“THE IMPACT OF ALTERNATIVE MEDICINE IN

GHANAIAN MEN OF AFRICAN DESCENT DIAGNOSED

WITH PROSTATE CANCER”

SYNOPSIS

SUBMITTED TO THE

INDIAN BOARD OF ALTERNATIVE MEDICINES ACADEMY, KOLKATA, INDIA

FOR THE DEGREE

OF

DOCTOR OF PHILOSOPHY

IN

ALTERNATIVE MEDICINE

BY

RAPHAEL NYARKOTEY OBU

REGISTRATION NO: FFF/13/23

UNDER THE GUIDANCE OF

SHREETAMA KANJILAL

INDIAN BOARD OF ALTERNATIVE MEDICINES,

KOLKATA, INDIA

March, 2015

“THE IMPACT OF ALTERNATIVE MEDICINE IN GHANAIAN MEN OF AFRICAN

DESCENT DIAGNOSED WITH PROSTATE CANCER”

ABSTRACT

About 50% of all men by 50years will have prostate cancer cells at the dormant stage in their

prostate gland so the question now is why are there great geographical prostate cancer

variations? It is also believed men of Africa descent have high androgen level than white men

and is the fuel for prostate cancer. According to a publication by the Ghana news Agency, Ghana

has exceeded the global prostate limits as the country records 200 cases out of every 100,000

men as against 170 world-wide, a survey by the Korle -Bu Teaching Hospital revealed(GNA -

August, 07, 2007). This study aims to look at the impact of alternative medicine on Ghanaian

men of African descent diagnosed with prostate cancer. This research study is in two forms,

firstly an observational study will be used to assess Ghanaian men diagnosed with Prostate

cancer and the use of traditional medicinal plant call croton membranaceus to ascertain its anti

cancer efficacy. Croton membranaceus root extract marketed as URO 500 at Center For Plant

Medicine Research in Ghana (Mampong , Akuapem) 10mg per capsule will be given to about 30

patient diagnosed with Prostate Cancer at the experimental site , De Men’s Clinic & Prostate

Research Lab in Dodowa, Akoto House for an observational study to be conducted and cohort

for this important research will report after three month of treatment after which their PSA will

be assess again as the PSA is the best marker in terms of the diseases monitoring or progressing.

Secondly, an extensive research using online search engines to conduct a literature review,

summarizing the body of evidence on impact of alternative medicine and prostate cancer use in

men of African descent to date will be use for this important second phase of the study.

Results will be analyzed using the PSA at the stage at diagnosis and after treatment with the

croton membranous. The International Prostate Symptoms score (IPSS) and the international

Index of Erectile Function (IIEF) questionnaire will also be assessing before and after.

Abdominopelvic Scan using Sonoscape A6 with full bladder to enable acoustic widow to assess

prostate Volume before and after will also be access.

INTRODUCTION:

BACKGROUND

Do the prostate cancer disparities seen in Black men around the world follow the path of the

Transatlantic Slave Trade? (Odedina et al 2009). Although prostate cancer incidence and

mortality rates have been declining in both African American and White men since 1991,

possibly due to improved diagnostic techniques, better screening and improved surgical and

radiologic treatments, the rates remain comparably higher among African American men. Why

does this disparity continue to exist among African American men in spite of the significant

research to eliminate this disparity? ( Odedina et al 2009).

Thus the variability in risk and mortality across these populations of West African descent

suggests a potential and important influence of environmental/lifestyle factors acting on prostate

cancer risk in these already susceptible populations. Can this my PhD research work data hold

the key to my better understanding of the etiology of lopsided burden of this disease in men of

African descent such as Ghanaian men? There are more questions than answers at this time:

Does the similar genetic characteristic of Black men of West African ancestry put them at higher

risk for prostate cancer compared with other groups? Are there common environmental

conditions/lifestyle factors among these men that may be responsible for the prostate cancer

burden experienced by this group? What is the relative contribution of genetic, lifestyle and

environmental factors in prostate cancer incidence and mortality among this group? (Odedina et

al 2009).

In Ghana, It is also opined that men with numerous or promiscuous men get this dreaded cancer.

However numerous researches also prove the benefit of frequent sex and prostate health. So does

frequent sex causes prostate cancer in men of African descent as most of the research black men

are not involve and even if they are they are only made of a few percentage. Prostate cancer

comes with lots of disparities from screening and treatments. It is also know that black men have

about 60% chances of getting prostate cancer than white men and according to the Prostate

Cancer UK(Prostate Cancer UK 2014) 1 in 4 black men will get prostate cancer in their life time

which involve men of west African continent.

