevent the development of prostate cancer, lifestyle changes such as diet and exercise can significantly

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shown usefulness in maintaining a healthy prostate. The antioxidant and anti-inflammatory properties of these natural supplements inhibit prostate cancer growth.

What is a robotic prostatectomy?

Robotic prostatectomy is a way to remove your prostate by a machine (robot). It is a type of keyhole surgery (laparoscopic), performed in the abdominal area using small cuts. The surgeon uses robotic arms and the attached camera. It is precise and minimally invasive.

How does a robotic prostatectomy work?

The machine (robot) has two units; the patient and control units. The patient unit is positioned by the operating table and holds the surgical instruments. The surgeon operates from the control unit, which

Robotic prostatectomy is a surgical technique to remove the prostate gland. The prostate gland is located at the base of the bladder and can develop cancer. Prostate cancer is the second most common cancer in men, and there were more than 1million cases in 2018.

Prostatectomy (including robotic and open surgery) is considered the most decisive way to treat localized prostate cancer. However, it is associated with risks such as incontinence and erectile dysfunctions.

Though there are no drugs to prevent the development of prostate cancer, lifestyle changes such as diet and exercise can significantly reduce your risk. Keeping your prostate healthy is essential if you want to reduce your risk of developing prostate cancer.

Natural supplements like lycopene, vitamin D, and omega-3 fatty acids have


provides a three-dimensional view of the prostate. This technique allows surgeons to perform complex surgeries completed without large openings.

In which situations is a robotic prostatectomy the best option?

Prostatectomy is suitable for treating prostate cancer before it spreads to other organs. Prostate cancer is the second most common male-specific cancer in the world. Thus, it is not a surprise that robotic proctectomy is now readily offered in many clinics around the world. Treatment decisions are based on disease stage, symptoms, and preferences. Your medical provider will discuss your options and the associated risks.

Localized prostate cancer, the predominant stage at diagnosis is majorly treated with radical prostatectomy, the surgical excision of your prostate gland. It is effective for controlling organ-confined prostate cancer, but there are associated complications.

Prostatectomy can be performed by open prostate surgery or minimally invasive methods like traditional laparoscopy or robotic-assisted laparoscopy. Open prostate surgery involves removing the cancerous prostate through a larger abdominal incision.

Minimal-inversive techniques use keyhole incisions to insert surgical equipment and complete the surgery. They are beneficial when there is a need to reduce wound healing complications. Robotic

prostatectomy is one such method, where the surgeon uses robotic-arms to make small and accurate movements during the operation.

Robotic prostatectomy is the best option for men with localized prostate cancer who want to speed up the recovery of urinary and sexual function after their prostate surgery.

Risks and benefits of robotic prostatectomy

What are the risks of robotic prostatectomy?

Like any major surgery, problems can occur during or after robotic prostatectomy. Studies have reported adverse reactions to anesthesia, bleeding, and blood clots from the surgery as well as damage to nearby organs and surgical site infection.


Damage to the intestines is common in robotic surgery compared to open surgery. Though extremely rare, people can die from robot-assisted prostatectomy complications. The risks of serious complications depend on your health and surgical team.

Robotic prostatectomy is a relatively new technique and has skill-associated risks. The need for complex suturing capability and delicate maneuvering of the robotic arms increases the risk of complications.

The rate of complication during and after laparoscopic prostatectomy has been linked with the number of operations performed by the surgical team (Gonzalgo et al., 2005). Clinically relevant complications following robotic prostatectomy are related to the number of previous cases performed the surgeon (Novara et al., 2010).

Compared to the traditional open surgery with well-defined long-term risks, surgeons only started robotic prostatectomy in the year 2000. The risks of robotic prostatectomy and conventional laparoscopic prostatectomy are similar. However, the long-term patient outcomes in men who underwent robot-assisted surgery are not well defined.

Studies have performed a comparative analysis of men treated for localized prostate cancer with open surgery, conventional laparoscopic, or robot-assisted surgery by surgeons who perform regular prostate surgeries. The results show that both groups have similar levels of incontinence and erectile dysfunction after one year of surgery.

About 15% of men often report clinically significant urinary incontinence, while 70% of men report clinically relevant erectile dysfunction. These results suggest that long-term outcome for robotic prostatectomy may follow similar partner to open surgery and conventional laparoscopy.

A survey of men who underwent radical prostatectomy showed that two years after surgery, more than 50% of the participants still had issues with erectile function (Litwin et al., 2001). About 35% of participants still experience some urinary function after two years. Studies have linked age with the rate of recovery. Younger men who underwent radical prostatectomy do better than their older counterparts (Litwin et al., 2001).


How can you best recover from a robotic prostatectomy?

While side effects like incontinence and loss of sexual function are unpredictable. Following your doctor’s discharge instructions can improve your recovery.

Reduced physical activity and hydration can improve wound healing, lowering your risk of surgical complications. Strain to the weak scar tissue formed in the first five weeks after surgery can result in wound-associated complications. Aim to reduce your physical activity in the first seven weeks. This will benefit your urinary continence and sexual function.

Studies have shown that balanced diets improve the wound healing process and enhance overall recovery. Thus, consuming vegetables and fruits will aid your recovery from radical prostatectomy. If you are unsure, talk to your doctor about your dietary needs.

What are the benefits of robotic prostatectomy?

The benefits of robot-assisted surgery are, in part, related to the use of a minimally invasive approach. Indeed, the benefits of robotic prostatectomy compared to prostatectomy by open surgery include reduced blood loss and wound healing time.

Compared to open surgery, robotic radical prostatectomy reduces clinically significant wound healing related complications.

Moreover, small cuts reduce the rate of infection.

Robot-assisted prostatectomy gives the surgeon an alternative to both open surgery and conventional laparoscopic. However, loss of sexual function and urinary incontinence are important side effects of any prostate surgery. To solve both problems, surgeons try to protect and preserve the blood vessels and nerves along the sides of the prostate, using a technique called nerve sparing. Though nerve-sparing is effective, it is not always successful in traditional methods.

The prostate is anatomically difficult to reach, making it difficult to spare nerves. However, the cameras used in robotic prostatectomy increases visualization for your surgeon. This enhances their capability to spare more nerves, promoting your return to normal sexual and urinary function.


Safety and effectiveness of robotic prostatectomy

How safe is a robotic prostatectomy?