Men of African descent have been label as endangered species and black ancestry have been

implicated as an established risk factor for the high rates of prostate cancers in the black

communities. However race and genetic specific evidence is still missing. Also according to the

American cancer society genetic prostate cancer accounts for only 5-10% of prostate cancers so

the question now lies is the high rates of prostate cancers in the black communities linked to

genetic or lifestyle or what I call De Jure or De Facto judging from the fact that cancer cells lies

dormant in all of us. There are also great geographical variations in prostate cancer incidence

between western societies and eastern societies. If cancer is a disease that starts in our cells and

our bodies are made of up of trillions of cells, group together to form tissues or organs such as

muscles and bones, the lungs, or the liver and genes inside each cell order it to grow, work,

reproduce and die and normally our cells obey these orders and we remain healthy then is

lifestyle or De Facto the major factor. If sometimes a cell’s instructions get mixed up and behave

abnormally and after a while, groups of abnormal cells can circulate in the blood or immune

system, or they can form a lumps or tumor then the health of Ghanaian men of African descent

cells is crucial if they want to live a long, healthy and vibrant life.

Why? Because cells provide the power for everything these men do–from thinking to growing.

Simply put, these men cannot be healthy unless their cells are healthy. So I have been wondering

if Ghanaian men of African descent lifestyle or de facto influence or promote prostate cancers or

even put the prostate cancer cells in their dormant stage in the management of the disease? Yes

because the body is jus t like a computer and it does exactly you tell it to do and not often how

you want it to do and it’s adapt to changes this is what is call compensatory adaptation at work.

For instance in the northern region in Ghana it has been observe that crops in the region cannot

yield high without using chemicals because the soil is used to the chemicals the farmers use to

grow their crops. This is one reason why the Okinawa’s and Humzas and it pertains to men in the

Asian enclaves who live to 145years stay freely from chronic degenerating diseases like cancers

and live happily healthy lives partly because of their way of life and the most important lifestyle

factor is the dietary habit. Men of African descent have buy into the ideal of modern devitalized

cheap foods and the result is the modern day civilization disease like cancers. In Ghana prostate,

breast cancers and now sky rocketing kidney diseases are on the increased the result poor health

and early death. This cheap food results in low enzymes levels in Ghanaian men depriving the

cells of good cellular nutrition resulting in sky rocketing prostate diseases because the prostate is

a deep inside organ just like the breast and uterus in women. The prostate sits between two

organs of elimination, the urinary bladder and rectum so the more toxic your urine and feces the

more the prostate is vulnerable in absorbing the toxic and toxic build up is one of the reasons

there is high sky rocketing prostatic diseases in Ghana and black communities. Every single

process is controlled and regulated by an enzyme produced by the body specifically for that

process. According to medical dictionaries, “life “is the regulated interaction of all the processes

performed by enzymes in the body it follows that disease is the disruption of this harmonious

interaction between enzymes.

The body’s enzymes work together. If a single cell becomes active, a whole cascade of enzymes

is immediately prepared for action. The enzyme matrix is genetically differentiated. In other

words, Europeans have and need different enzymes than Asian. Statistics show that a person’s

life expectancy and quality of life is directly proportional to the efficiency of the body’s enzyme.

At birth and during breast feeding, every infant receives a large supply of enzymes for his or her

future life. The infant’s future vitality and health depends on this supply of enzymes being

properly maintained. This is guaranteed by unprocessed foods that ensure the supply of enzymes

components so low enzymes levels cause of today’s civilization or lifestyle diseases that have

being implicated that black men have 60% chances of getting prostate cancers than their white

counterparts. According to world wide studies, over 80 of the population suffer a lack of vital

nutrients or low enzyme levels.

As early as 1991, the “declaration of Santa fee”, leading nutritional scientist stated that poor

nutrition and the severe exposure of our food to pesticides, processing and conservations are the

main reasons for serious illnesses. Hence the reason for the low enzymes in Ghanaian men of

African descent would the early of fast foods stuffs, long storage periods and additional

processing in today’s food factories using methods such as irradiation , heating , sterilizations

and conservation have a massive and negative impact on essential enzymes and other vital

substances. Fast food crazes in Ghana for example has a nutritional value dangerously close to

zero and serves virtually no other purpose than to make individuals feel satiated. It has also been

revealed that black men have low level of Vitamin D level and the darker the skin the lower the

vitamin D level in black men

STATEMENT OF PROBLEM

Very often you find elderly male patients in Ghana above 40years complaining of a feeble urinay

stream, hesitancy, dribbling, having to urinate frequently and urgently, feeling that they can’t

empty their bladder completely and loss of libido. These observations are usually on the increase

whilst little or no effort is made to raise awareness for early detection and treatment (Obu 2014).

In Ghana and most African countries, prostate cancer is the most common cancer in males after

hepatocellular carcinoma. Whereas in the advanced countries, screening for prostate specific

antigen (PSA) has led to early detection and management of the disease, screening has been very

low in Ghana, thus leading to low detection rate, poor management and increased mortality(

Arthur et al 2006)

A survey conducted on the prevalence of the disease as reported at five major hospitals in the

country. It was observed that 83.6% of the subjects had their PSA levels above the upper limit of

the reference range (4 ng/ml), with their ages ranging between 56 to 85 years. Coincidentally, the

survey also revealed that 96.5% of those who had the disease within the period of study were

above 50 years (Arthur et al 2006). Most research in prostate cancer is based on how the disease

behaves in white men and not black men yet it is black men who are hit hard with this disease.

The quality of treatment men received and the health related quality of life of prostate cancer

patients will differ according to race and access to health care, even after accounting for patient

and disease characteristics, type of primary treatment and other factors (Obu 2014).

Not all men diagnosed with prostate cancer will need treatment and men needs different

treatments option in Ghana to make their inform decision on treatment options. Conventional

treatment only target the symptoms or kill both normal and healthy cells and about 30-45% of

men diagnosed with prostate cancer will have recurrence. There is the need for a holistic

treatment to target cancer dormancy to prevent recurrence. 76% of all men diagnosed with

prostate cancer will suffer either permanent or temporal erectile dysfunction and could go on to

about 95% after radical prostatectomy and the quality of treatment for prostate cancer men

received and survival rates also depends upon where men leave.

According to the men’s charity in Ghana, Men’s Health Foundation, 1 in 5 Ghanaian men will

get prostate cancer in their life time. The charity work out the Ghanaian men life time risk factor

and was published during the world cancer day , February 04, 2015 with their supporting

statistics, 95% of Ghanaian men are not aware of prostate cancer

Closed to 1000 men are diagnosed with prostate cancer yearly in Ghana

1 in 5 men will get prostate cancer in Ghana

7 out of 9 men diagnosed with prostate cancer will die in Ghana

3 of 4 men will get enlarged prostate

Unspecified number of Ghanaian men are living with and after prostate cancer in Ghana

almost 10 out of 10 adults (100) in Ghana don’t know what the prostate gland does

95% of Ghanaian men didn't know the Prostate sits underneath the bladder.

5% correctly thought it was the size of a golf ball.

95% of Ghanaian men don’t know that closed to 1000 men diagnosed with Prostate

Cancer yearly in Ghana and closed to 800 men died of the disease.

100% of Ghanaian men said that not enough is being done in Ghana about it to raise

awareness on the disease.

Not enough Ghanaian men know about their risk of prostate cancer.

98% are not even aware that being black is a key risk factor.

100% said it was time for Ghana to consider a specific policy on prostate cancer in Ghana

and men must screen for free under the National Health Insurance Scheme (NHIS)

Statistics areas we used: churches, corporate institutions and communities

Total of 100 Men answered the Men united V Prostate Cancer Questionnaire form

The screening involved ultrasound and PSA simultaneous

Highest PSA level =3756ng/ml

Age group=45-75years

12 referred Men who came after biopsy

5 confirmed with prostate cancer

99.99% of Ghanaian men were not happy with their sex life

The clergy and fire service had excellent prostate health at Dodowa

Highest Prostate Volume -=274g

Lowest prostate volume=8.75g

90% of Ghanaian men prefer herbal medicine because of media advertisement and bogus

treatment claims

5% had family history of the disease , Some also don’t know

90% also don’t know that the PSA test is not a test for prostate cancer but it is a test to

know your risk of prostate cancer simply it is a prostate cancer risk test and normal result

doesn’t mean that you are cancer free!

90% men also don’t receive the right treatment information regarding prostate cancer

treatment.

92% also don’t know that there is no evidence of using traditional herbal medicine to

cure prostate cancer and they are only move by media advertisement of false cancer cure!

90% also don’t know the benefits of using complementary medicine in the management

of prostate cancer and it right use

95% are not aware of the PSA test for prostate cancer screening

90% also don’t know the work of the prostate gland also thought that it is a taboo for a

man to have prostate because of the education they received.