Extrinsic and intrinsic factors modulate the outcome of prostate surgeries. For instance, the experience of your surgeon can predict the occurrence of complication. Laparoscopies share this link between the surgeon and outcome.

The absence of standardized reporting guideline makes it challenging to quantify all the safety issues associated with robotic prostatectomy. A classification system has been developed to aid the reporting of surgical complications (Clavien et al., 2009). Based on this system, the rate of robotic prostatectomy associated complications is between 8% and 40%. Thus, robotic prostatectomy may become worryingly unsafe for you in the presences of other healthcare factors.

Carlsson et al. showed that robotic radical prostatectomy had lower (3.7%) high-grade complications compared to open radical prostatectomy (12.5%) (Carlsson et al., 2010).

The literature on overall complication rates reported bleeding, injuries, and anastomotic leakage (Carlsson et al., 2010; Novara et al., 2010). Injuries to the bowel, bladder, and ureteral have been reported in some cases (Carlsson et al., 2010; Novara et al., 2010).

While some of the safety issues are less severe, complications like anastomotic leakage may lead to mortality and require re-operation to resolve. Surprisingly, patient comorbidities and clinical

characteristics of the malignancy are not significantly associated with the occurrence of these complications (Novara et al., 2010). However, having a larger prostate increases your risk of experiencing these complications (Carlsson et al., 2010).

Robotic system failure is exclusive

to robot-assisted surgeries. Machine failure can compromise patient safety, especially during surgery. Fortunately, to date, cases have been pre-induction of anesthesia. Early system and mechanical failures present little risk to patients, and the risk is further reduced by strict policy on calibration.

Generally, complications caused by anesthesia, wound, and deep vein blood


clot are lower in robotic prostatectomy or equal to the levels observed men who underwent conventional surgery.

How effective is a robotic prostatectomy?

Studies investigating the effectiveness of robotic prostatectomy show that it can remove cancers like other types of prostate surgery. A recent retrospective study showed equal mortality risks between robot-assisted prostatectomy open prostatectomy (Hu et al., 2017). Interestingly, the risk remained the same, even for cancer-specific deaths (Hu et al., 2017).

Meta-analyses by Moran et al. and Novara et al. as reported no difference in overall mortality or cancer-specific mortality between robotic prostatectomy and open radical prostatectomy (Moran et al., 2013; Novara et al., 2012). It is important to note that further work is needed to expand the follow-up period of robot-assisted prostatectomy to match the follow-up time achieved in traditional prostatectomy.

In terms of side effects, a recent randomized clinical trial involving 326 men with localized prostate cancer investigated how men recovered from robotic prostatectomy compared to open radical surgery. Coughlin and colleagues showed that men had an equal level of urinary incontinence and erectile dysfunction in either group (Coughlin et al., 2018).

These results are supported by a high-quality Cochrane analysis using

randomized clinical trials (Ilic et al., 2018), which found no difference in complications. These results suggest that robotic prostatectomy is as effective as the open prostatectomy. However, you need to note that the risk of your cancer returning over long-term remains unclear because of the relative infancy of the technique and lack of long-term evidence.

What are other surgical options available besides a robotic prostatectomy?

Other ways of having your prostate removed include;

1. Retropubic prostatectomy, where the surgeon assesses the prostate gland through an abdominal incision.

2. Perineal prostatectomy performed through an incision between your testicles and anus.

3. Conventional laparoscopic, which is similar to robotic-assisted prostatectomy and performed through a small abdominal incision (keyhole).

Generally, conventional laparoscopic prostate surgery shares the advantages of robotic prostatectomy when compared to open prostatectomy by retropubic and perineal assess. There is reduced bleeding, scarring, hospital stay, and recovery time in keyhole prostatectomy compared to open prostatectomy.

Your healthcare provider may offer you these alternatives depending on availability. However, the literature


seems to show that outcomes are similar between open and keyhole prostatectomy techniques.

Natural alternatives to robotic prostatectomy

What are some natural ways to avoid robotic prostatectomy?

Radical prostatectomy is still the most decisive way to treat men with localized prostate cancer. Robotic prostatectomy makes it easier to reduce damage to the surrounding blood vessels and nerves, increasing the chances of achieving urinary continence and sexual function. However, some men have a good outcome with less invasive surgery.

Researchers continue to test alternative remedies to reduce the risk of prostate cancer, which will, in turn, stop you from developing the disease and needing radical prostatectomy — however, there no definitive drugs to prevent prostate cancer. You can make positive health choices to reduce your risk and avoid the eventual prostatectomy. It is important that you know the risk factors for prostate cancer to be able to lower the risk of developing the disease naturally.

Old age, family history of prostate cancer, high-fat diet, obesity, and African descent all increase your risk of developing prostate cancer. Though you cannot control some of these risks, gaining awareness of the role of diet and physical activity in prostate cancer provides you with a potent tool to reduce your risk.

Healthy diet

There is evidence that a low-fat diet rich in fruit and vegetables can lower your risk of prostate cancer. Consider reducing your consumption of meats, oils, and dairy products.

Healthy weight

Obesity is now the second highest cause of cancer death after smoking. Studies have shown that lower daily calorie intake and regular exercise reduce your risk of developing prostate cancer. Aim to maintain a healthy weight through diet and physical exercise.


Which natural supplements will help improve your prostate health?

Heredity and the environment influence the development and progression of prostate cancer. However, diet is thought to account for a significant proportion of prostate cancer cases and promotes the progression of prostate cancer to lethal aggressive disease. Thus, a healthy diet and natural supplements can enhance your prostate health. Several natural agents with anti-cancer and antioxidant properties have been identified, including;

1. Lycopene, a natural carotenoid hydrocarbon found in red fruits and vegetables. It was initially linked to a reduced risk of prostate cancer based on the observation that consumption of tomato-based foods may reduce the risk of prostate cancer. Many studies have been conducted to test the effect of lycopene supplement on prostate cancer risk, with promising results (Giovannucci, 2002). The full mechanism of lycopene’s modulation of prostate health remains unclear. Crawford postulated that lycopene might be acting through its inverse association with insulin growth factor (Crawford, 2003), while some authors argue it is through tumor inhibition and differentiation of normal cells (Lu et al., 2001). However, the most accepted theory is the antioxidant activity of lycopene, which can reduce oxidative stress induced DNA damage.