Almost, 100% of Ghanaian men don’t know that not all men diagnosed with prostate

cancer will need treatment and also don’t know that watchful waiting and active

surveillance is part of the management process of prostate cancer

Almost 100% of women also thought that promiscuous men or womanizers get prostate

cancer

90% of men also thought that frequent sex, multiple sexual partners get this dreaded

disease

90% of Ghanaian men don’t know the difference between enlarged prostate, prostate

cancer and prostatitis!

98% of herbal practitioners in Ghana don’t have much knowledge in the disease and it

management and would also not refer patients to see urologist or prostate cancer medical

expert hence there is the need for collaboration between this practitioners and the

Traditional and alternative heath practice council must organized programs in cancer

management to members who want to specialize in the field.

98% of men also don’t know that the quality of treatment received, rate of survival and

support also depends upon where men live

Almost 100% of men also don’t know when using the natural approach for prostate

cancer management it may takes time and hence they must not expect immediate result

(Men’s Health Foundation Ghana, 2015)

The research proposal implies the impact of alternative medicine in Ghanaian men of African

descent diagnosed with prostate cancer. It is also estimated that by 2030, prostate cancer will be

the most commonly diagnosed cancer. In Ghana among males, the mean age at diagnosis for

cancers was 48.4 compared with 53.0 years for females and Prostate accounts for 13.2 %(Laryea

et al 2014). Another study that estimate the prostate cancer burden in West African men the

study authors performed a population based screening study with biopsy confirmation in Ghana.

They randomly selected 1,037 healthy men 50 to 74 years old from Accra, Ghana for prostate

cancer screening with prostate specific antigen testing and digital rectal examination. Men with a

positive screen result (positive digital rectal examination or prostate specific antigen greater than

2.5 ng/ml) underwent transrectal ultrasound guided biopsies.

In their results of the 1,037 men 154 (14.9%) had a positive digital rectal examination and 272

(26.2%) had prostate specific antigen greater than 2.5 ng/ml, including 166 with prostate specific

antigen greater than 4.0 ng/ml. A total of 352 men (33.9%) had a positive screen by prostate

specific antigen or digital rectal examination and 307 (87%) underwent biopsy. Of these men 73

were confirmed to have prostate cancer, yielding a 7.0% screen detected prostate cancer

prevalence (65 patients), including 5.8% with prostate specific antigen greater than 4.0 ng/ml.

the study authors concluded that in this relatively unscreened population in Africa the screen

detected prostate cancer prevalence is high, suggesting a possible role of genetics in prostate

cancer etiology and the disparity in prostate cancer risk between black and white American men.

According to the authors further studies are needed to confirm the high prostate cancer burden in

African men and the role of genetics in prostate cancer etiology.

The editorial of Today Newspaper, the Daily Democrat and the New statesman on 4 February

2015 called on the Ghanaian government to wake up on Prostate cancer. The same editorial on 1

September in the Today Newspaper also called for a prostate cancer policy for men in Ghana.

There is lot of conflict of interest exciting between traditional, alternative medicine practitioners

and conventional practitioners in Ghana in the management of prostate cancer (Obu 2014). There

is a long standing issues whether there is current evidence in using traditional or indigenous

herbal medicine to cure prostate cancer as most indigenous practitioners in Ghana make lot of

claims using the media to advertise their ability to cure prostate cancer using local herbs as there

is no pragmatic measures from the traditional medicine council to regulate the practitioners in the

field in the case of medical advertisement.

Some conventional practitioners called on the Ghanaian government to institute a policy to

punish herbal practitioners who advertise their treatment for prostate cancer because they

believed that these practitioners are rather amassing wealth and killing Ghanaian men. In the

chronicle paper Jan 21, 2015, according to the story, Dr. James Edward Mensah, head of the

Urology department at the Korle-Bu Teaching Hospital has called on government to institute

measures to prosecute practitioners in the herbal sector who claim they have treatment for

prostate cancer.

According to him, these self-acclaimed herbal doctors do not have scientific knowledge about

the disease; rather they are amassing wealth out of the ignorance of people who visit their

facilities for treatment. Dr. Mensah explained that these herbal doctors are just misinforming and

killing people in the country, as a result of their activities.

PURPOSE OF THE STUDY

In Scientific research the purpose of statement indicates ‘why you want to do the study and what

you intend to accomplish’ (Locke, Spirduso, and Silverman, 2000). According to this; the

purpose of this research study is to first explore the impact of alternative medicine in Ghanaian

men of African descent diagnosed with prostate cancer as most prostate cancers are slow

growing and men diagnosed with prostate cancer die of other cause and not from the disease.

It has also been revealed that prostate cancer can be very aggressive in black men who are on

active surveillance or watchful waiting as a form of prostate cancer management because of

tumor biology and therefore present with more complications before surgery(Ha et al 2013 ) so

this study intends to reveal whether Ghanaian men of African descent diagnosed with prostate

cancer can benefit from alternative medicine as a form of prostate cancer management if they for

go conventional treatments and also solve the long standing controversy in the health sector

between the conventional practitioners, traditional and alternative medical practitioners claim in

the media of finding cure for prostate cancer using the herb plant call croton membranaceus in

Ghana. It will also assess the anti cancer efficacy of croton membranaceus and prostate cancer.

This research will also prove whether Ghanaian men relying solely on alternative therapies alone

are gambling with their cancers. The research study will finally also show the benefits of

integrative approach in the management of prostate cancer in Ghana to reduce the prostate cancer

related mortality rates in the country.

HYPOTHESES OF THE STUDY

1. Impact of alternative medicine in Ghanaian men of African descent diagnosed with

prostate cancer.

2. The barrier face by Ghanaian men diagnosed with Prostate cancer who are considering

relying on alternative medicine in Ghana

3. Conventional doctors knowledge, perception and attitudes towards Ghanaian men

diagnosed with Prostate cancer

4. Conventional doctors relationship with alternative practitioners in the patients’ cancer

journey.

5. No conventional treatment is superior and about 30-45% of all conventional cancer

treatment recurred.

6. Conventional cancer treatment cannot target prostate cancer at its dormant stage whether

at the cellular level or tumor stage

7. There is significant benefits in using the Integrative approach in the management of

Ghanaian men prostate cancer patients diagnosed with Prostate cancer as integrative

approach can put the cancer at its dormant stage and prevent recurrence

8. Relying on Traditional or folk medicine and neglecting conventional treatment could also

be a calculated gamble for Ghanaian men diagnosed with prostate cancer.

9. Treating Prostate Cancer starts from the cellular or tumor dormant level and conventional

therapies have a long way to go to find cure for prostate cancer.

10. Low enzymes level breed prostate diseases in Ghanaian men

RESEARCH METHODOLOGY

1. Croton membranaceus root extract marketed as URO 500 at Center For Plant Medicine

Research in Ghana (Mampong , Akuapem) 10mg per capsule will be given to patient

diagnosed with Prostate Cancer at the experimental site , De Men’s Clinic & Prostate

Research Lab in Dodowa, Akoto House for an observational study to be conducted

2. Prostate cancer patients will be made to sign a form and this will form the cohort to take

part in the study and will be under medical supervision. The stage of diagnosis and age

will be reported. Patients will also be made to report any adverse effects and report them

using a help line to be provided. Any Conventional treatment in case the patient has

started will also be presented for this important research. Patients will be sought from

various hospitals in Ghana for this important research.

The Four main research instruments for this observational study will include:

3. The International Prostate Symptoms Score(IPSS)

4. The international Index of Erectile Function (IIEF) questionnaire

5. Blood sample for PSA and special biochemical tests before and after

6. Abdominopelvic Scan using Sonoscape A6 and patients will have a full bladder to enable

acoustic widow to assess prostate Volume before and after.

The cohort for this research will report after three month of treatment

7. Case study for this research will involved Ghanaian men diagnosed with organ confined

prostate cancer who started hormone treatment that were supported with complementary

therapies at the De Men’s Clinic & Prostate Research Lab in Dodowa, Akoto House

8. Finally, extensive research using online search engines to conduct a literature review,

summarizing the body of evidence on impact of alternative medicine and prostate cancer. The

aim is to merely examine the available proof in an effort to better understand the impact

alternative medicine used and prostate cancer among men of African descent. A systematic

search of the computerized database, MEDLINE, will be conducted for each alternative

treatments type from the originating date of MEDLINE to date using the following keywords:

alternative medicine, prostate cancer, race, prostate cancer incidence; and the inclusion criteria

will be:

Original studies and review articles;

Publication in English;

Relevance to prostate cancer impact, incidence, prevalence or mortality; and

Sufficient quality and quantity of evidence based on study design and validity on

men of African descent with good evidence to support study conclusion.

11. Limitations of the study

The study is restricted with limited sample and variables straightly to Ghanaian men of West

African descent as black men are more prone to and there is research also on tumor biology as

black also have more aggressive to prostate cancer than their white counterparts.

The Attitude Scale doesn’t include all the dimensions as the quality of treatment and rate of

survival also depends upon where men live

The Barriers Inventory doesn’t include all the barriers as most Traditional practitioners in Ghana

lacks the scientific knowledge in the management of the disease and about 70-8% of Ghanaians

depends upon Traditional herbal medicines.