2. Vitamin D, a group of fat-soluble steroids that have been linked

to prostate cancer development and progression. Studies that randomly assigned men to vitamin D supplementation or placebo reported improvements in the prostate tumor in the vitamin D group compared to the placebo group (Posadzki et al., 2013). Vitamin D can reduce inflammation and cancer growth by reducing reactive oxygen species. Besides supplementation, you can get vitamin D from the sun or fatty fish.

3. Omega-3 fatty acids are polyunsaturated fatty acids associated with reduced risk of prostate cancer (Berquin et al., 2007). Like vitamin D, Omega-3 fatty acids can reduce inflammation and in turn, reduce prostate cancer development. The observation supports the role of omega-3 fatty acids in prostate health that men with defects in one of the enzymes involved in fatty acid metabolism increases the risk of prostate cancer (Fradet et al., 2009).


What might happen if you choose not to have robotic prostatectomy?

Untreated localized prostate cancer can develop to advance disease, spreading to your lymph nodes and bones.

Prostate cancer patients with advanced or metastatic prostate cancer have a poorer outcome compared to those with early-stage disease. Indeed, early detection is an important determinant of successful management of any cancer.

You should speak to your medical provider if you are concerned about the side effects of radical prostatectomy. Your healthcare provider can implement an alternative prostate cancer treatment option that is suitable for the stage of your cancer. This may include radiation therapy, hormone therapy, and watchful waiting and active surveillance.

Sources:1. Berquin, I.M., Min, Y., Wu, R., Wu, J., Perry,

D., Cline, J.M., Thomas, M.J., Thornburg, T., Kulik, G., Smith, A., 2007. Modulation of prostate cancer genetic risk by omega-3 and omega-6 fatty acids. The Journal of clinical investigation 117, 1866–1875.

2. Carlsson, S., Nilsson, A.E., Schumacher, M.C., Jonsson, M.N., Volz, D.S., Steineck, G., Wiklund, P.N., 2010. Surgery-related complications in 1253 robot-assisted and 485 open retropubic radical prostatectomies at the Karolinska University Hospital, Sweden. Urology 75, 1092–1097.

3. Clavien, P.A., Barkun, J., De Oliveira, M.L., Vauthey, J.N., Dindo, D., Schulick, R.D., De Santibañes, E., Pekolj, J., Slankamenac, K., Bassi, C., 2009. The Clavien-Dindo classification of surgical complications: five-year experience. Annals of surgery 250, 187–196. Sources continued on page 38


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1) Fish

Rich in Omega, fish, is the ultimate inflammatory. The Omega 3 in fish interfere with immune cells called leukocytes and enzymes are known as cytokines, which are both key players in causing inflammation.

By blocking inflammation and boosting circulation, Omega 3 helps to ease the pain of inflammatory diseases, such as arthritis.

One study which looked at the effect of Omega 3 fatty acids in patients with rheumatoid arthritis had encouraging results. Sixty patients with rheumatoid arthritis were enrolled in a 12-week, double-blind, randomized study, during which they were administered Omega 3 supplements.

Some brands will lure you in with deceptively healthy and wholesome branding, leaving you congratulating yourself on your healthy choice, when in reality, you have just consumed 30g of sugar. Learning to eat healthily starts by educating yourself.

Many diseases that plague our society, such as heart disease, diabetes, and high blood pressure, are as a consequence of lifestyle choices. At the root of many of these health issues is inflammation.

In this day and age, eating healthily has become increasingly difficult. With so many options available,

making the right decision can be confusing at the best of times...

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“By tackling inflammation, you will not only improve your overall health but

prevent chronic diseases from developing.”


and Lowe (2006) analyzed several studies conducted since 1993, regarding the medical benefits of garlic in preventing cardiovascular diseases. They claim that increased garlic consumption reduces the risk of cardiovascular disease.

Garlic has also been shown to have anti-cancer properties and can prevent the formation of free radicals which contribute to the development of cancer and BPH.They say good things come in small packages and when it comes to garlic this couldn’t be truer.

4) Avocado

Although some might regard avocado as a ‘millennium’ fad, splashed across social media in snazzy brunch pictures, it has long been viewed as the ultimate superfood.Packed with potassium, magnesium, fiber,

By the end of the study, an astonishing 76% of patients were satisfied with the project. Researchers concluded that Omega 3 was effective in reducing symptoms.

2) Nuts

Nuts are bursting with healthy fats and are low in saturated fat. As a result, when it comes to the inflammation, they can do no wrong. One study suggested that eating a handful of nuts (only a handful, as they are high in fat), five times a week could help to reduce inflammation. The research team analyzed data from two different long-term studies, the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS).

The research found that people who ate nuts at least five times per week had 20% lower levels of C-reactive protein (CRP) compared to people who never or rarely ate nuts. They also had 16% lower levels of interleukin-6 (IL-6), another inflammatory marker.

3) Garlic

It may leave you breath smelling ripe, but garlic is revered throughout the world for its healing capabilities. Not only is it antibacterial, helping to fight infection, but it’s also a powerful weapon against inflammation.

The sulfur compounds found in garlic help to stimulate your immune system to fight disease. A critical review by Rahman


and heart-healthy monounsaturated fats, avocados have been shown to combat inflammation. One study, evaluated the antioxidant, anti-inflammatory, and cytotoxic properties in the peel and seed of the avocado.

Overall it concluded that avocados are essential sources of natural antioxidant and act as anti-inflammatory agents.

5) Turmeric

Used for centuries throughout Asia, Turmeric is renowned for its anti-inflammatory and antioxidant properties. The active ingredient in turmeric is curcumin, and many studies have endorsed its natural anti-inflammatory capabilities.

A study published in Oncogene in 2004 found that turmeric and curcumin are just as effective as several anti-inflammatory drugs such as ibuprofen, aspirin, tamoxifen, sulindac, and naproxen.

Don’t get me wrong; inflammation isn’t always a bad thing. It is our bodies way of fighting infection, and without it, pathogens like bacteria could easily harm our bodies.However, when it becomes chronic inflammation, it can result in many health problems and is responsible for diseases such as heart disease, cancer, metabolic syndrome, and Alzheimer’s.

6) Green Leafy Vegetables

From the early days of childhood, we have often been warned to eat our greens, and it seems there was a good reason for this!Dark green leafy vegetables such as kale, spinach, and broccoli are rich in vitamin E and are believed to protect against inflammatory molecules such as cytokines.Vegetables such as kale are high vitamin K, which is important for bone mineral density and osteoporosis prevention.

In one study, researchers investigated the relationship between vitamin K and bone mineral density in young Korean women. The researchers concluded that the study was of great significance, showing correlations between vitamin K nutritional status and inflammatory responses.

7) Blueberries

Rumored to leave you with glowing skin, blueberries are not only a great source of antioxidants but also have powerful anti-inflammatory properties. Sad to say this does not mean gorging on blueberries muffins, but the beautiful blueberries themselves.


A study which reviewed the anti-inflammatory effects of blueberries concerning post-traumatic stress found that blueberries can reduce stress levels and inflammation and restore neurotransmitter imbalances, helping to reduce anxiety levels and even depression.

Conclusion

When it comes to inflammation, it should be remembered that there is the good and the bad. Acute inflammation is the body’s short-term response to tissue injury, such as a cut. It is the body’s way of healing and battling infection and is followed by redness, swelling, and pain.

Chronic inflammation, meanwhile, is long-term inflammation, which can last for a duration of months and even years. This form of inflammation can eventually lead to diseases and conditions and is at the root of many chronic diseases.

Embracing a healthy diet is a necessary part of living a healthy and happy life. Although we are surrounded by temptation, in the form of sugary snacks and readily available fast food, taking the time to make, an educated decision about your diet will not only leave you feeling good inside but will help to protect you against inflammation and the many diseases it can cause.

Sources:1. Rajaei E, Mowla K, Ghorbani A, Bahadoram

S, Bahadoram M, Dargahi-Malamir M. The Effect of Omega-3 Fatty Acids in Patients With Active Rheumatoid Arthritis Receiving DMARDs Therapy: Double-Blind Randomized Controlled Trial. Glob J Health Sci. 2015;8(7):18–25. Published 2015 Nov 3. doi:10.5539/gjhs.v8n7p18

2. Yu Z, Malik VS, Keum N, et al. Associations between nut consumption and inflammatory biomarkers. Am J Clin Nutr. 2016;104(3):722–728. doi:10.3945/ajcn.116.134205. Sources continued on page 39


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Prostate cancer is the most common cancer in men. It affects one in three American men during their lifetime. By the age of 50, many men start to get screened, usually undergoing a PSA test.

During this screening, if it seems that an individual has the possibility of cancer, it’s common medical practice to recommend a biopsy. This is to confirm whether cancer is present, as to make a prostate cancer diagnosis and determine the aggressiveness of the disease. But, mounting evidence suggests that biopsies have many dangerous and unpleasant side effects.

What is a prostate biopsy?

A prostate biopsy is a procedure used to detect prostate cancer. Small samples of the prostate are removed and then observed under the microscope.

A urologist or surgeon usually performs this procedure. They will look at the prostate cell samples to see if they are cancerous. Cancer cells are often irregular in size and shape and exhibit aggressive growth.

Doctors usually recommend a biopsy of your prostate gland based on certain findings. One is if your prostate-specific antigen (PSA) blood test results are higher than average for your age.

Another is if your doctor detects signs of a prostate problem during your digital rectal exam (DRE). Although the PSA and DRE or show a possible problem with your prostate, a biopsy is needed to confirm if it’s cancer.

A prostate biopsy involves collecting minute samples of the prostate gland. The doctor passes a needle through the

This article will discuss the safety of undergoing a prostate biopsy and the 5 side effects that could

affect your quality of life.


• Transperineal biopsy: Unlike the TRUS Guided Biopsy, this is where the doctor inserts a needle into the prostate through the skin between the testicles and the anus. This area is called the perineum.

The needle is inserted through a template or grid. This is a targeted biopsy, which can be target a specific area of the prostate using MRI scans. An advantage of the TP biopsy is that it can now be performed under local anesthesia.

Side effects of a prostate biopsy

Although one of the most common procedures for detecting prostate cancer, biopsies carry many potential risks and complications which we will discuss below.

1) Bleeding

Just like any invasive procedure, bleeding will occur. It’s normal to see a small amount of blood in your semen or urine for about two weeks. However, it becomes a significant problem if bleeding takes a long time or if it gets worse.

One study reviewed the safety of transrectal ultrasound-guided needle biopsy. It found that 58 patients (63%) experienced haematuria and experienced rectal bleeding 23 patients (25%).

Severe rectal bleeding is an uncommon complication yet in some instances can be life-threatening. So, both patients and practitioners should be aware of the risks.

rectal wall or makes a small cut in the area between the anus and rectum to obtain the samples. A CT or MRI scan is also used to guide them through the procedure.

A prostate biopsy takes about 10 minutes and is usually done in the doctor’s office. The samples will be sent to a lab and will be looked at under a microscope to see if they contain cancer cells. If cancer is detected in the patient, it will also be assigned a grade. The results are available after 1 to 3 days, but it can sometimes take longer.

Types of prostate biopsy

A prostate biopsy may be done in several different ways:

• Transrectal method: At the moment, most biopsies are done using transrectal ultrasound-guided (TRUS) technique. A TRUS prostate biopsy is where the needle goes through the wall of the back passage (rectum).

• Perineal method: This is done through the skin between the scrotum and the rectum.

• Transurethral method: This is a type of biopsy done through the urethra using a cystoscope (a flexible tube and viewing device).


2) Pain

After the biopsy, it is highly common for patients to experience discomfort and pain. This usually only lasts for a few days after the procedure, but the degree of pain will vary for each individual. While some may find it very painful, other people only report a slight discomfort. This is because of the injury caused by the needle on your prostate cells.

A prospective cohort study measured the short-term outcomes of men undergoing a prostate biopsy. The participants were asked to complete a questionnaire, measuring the frequency and effect of symptoms related to pain, infection, and bleeding. The results found that pain was reported by 43.6%, fever by 17.5%, haematuria (blood in urine) by 65.8%, hematochezia (anal bleeding) by 36.8%, and haemoejaculate (the presence of blood in a man’s ejaculate) by 92.6%)men during the 35 days after a biopsy.

Although the researchers concluded that most men well tolerate prostate biopsy, it is associated with significant symptoms in the minority and affects attitudes to repeat biopsy. Pain is a very important symptom to monitor. Worsening and persistent pain may indicate a bigger problem. If this is the case, you need to see your doctor for a follow-up.