FINDINGS OF THE STUDY

1. Alternative medicine has great impact on Ghanaian men diagnosed with Prostate

Cancer as most prostate cancers are slow growing

2. Relying slowing on Traditional Medicine and forsaking Conventional Treatment can

be a calculated gamble to Ghanaian men diagnosed with prostate cancer and the

cancer can latter be very aggressive.

3. Integrative approach in Prostate Cancer Management in Ghana is the best way to

tackle prostate cancer in Ghana to prevent the high mortality rates in the county

4. Conflict of interest in the Ghana Health Sector between the Traditional and allopathic

practitioners show be solve in transforming the future of prostate cancer in Ghana to

support patient quality of life and rate of survival.

5. Most of the Conventional practitioners have little or no knowledge in the alternative

approach use in the management of prostate cancer in Ghana.

6. There must regulations in advertisement in medical treatment information by the

Traditional and Alternative Practice Council to regulate practitioner’s advertising

their treatment in Ghana.

7. Conventional Practitioners have bad attitude towards patients who claim to use some

of alternative medicine for prostate cancer in Ghana.

8. More studies on Croton membranacues is needed to ascertain it anticancer properties

and also combining it with other plants to have it synergistic effects.

9. Alternative Practitioners should not promise patients cure for prostate cancer as good

physician do not promise cure.

10. The Traditional and Alternative Practice Council in Ghana should organize workshop

and educational programs in prostate cancer management in both conventional and

alternative to its practitioners to know the scientific knowledge in the disease.

11. Future Prostate cancer centers in Ghana should target the integrative approach to the

management of the disease as patients have more confidence in that approach.

12. De Facto or lifestyle has great impact on Prostate Cancer cells to become abnormal

13. De Facto or lifestyle has the tendency to prevent prostate cancer recurrence after

treatment.

14. The high rates of prostate cancer incidence in men of Africa descent can be reduce if

men of Africa descent become more proactive about their health, early screening and

practice good dietary habits.

15. The enzyme matrix is genetically differentiated by race?

16. Person’s s life expectancy and quality of life is directly proportional to the efficiency

of the body’s enzyme system and we see this in Asians because of their diets.

17. Safe sex is good for prostate health as toxic get out of the prostate which is good for

prostate health and a form of exercise for the prostate.

18. Too much of sitting position also not good for the prostate as it puts pressure on the

prostate.

19. we all have cancer cells in our bodies

20. About 50% of all men by 50years will have prostate cancer cells at the dormant stage

in their prostate gland so the question now is why are there great geographical

prostate cancer variations?

21. The recipe for good health lies in our food and water

22. Testosterone is not the cause of prostate cancer in men of African descent but rather

the accumulation of synthetic estrogen the body accumulate as men ages from the

food and plastic containers

23. The enzyme 5 alpha reductase inhibitor that converts testosterone into the potent form

Dihydrotestosterone DHT ground prostate disease.

24. Hormone therapy does not cure prostate cancer

FORMAT

I intend to structure my thesis as a series of chapters modified from journal articles that have

or will result from this thesis.

ABSTRACT

INTRODUCTION

REVIEW OF LITERATURE

CHAPTER 1: Aetiology and Physiology of the Prostate Gland

Chapter 1will be based on a literature review and I will aim to explain the aetiology and

Physiology of the Prostate Gland

CHAPTER 2: Role of Endocrinal Regulatory of Prostate Gland.

Here, I will discuss the role of endocrinal regulatory of prostate gland

CHAPTER 3: Aetiology of Prostatic cancer

In this chapter I will focus on causes and established risk factors of prostate cancer in men of

African descent as they are more prone to prostate cancer. This chapter will also discuss whether

men of African descent cancer risk are as a result of De Facto or De Jure. It will also looks at the

influence of low enzyme levels in men of African descent as a possible cancer cause. It will look

at whether androgen level plays a significant factor in prostate cancer in black men.

CHAPTER 4: Topographical Impact of Prostatic Cancer

This chapter includes a summation of the topographical impact of prostate cancer and also

discuses why prostate cancer is not universal occurrence as there is great geographical variation

in prostate cancer in western men and eastern men. It will also focus on the men in Okinawa and

Humzas communities and how they stay off prostate cancer and why aging is not a, major

problem in prostate cancer as the centenarian are able to stay free of prostate cancer. It will also

look at the disease on the Africa continent in general and lifestyle factors that contribute to

Ghanaian men chances of getting prostate cancer in Africa.