3) Infection

A further risk of having a prostate biopsy is an infection. Surgeons will usually prescribe

strong antibiotics to reduce the risk of infection. However, infection almost always occurs. Research indicates that resistance to antibiotics is increasing the likelihood. In some cases, the result of the infection is that there is long-term sexual dysfunction.

Occasionally, these infections can turn into life-threatening sepsis. This is as needles used to detect cancer are passed through the rectum. As a result, if the needles transport bacteria from the bowel into the prostate, bladder, and the bloodstream, an infection can occur.

A study by John Hopkins researchers was published in The Journal of Urology. It found that men hospitalized as a result of a biopsy-related infection had a 12-fold higher chance of dying than those who did not undergo a biopsy.

4) Acute urine retention

The procedure does injure the prostate gland, causing it to swell. And this makes it hard for you to pass urine.


If the prostate is particularly enlarged (>50mL) or the man has pre-existing risk factors, e.g., a poor flow, a high residual volume or previous urinary retention, then the risks of biopsy-induced urinary retention are significant.

Acute urine retention is a medical emergency, and you need to seek help at once. The doctor often inserts a catheter to drain the retained urine, and it will take a few days for you to recover.

5) Sexual problems

Several studies have found that men develop Erectile Dysfunction after having a prostate biopsy. In 2015, BJUI International published a study involving 220 men who underwent transrectal prostate biopsy.

Overall the researchers reported an increased risk of temporary ED after biopsy of approximately 5%. While this happens rarely and should improve over time, the study concluded that the effects of TRUS-guided prostate biopsy on ED have probably been underestimated.

It is important to be aware of these side effects so patients can be appropriately counseled. If sexual problems persist, you should consult your doctor.

Are prostate biopsies safe?

One of the main issues with prostate cancer screening tests is that they can lead to misdiagnosis and as a result, overtreatment. Even if you take many samples, a biopsy can still sometimes miss cancer. This occurs if none of the biopsy needles pass through the rights areas. Thus, the biopsy will have a false-negative result. In fact, one study found that biopsies detected only 67.8% of prostate cancers.

What is the alternative to a prostate biopsy?

Doctors have long relied on biopsies to determine prostate cancer. And biopsies are proven to be dangerous. Often, a prostate biopsy finds traces of low-grade cancer that don’t need to be treated.

MRI

But in recent years, doctors have found out that new imaging studies like high-resolution MRI and ultrasound can be alternatives to a prostate biopsy. They have proven to be very accurate and safe. A multi-parametric MRI or a color Doppler ultrasound has a 95 to 98% chance of determining the location and grade of prostate cancer cells.


According to the Diagnostic Center for Disease, an MRI scan predicts and confirms the presence of prostate cancer more frequently than a biopsy. A hi-res MRI features the most sensitive and specific imaging modality that allows it to produce a very clear picture of the entire prostate and pelvic region.

Experts claim that this is a quantum leap from the blind biopsy approach. It will minimize the need for biopsies, and could potentially save millions of dollars for the healthcare industry.

PCA3 Test

The PCA3 test is another alternative. PCA3 stands for “Prostate Cancer gene 3”, a protein that is produced by prostate cancer cells at much higher levels. PCA3 leaks into the urine when the prostate gland is stimulated.

Unlike the PSA test, a high PCA3 test can only result from cancer – not from an enlarged prostate, inflamed prostate or other non-cancerous prostate problem.For this test, you need to undergo a DRE.

This will stimulate PCA3 to leak into the urine. A urine sample is then collected and sent to the lab. It takes about 1-2 weeks to get the results. The higher the PCA3 score, the more likely you have prostate cancer.This test is also used to determine the effectiveness of cancer treatment. The higher the score, the more aggressive is the prostate cancer.

Conclusion

Before having a biopsy, do your research. Do not blindly agree to a procedure without being aware of the possible life-changing side effects it could have.

There are alternatives to a prostate biopsy, like MRI and the PCA3 test. These methods are non-invasive and accurate. Plus, they don’t have the negative side effects that result from a prostate biopsy.

Sources:1. Glaser, A, Downing, A, Wright, P,

Hounsome, L. (2018). Life after prostate cancer diagnosis: One step beyond.. Journal of Clinical Oncology. 36 (6), p40-40

2. Lee G, Attar K, Laniado M, Karim O.. (2006). Safety and detailed patterns of morbidity of transrectal ultrasound guided needle biopsy of the prostate in a urologist-led uni. International Urology and Nephrology. 38 (2), p281-285.

3. Liau, J, Goldberg, D, Arif-Tiwari, H. (2019). Prostate Cancer Detection and Diagnosis: Role of Ultrasound with MRI Correlates. Current Radiology Reports. 7 (7), 0.

4. Loeb S, Carter HB, Berndt SI, Ricker W, Schaeffer EM. Is repeat prostate biopsy associated with a greater risk of hospitalization? Data from SEER-Medicare. J Urol. 2012;189(3):867–870. doi:10.1016/j.juro.2012.10.005

5. Murray KS, Bailey J, Zuk K, Lopez-Corona E, Thrasher JB1. (2015). A prospective study of erectile function after transrectal ultrasonography-guided prostate biopsy.. BJU International . 116 (2), p90-95. Sources continued on page 39


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Prostate inflammation

Inflammation of the prostate is known as prostatitis, and it is one of the most common prostate problems in males. It is estimated that 50% of men experience symptoms of prostatitis at some point during their lifetime.

There are three different classifications of prostatitis: acute bacterial prostatitis (I), chronic bacterial prostatitis (II), and chronic non-bacterial prostatitis (III).

The most common symptoms of prostatitis include:

• Urinary tract symptoms pelvic pain• Painful urination• Urinary tract infections• Urination problems• Painful ejaculation• Erectile dysfunction• Flu-like symptoms

• Pelvic pain, rectal pain, abdominal pain and/or low back pain

• Tests for prostatitis

If you are experiencing any of the symptoms of prostatitis, you should see your doctor so that further tests can be taken to confirm whether you have prostatitis.

Urine test

A urine test can be beneficial for diagnosing bacterial prostatitis.Bacteria and excessive white blood cells are found in the urine in people with bacterial prostatitis.