CHAPTER 5: Pathology of Prostate cancer

I will present the modern special pathology of prostate cancer.

CHAPTER 6: Clinical Features of Prostate Cancer

Here I will discuss my overall findings and understanding of clinical features before and after

diagnosis in Africa as even in areas where screening is available, many prostate cancers are

diagnosed after the symptoms begin. However, the risk posed by particular symptoms is largely

unknown, especially in unselected populations such as primary care.

CHAPTER 7: Diagnosis of Prostatic cancer in Africa in Holistic Concept

In this chapter it will reveal prostate cancer diagnosis, screening in African men and also agues

for separate screening programs for men of African descent. It will show how the cancer is stage

CHAPTER 8 Isolation of Alternative Therapies to treat prostate cancer

This chapter will concentrate on management of prostate cancer by alternative therapies and will

isolate each evidence based alternative approach to treat prostate cancer

CHAPTER 9 Justification of Treatment by Alternative Therapies

This chapter will present evidence based research that support using alternative remedies to treat

prostate cancer. It will also involve using the integrative approach to manage prostate cancer and

some notable organization that have supported the use of alternative therapies to manage prostate

cancer.

CHAPTER 10 Indication of Selection of Alternative Therapies to treat prostate cancer

In this I will focus on patients selection in choosing alternative treatment for prostate cancer as

also relying on these therapies alone and forsaking conventional treatment could be a calculated

gamble for the patient and various side effects from alternative therapies for prostate cancer

management.

CHAPTER 11 Modus Operandi of Alternative Therapies

This chapter will focus on each evidence based alternative therapies for prostate cancer and how

they work to manage men diagnosed with prostate cancer and the cost involved.

CHAPTER 12 Prostate Cancer Prognoses

This chapter will focus on prostate cancer life expectancy rate as it also not universe because the

quality of treatment men received also depends upon where men life as Ghanaian men belongs to

men of African descent and leaving in West Africa with lack of health care access and mostly

relying on Traditional remedies Taking that into consideration, the relative survival rates for

most kinds of prostate cancer are actually pretty good in advance countries but most not counting

men with prostate cancer who die of other causes: 99% of men with the most common types of

prostate cancer overall will survive more than five years after diagnosis that are not evidence

based. In Ghana most of the cancers are diagnosed at the late stage that makes survival rates to

be much lower in Ghana.

CHAPTER 13 Role of Holistic medicines for treatment of Prostate Cancer

In this chapter I will focus on how the integrative program benefits men diagnosed with prostate

cancer. Dietary changes and lifestyle modifications for Ghanaian men that can prevent prostate

cancer recurrence and especially how some Ghanaian dietary habits can help prevent or allow the

cancer to recur.

CHAPTER 14. Why This Topic-“Impact of Alternative Medicine in Ghanaian Men of African

descent diagnosed with Prostate cancer”.

In my years of experience in medical ultrasound diagnosing men with prostate diseases in the

Herbal Hospitals in Ghana and who work previously with a medical doctor who specialized in

using Traditional medicine to solve Ghanaian men Prostate issues I then developed the interest in

prostate issues and after my masters program in Prostate Cancer –Sheffield Hallam University,

UK when I was therefore introduced to the real world of prostate cancer controversies and

realizing conventional therapies have a long way in finding cure for prostate cancer and the

treatment only suppress symptoms I therefore chose this topic to look at the alternative remedies

and impact of Ghanaian men diagnosed with Prostate cancer. In Ghana some herbal

practitioners also makes lots of claims of finding cure for prostate cancer using traditional

medicine and displaying lots of awards on their bill boards that I try to find their work in any

scientific journey that I was unable to find which means their claims are only speculative in the

media in Ghana. This chapter will focus on why this topic is relevant to solve the controversy in

using alternative therapy to treat prostate cancer to give the conventional practitioners the

overview in management of the disease using the alternative means and also solve the long

standing issues in Ghana on whether there is evidence in using traditional medicine to treat

prostate cancer as conventional practitioners in Ghana believe that Traditional or Herbal

Practitioners lack the scientific knowledge in the management of the disease. Finally to see if

Ghanaian men of African descent that rely on traditional or alternative medicine are gambling

with their prostate cancer or not.

CHAPTER 15 Three Cases Treated in Ghana at the De Men’s Clinic & Prostate Research Lab in

Dodowa, Akoto House.