Blood PSA test

Most men with prostatitis have an abnormally elevated PSA level at the time. There is usually a steep rise in PSA levels.Therefore, a PSA test long in conjunction


The main difference between acute and chronic prostatitis is that the symptoms of chronic prostatitis last more than three months. Antibiotic medication is typically given to get rid of the germ that is causing bacterial prostatitis. However, a long-term antibiotic can have side effects. It also reduces the amount of health-supporting microbes like Bifidobacterium and Lactobacillus (2).

These bacteria are an essential part of healthy gut microflora. Disruption to the gut microflora increases the risk of prostatitis recurrence.

Chronic non-bacterial prostatitis

Chronic non-bacterial prostatitis is by far the most common form of prostatitis. The symptoms are similar to chronic bacterial prostatitis, but there are no bacteria present. The cause is not fully understood.

with other examination may help diagnose bacterial prostatitis. In the vast majority of cases, this elevation is due to inflammation in the prostate.

Digital Rectal Exam

A doctor may undergo a digital rectal exam (DRE) to assess whether your prostate is enlarged, swollen, or tender. Your doctor can also rule out other severe prostate conditions during this examination.

Urodynamic tests

Measuring post-void residual urine is useful for measuring bladder emptying capabilities. Urinary retention can cause prostatitis if the urine is infected with bacteria. Therefore, the inability to completely empty your bladder may lead to prostate infection.

A post-void residual urine measurement provides useful information to determine whether a patient has incomplete bladder emptying. Urinary retention can be a causative factor in recurrent urinary tract infections.

Types of prostatitis

Bacterial prostatitis

Bacterial prostatitis accounts for about 5-10% of all prostatitis cases. Acute prostatitis can develop into chronic prostatitis if the first occurrence is not recognized and treated, inadequate duration of antibiotic treatment, or antibiotic resistance (1).


However, men who have non-bacterial prostatitis typically have a higher level of inflammation. Therefore, natural anti-inflammatory supplements have been of interest for treating prostatitis.null

Natural remedies for prostatitis

1) Probiotics

Men that have previously had prostatitis have a 20%-50% risk of a recurrence (1). Research has also found that men with chronic prostatitis have lower levels of seminal lactobacilli than healthy men (3).This shows that antibiotic treatment of prostatitis alone is not adequate for many men. Probiotic supplementation can restore the loss of healthy bacteria in your gut microflora caused by antibiotic treatment. This would lower the risk of a bacterial infection recurrence.

The benefits of probiotics for treating bacterial prostatitis have been demonstrated in human clinical research. One study looked at the effects of supplementing with probiotics alongside antibiotics for treating chronic bacterial prostatitis (2). Two hundred ten men affected by chronic bacterial prostatitis were randomly allocated to receive a lactobacillus supplement with antibiotics or antibiotics alone for 30 days.

At the end of the study, 27.6% of the group that received only antibiotics had a UTI (urinary tract infections) recurrence, while only 7.8% of the combination group experienced a recurrence (Busetto 2014).

Probiotics can protect against harmful type bacteria and restore the loss of healthy-supporting bacteria lost to antibiotics treatment. This makes probiotics one of the best treatments for bacterial prostatitis.

2) Curcumin

Curcumin is a potent bioactive constituent in the spice Turmeric. Turmeric is regularly used in India for cooking and in traditional medicine. Curcumin is well-known for its potent anti-inflammatory effects. Curcumin also has an excellent safety profile, and it serves as a viable alternative to anti-inflammatory drugs.

A clinical study was carried out to see if a combination of curcumin and calendula was able to help treat chronic non-bacterial prostatitis (4). After three months, the men that took the herbal supplement had a significant improvement in urinary symptoms and erectile function compared to the placebo group (4).


Another study compared the effects of using antibiotics with saw palmetto, curcumin, and quercetin, for treating chronic bacterial prostatitis (5). After one month, 90% of men that took the supplement did not report a recurrence of prostatitis, while only 27% of men that took antibiotic alone did not report recurrence. After six months of treatment, none of the supplement group reported symptoms of prostatitis, and two patients did in the antibiotics only group (5).

One issue is that none of these studies have looked at the effects of curcumin alone on treating prostatitis, and therefore, it is unknown whether using curcumin alone would be effective.

However, using curcumin with other natural anti-inflammatory ingredients such as quercetin and saw palmetto can improve the symptoms of chronic non-bacterial prostatitis.

3) Quercetin

Another supplement that can help treat chronic non-bacterial prostatitis is quercetin. Quercetin is a flavonoid found in high concentrations in capers, and red onion (1).

Animal research has demonstrated that quercetin can protect against chronic prostatitis by reducing inflammation and oxidative stress (6). A human clinical showed that 1 gram of quercetin daily for four weeks significantly improved the symptoms of chronic non-bacterial prostatitis (7).

Another human clinical study showed that taking quercetin alongside curcumin, saw palmetto, and antibiotics were more effective at treating chronic bacterial prostatitis than taking antibiotics alone (5).90% of the men that took the supplement with antibiotics did not experience an infection recurrence, while only 27% of men than took antibiotic did not have an infection recurrence (C5).

For quercetin to be effective quercetin, you would require either a high dose (1 gram per day) or a lower dose when combined with other ingredients like curcumin and saw palmetto.

4) Pollen extract

Pollen extract is another potent natural anti-inflammatory. Research has demonstrated that pollen extract has anti-inflammatory effects on rats induced


with prostatitis (8). In a human clinical study, patients that were given pollen extract reported a significantly greater improvement in symptoms of chronic non-bacterial prostatitis and a greater improvement in the quality of life than men that were given a placebo (9).

Another study provided strong evidence that pollen extract can reduce inflammation within the prostate (10). Pollen extract is a good option for anyone who has chronic non-bacterial prostatitis.

5) Saw palmetto

Saw palmetto is regularly used to treat prostate enlargement. This is because of its ability to reduce DHT, which is a potent hormone that plays an essential role in prostate enlargement. Saw palmetto also has potent anti-inflammatory properties and has been suggested as a potential treatment for prostatitis.

A study looked at the efficacy of saw palmetto for treating chronic bacterial prostatitis (11). Fifty-six men were given antibiotics for 15 days, and half of the

men were also given saw palmetto for eight weeks. While both groups had a similar reduction in bacteria, the group that took saw palmetto reported a more significant decrease in prostatitis pain and symptoms (11). This is likely due to the anti-inflammatory effects of saw palmetto.

Other studies have also shown that when saw palmetto is used alongside other natural ingredients like probiotics (2),

quercetin and curcumin (5) are effective for treating prostatitis.

Summary

Although prostatitis is not a life-threatening condition, it does have a debilitating effect on your quality of life and prostate health. Several natural ingredients can treat prostatitis.

For anyone suffering from a form of bacterial prostatitis, it is imperative that you supplement with probiotics.

A combination of saw palmetto, curcumin, and quercetin have shown to be clinically effective at reducing pain and should be used by men suffering from any form of prostatitis.


Physical activity can also help to alleviate pelvic pain, and pelvic floor exercises (also known as Kegel exercises) have been shown to be of particular benefit.

Using natural treatment for prostatitis can also prevent you from having an unnecessary PSA test by reducing inflammation and PSA levels.

It takes a holistic approach that can benefit not just the prostate, but your entire body. One of the simplest ways to start treating urinary tract issues is Prostate Healer. This powerful healing tincture contains 8 of the most potent rejuvenating herbs available in Ayurvedic science.

It’s an effective, fast working tincture and because it is an all-natural formula and non-GMO, there are no side effects. Patients report significant improvements in the first few weeks, and within three months, they say their prostatitis is gone.

Try it today! Here’s a link for more info: https://www.bensnaturalhealth.com/ben-s-

https://www.bensnaturalhealth.com/ben-s-prostate-healer.html


https://www.bensnaturalhealth.com/psa-test-kit.html?utm_source=Natural-Choice&utm_medium=email&utm_campaign=Monthly-Newsletter-July-2019&utm_content=PSA-Blood-Test


TOP TIPS: You can buy the cedar planks in any grocery store, particularly where the grilling items are or at your local hardware store. Serve these on lettuce leaves for a crunchy texture with some mayo and a squeeze of lemon for a tangy, delicious taste!

GRILLED CEDAR PLANK SALMON BURGERS

4 Servings 1 Hour Difficulty: Medium

INGREDIENTS

METHOD

• 1 ½ pounds wild caught salmon fillets

• 1 ½ tablespoons mayonnaise

• 1 ½ tablespoons

mustard• ½ small red

onion, diced• 1 stalk celery,

diced• 2 tablespoons

fresh dill• 2 cloves

garlic, minced• 2 teaspoons

salt• 1 teaspoon

black pepper• Fresh lemon

juice, to taste

1. Soak the cedar planks in water for at least 2 hours before you plan on cooking. You will need enough planks to cook all your salmon patties. Preheat your grill and set it up for indirect heat, at about 350-375F.

2. Remove the skin and any pin bones from the salmon. Cut the salmon into smaller pieces then add it to a food processor. Add the mayo, mustard, dill, salt, pepper, and garlic. Pulse until the salmon turns into a smooth paste.

3. Scrape the salmon paste out of the food processor and transfer it to a mixing bowl. Mix in the onion and celery.

4. Add the planks to the grill to allow them to preheat. Form the salmon mixture into equally sized patties. Place two on each plank then grill for about 25-30 minutes or until the salmon is fully cooked through. Remove the planks from the heat then squeeze a touch of lemon juice over the top. Serve with your favorite toppings.

Protein47.08g

Fats16.76g

Carbs1.7g


TOP TIPS: Optional Toppings could be whipped cream, cocoa powder, and

strawberries. With the strawberries you can thinly slice them and then layer them inside, or swap it out for your

favourite fruit!

KETO NEAPOLITAN CHIA PUDDING

3 Servings 30 Mins Difficulty: Easy

INGREDIENTS

METHOD

• ½ cup chia seeds

• 1 ½ cups unsweetened almond milk

• 2 tablespoons monk fruit sweetener

• 1 teaspoon vanilla extract

• 4 medium strawberries, diced

• 2 teaspoons unsweetened cocoa

powder• Optional

Toppings: whipped cream, cocoa powder, and strawberries

1. In a bowl, mix the chia seeds, almond milk, sweetener, and vanilla extract. Chill in the fridge for 10-15 minutes or until firm.

2. Evenly divide the chia seed mixture into three bowls.

3. In one bowl, add in the cocoa powder then mix. Taste and adjust the sweetness if desired.

4. Microwave the strawberries for about 30 seconds to soften, then mash with a fork. Mix into another one of the chia seed bowls.

5. You should now have vanilla, chocolate, and strawberry layers. Use small glasses then layer a bit of each color inside. I like to do chocolate, strawberry, then vanilla. Use some sliced strawberries along the sides of the glass for the middle layer.

Protein6.27g

Fats11.47g

Carbs4.53g


https://www.bensnaturalhealth.com/rejuvenayte-plus.html?utm_source=Natural-Choice&utm_medium=email&utm_campaign=Monthly-Newsletter-July-2019&utm_content=Rejuvenayte-Plus


ASK BEN DO YOU HAVE QUESTIONS?

In case this is your first issue of our monthly journal The Natural Choice, Ask Ben is a recurring segment in every issue in which Ben responds to questions from you, the reader.

Many of our readers love engaging with us and asking a multitude of deep questions regarding their lifestyle. We provide feedback that inspires and equips our customers on exactly what

they need to do for themselves in order to be victorious in their battle with health problems.

We believe all of your questions are valuable and choose some of the best to include in our monthly Natural Choice Articles. This is so that others going through similar experiences can learn how they can also live a more fulfilling life with the contribution of you and the community.

We are empowered by your feedback and this propels us to do more to provide the best service we can.

If you would like to have your prostate health or supplement related question, no matter the nature, answered by Ben in an upcoming issue of The Natural Choice then please feel confident to email your question to [email protected] or alternatively click the button below.

Get Involved With Our Community

http://www.bensprostate.com/ask-ben-a-question/

http://www.bensprostate.com/ask-ben-a-question/


Hi William,

We have actually written an article discussing honey as an alternative to sugar which may interest you https://www.bensdiabetes.com/is-honey-a-healthier-alternative-to-sugar/. Certain honeys, such as manuka, do offer health benefits, but it is important to bear in mind that honey has a very similar effect on the body that sugar has.

I wish you good health,

Ben

Q.

A.

Hi Ben,

Is honey an acceptable replacement for sugar, in say coffee or tea?

Thanks, William


Q.