I will discuss the benefit of my prostate cancer program using the integrative approach to treat

patients successfully and its impact on prostate cancer dormancy

MATERIALS AND METHODS

RESULTS

DISCUSSION

REFERENCES

APPENDICE

References

1. FKN Arthur, FA Yeboah, M Adu-Frimpong, EE Sedudzi, KA Boateng(2006) Prostate

cancer screening in Ghana - a clinical benefit? Journal of Science and Technology

(Ghana)

2. “1 in 5 Ghanaian Men Will Get Prostate Cancer In Their

...https://233livenews.wordpress.com/.../1-in-5-ghanaian-men-will-get-pros...

Last accessed dated Feb 4, 2015

3. Dennis O Laryea, Baffour Awuah, Yaw A Amoako, E Osei-Bonsu, Joslin Dogbe, Rita

Larsen-Reindorf, Daniel Ansong, Kwasi Yeboah-Awudzi, Joseph K Oppong, Thomas O

Konney, Kwame O Boadu, Samuel B Nguah, Nicholas A Titiloye, Nicholas O Frimpong,

Fred K Awittor and Iman K Martin(2014) Cancer incidence in Ghana, 2012: evidence

from a population-based cancer registry. BMC Cancer 2014, 14:362 doi:10.1186/1471-

2407-14-362

4. Hsing AW, Yeboah E, Biritwum R, Tettey Y, De Marzo AM, Adjei A, Netto GJ, Yu K4,

Li Y, Chokkalingam AP, Chu LW, Chia D, Partin A, Thompson IM, Quraishi SM, Niwa

S, Tarone R, Hoover RN(2014) High prevalence of screen detected prostate cancer in

West Africans: implications for racial disparity of prostate cancer. J Urol. 2014

Sep;192(3):730-5. doi: 10.1016/j.juro.2014.04.017. Epub 2014 Apr 18.

5. World Cancer Awareness Day: Why Ghana must wake up ...

www.todaygh.com › Editor's Choice last accessed Feb 4, 2015 –

6. The Need for Prostate cancer policy for men .www.todaygh.com › Editor's Choice

Last accessed Sep 1, 2014

7. Prosecute Herbal Doctors Who Advertise Prostate Cancer ...

Last accessed the chronicle.com.gh › News January 21, 2015

8. Dr. Karl-Heinz Blank, Ekkehard Arnd Wittich Scheller, Johannes Aaron Seidler,

Dr.med.vet. Lothar Knopf .Dr. Axel Kohler handbook on Diagnosis: “Healthy at Last!”

Spectacular healing success with cascade-fermented enzymes. April 2012

9. Canadian Cancer Society handbook on Radiation Therapy, A guide For People with

Cancer

10. Folakemi T Odedina, Titilola O Akinremi, Frank Chinegwundoh, Robin Roberts, Daohai

Yu, R Renee Reams, Matthew L Freedman, Brian Rivers, B Lee Green and Nagi

Kumar(2009) Prostate cancer disparities in Black men of African descent: a comparative

literature review of prostate cancer burden among Black men in the United States,

Caribbean, United Kingdom, and West Africa. Infectious Agents and Cancer 2009,

4(Suppl 1):S2 doi:10.1186/1750-9378-4-S1-S2

11. 1 in 4 stat explained Prostate Cancer UK

Last accessed prostatecanceruk.org/about-us/how...make.../black.../1-in-4-stat- explained...

12. Yun-Sok Ha, Amirali Salmasi, Michael Karellas, Eric A. Singer, Jeong Hyun

Kim, Misop Han, Alan W. Partin, Wun-Jae Kim, Dong Hyeon Lee, and Isaac Yi Kim(2013)

Increased Incidence of Pathologically Nonorgan Confined Prostate Cancer in African-

American Men Eligible for Active Surveillance. Urology. 2013 Apr; 81(4): 831–835.

13. Locke, L., Spirduso, W. W., & Silverman, S. (2000). Research proposals that work. 4th

Edition. New York: Sage Publishing Co., issued August 1999. 3rd Edition, 1993; 2nd

Edition, 1987; 1st Edition, 1976 New York: Teachers College Press

14. Ghana exceeds global prostate cancer records | Health ...

www.ghanaweb.com/GhanaHomePage/NewsArchive/artikel.php?ID... Last accessed Aug

7, 2007

15. Obu Raphael (2014). An evaluation of the factors that might influence the prostate cancer

mortality rate and QOL of Ghanaian men; including the impact of a healthy relationship

and cultural issues. Global Research Journal Of Health and Epidemiology: ISSN-2360-

7920, Vol.1(2)pp012-017

16. Deborah Mitchell(2012)Black men and prostate cancer last accessed

www.prostate.net/2012/.../why-black-men-higher-risk-prostate-cancer/