A. Hi Duane,

TURP has a number of potential side effects. About 90% of men experience retrograde ejaculation, which can have a negative impact on fertility. Many men also experience urinary incontinence. Other potential side effects are erectile dysfunction urethral stricture, which can make it more difficult to urinate, and a UTI. About 10% of men require TURP again because the prostate becomes enlarged again. If you would like to discuss this in further detail, please get in touch with our team via our toll-free number 1-888-868-3554 in the US and +44 (0) 845 423 8877 in the UK.

The Ben’s Natural Health Team.

Hi Ben,

My name is Duane Gaither and I have had an enlarged prostate since 2011/4 times the size. My doctor has prescribed Finastetide and Tamsulosin. I am still over 3 times the size and retain a lot of water in my bladder. Now he wants to do surgery- TURP procedure. Is that good or bad? He wants to do it this summer, probably July. How safe and effective is it?

Duane


“Robotic Prostatectomy for Prostate Cancer” sources continued:1. Coughlin, G.D., Yaxley, J.W., Chambers, S.K.,

Occhipinti, S., Samaratunga, H., Zajdlewicz, L., Teloken, P., Dunglison, N., Williams, S., Lavin, M.F., 2018. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: 24-month outcomes from a randomised controlled study. The Lancet Oncology 19, 1051–1060.

2. Crawford, E.D., 2003. Epidemiology of prostate cancer. Urology 62, 3–12.

3. Fradet, V., Cheng, I., Casey, G., Witte, J.S., 2009. Dietary omega-3 fatty acids, cyclooxygenase-2 genetic variation, and aggressive prostate cancer risk. Clinical Cancer Research 15, 2559–2566.

4. Fredericks, S., Yau, T., 2013. Educational intervention reduces complications and rehospitalizations after heart surgery. Western journal of nursing research 0193945913490081.

5. Giovannucci, E., 2002. A review of epidemiologic studies of tomatoes, lycopene, and prostate cancer. Experimental biology and medicine 227, 852–859.

6. Gonzalgo, M.L., Pavlovich, C.P., Trock, B.J., Link, R.E., Sullivan, W., Su, L.-M., 2005. Classification and trends of perioperative morbidities following laparoscopic radical prostatectomy. The Journal of urology 174, 135–139.

7. Hu, J.C., O’Malley, P., Chughtai, B., Isaacs, A., Mao, J., Wright, J.D., Hershman, D., Sedrakyan, A., 2017. Comparative effectiveness of cancer control and survival after robot-assisted versus open radical prostatectomy. The Journal of urology 197, 115–121.

8. Ilic, D., Evans, S.M., Allan, C.A., Jung, J.H., Murphy, D., Frydenberg, M., 2018. Laparoscopic and robot‐assisted vs open radical prostatectomy for the treatment of localized prostate cancer: a Cochrane systematic review. BJU international 121, 845–853.

9. Litwin, M.S., Melmed, G.Y., Nakazon, T., 2001. Life after radical prostatectomy: a longitudinal study. The Journal of urology 166, 587–592.

10. Lu, Q.-Y., Hung, J.-C., Heber, D., Go, V.L.W., Reuter, V.E., Cordon-Cardo, C., Scher, H.I., Marshall, J.R., Zhang, Z.-F., 2001. Inverse associations between plasma lycopene and other carotenoids and prostate cancer. Cancer Epidemiology and Prevention Biomarkers 10, 749–756.

11. Moran, P.S., O’neill, M., Teljeur, C., Flattery, M., Murphy, L.A., Smyth, G., Ryan, M., 2013. Robot‐assisted radical prostatectomy compared with open and laparoscopic approaches: a systematic review and meta‐analysis. International Journal of Urology 20, 312–321.

12. Novara, G., Ficarra, V., D’Elia, C., Secco, S., Cavalleri, S., Artibani, W., 2010. Prospective evaluation with standardised criteria for postoperative complications after robotic-assisted laparoscopic radical prostatectomy. European urology 57, 363–370.

13. Novara, G., Ficarra, V., Mocellin, S., Ahlering, T.E., Carroll, P.R., Graefen, M., Guazzoni, G., Menon, M., Patel, V.R., Shariat, S.F., 2012. Systematic review and meta-analysis of studies reporting oncologic outcome after robot-assisted radical prostatectomy. European urology 62, 382–404.

14. Posadzki, P., Lee, M.S., Onakpoya, I., Lee,


H.W., Ko, B.S., Ernst, E., 2013. Dietary supplements and prostate cancer: a systematic review of double-blind, placebo-controlled randomised clinical trials. Maturitas 75, 125–130.

“7 Best Foods To Reduce Inflammation” sources continued:1. Rahman K, Lowe GM. (2006). Garlic and

cardiovascular disease: a critical review.. Journal of Nutrition. 136 (3), p736-740.

2. Tremocoldi MA, Rosalen PL, Franchin M, Massarioli AP, Denny C, Daiuto ÉR, et al. (2018) Exploration of avocado by-products as natural sources of bioactive compounds. PLoS ONE 13(2): e0192577. https://doi.org/10.1371/journal.pone.0192577

3. Takada Y1, Bhardwaj A, Potdar P, Aggarwal BB.. (2004). Nonsteroidal anti-inflammatory agents differ in their ability to suppress NF-kappaB activation, inhibition of expression of cyclooxygenase-2 and cyclin D1, and abrogation of tumor cell proliferation.. Oncogene. 23 (57), p9247-58.

4. Kim M, Kim H, Sohn C. Relationship between vitamin K status, bone mineral density, and hs-CRP in young Korean women. Nutr Res Pract. 2010;4(6):507–514. doi:10.4162/nrp.2010.4.6.507

5. Ebenezer PJ, Wilson CB, Wilson LD, Nair AR, J F. The Anti-Inflammatory Effects of Blueberries in an Animal Model of Post-Traumatic Stress Disorder (PTSD). PLoS One. 2016;11(9):e0160923. Published 2016 Sep 7. doi:10.1371/journal.pone.0160923

“5 Side Effects of Prostate Biopsy” sources continued:1. Rosario DJ, Lane JA, Metcalfe C, et al. Short

term outcomes of prostate biopsy in men

tested for cancer by prostate specific antigen: prospective evaluation within ProtecT study. BMJ. 2012;344:d7894. Published 2012 Jan 9. doi:10.1136/bmj.d7894

Keto recipes and images sourced from:1. https://www.ruled.me/

Documents

· incontinence and erectile dysfunctions. Though there are no drugs to prevent the development of prostate cancer, lifestyle changes such as diet and exercise can significantly