About one in every nine men will be diagnosed with prostate cancer during his lifetime. The risk for developing prostate cancer is greatest for men over the age of 65, especially those who African-American. In the Unites States, second to skin cancer, prostate cancer is the most common cancer diagnosed in men. It’s estimated that about 164,690 new cases of prostate cancer are detected each year, and about 29,430 deaths annually are caused by prostate cancer. (1) This makes it all the more important to pay attention to any prostate cancer symptoms you may notice.
According to the Prostate Cancer Foundation, “age is the biggest — but not the only — risk factor for developing prostate cancer.” (2) Other important lifestyle and genetic factors that can increase your risk include family history of cancer, smoking, race, obesity and lifestyle habits, such as the quality of your diet.
What can a man do to look after his prostate health? Every man over the age of 50 is encouraged to routinely visit his doctor for early screening prostate exams given how important it is to find and treat prostate cancer in its earliest stages. When cancer is detected, there are many complementary/alternative treatments available that can be used along with, or sometimes instead of, standard cancer treatments like chemo, radiation, surgery or immunotherapy. These include natural approaches like dietary modifications, exercise, yoga, acupuncture, stress management and herbal treatments.
What are the signs of prostate cancer and most common prostate cancer symptoms, and what can you do to help prevent and/or treat this common disease? Read on to learn more about prostate cancer symptoms and more.
What Is Prostate Cancer?
Prostate cancer, one of the most common types of cancer in men, is cancer that occurs in the prostate. Only men can develop prostate cancer, since women do not have a prostate. The prostate gland is a small, walnut-shaped gland in men that produces the seminal fluid. (3) Seminal fluid mixes with sperm from the testes and helps transport sperm, making ejaculation and conception possible. Here’s a bit more about the anatomy of the prostate and how it affects other organs and nerves:
- The prostate is about the size of a golf ball and located deep inside the groin, between the base of the penis and the rectum.
- The prostate is divided into several anatomic regions. The peripheral zone is the the back of the prostate, which can be felt during a physical exam/screening test. This is where most cases of prostate cancer start, potentially before spreading elsewhere.
- Above the prostate are the seminal vesicles, which store and secrete ejaculate.
- Along the side the prostate runs a group of nerves and blood vessels (a neurovascular bundle) that controls erectile function.
- The urethra, a narrow tube that connects to the bladder, runs through the middle of the prostate. The urethra carries urine and semen out of the body and is needed to empty the bladder.
- The rectum, which is located behind the prostate, is the lower end of your intestines. It connects to the anus and is involved in bowel movements.
- Prostate growth occurs during adolescence and is controlled by the male hormone testosterone and its byproduct dihydrotestosterone (DHT).
Prostate cancer is said to sometimes be a”silent” disease because in the earlier stages, sometimes which lasts for years, the tumor in the prostate gland is not big enough to cause any pain or prostate cancer symptoms. (4) Not every person who is diagnosed with this condition will experience any warning signs or noticeable prostate cancer symptoms to alert them to a problem. This is exactly why experts feel that prostate cancer screening is so important and life-saving.
Prostate Cancer Symptoms
When someone does develop prostate cancer symptoms, what are the early warning signs of prostate cancer? The most common prostate cancer symptoms in men include: (5)
- Difficulty urinating normally. This can include feeling a burning or painful sensation, having trouble starting and maintaining a steady stream of urine, weak urinary stream, experiencing dribbling or leaking of urine, more frequent need/urge to urinate, excessive urination at night, or urinary retention (not being able to urinate).
- Sexual problems, including erectile dysfunction (difficulty having or keeping an erection), painful ejaculation or a decrease in the amount of fluid ejaculated.
- Blood in the urine (hematuria) or semen.
- Pressure or pain in the groin and rectum.
- Pain or stiffness in the lower back, hips, pelvis or thighs. Prostate cancer can cause pelvic pain and back pain because the enlarged/inflamed prostate or a tumor may press against nerves.
Prostate Cancer Causes and Risk Factors
Like other types of cancer, prostate cancer is believed to be caused by a combination of factors, including those that are genetic and lifestyle-related. Prostate cancer develops when cells in the prostate mutate and divide, caused by abnormal changes in the cells’ DNA. As the cells start to grow and divide more rapidly than normal cells, healthy cells die off and abnormal cells form a tumor. The tumor will sometimes stay within the prostate gland but other times will spread and invade nearby tissue or metastasize to other parts of the body.
Researchers now know that risk factors for developing prostate cancer include: (6)
- Being over the age of 65. The average age at diagnosis of prostate cancer in the United States is 69 years old. As a man gets older, his chance of developing prostate cancer increases.
- Family history of cancer, especially prostate cancer. Men who have/had a close relative with prostate cancer are twice as likely to develop the disease compared to those who don’t. If the affected family members was diagnosed before the age of 65, the risk is even higher. A family history of other cancers, such as breast cancer, ovarian cancer, colon cancer or pancreatic cancer, also increase a man’s risk for developing prostate cancer.
- Genetic factors. Certain genes have been identified that can increase the risk of prostate cancer.
- Being African-American. Men of African descent are an estimated 73 percent more likely to develop prostate cancer compared with white men. It is still not known exactly why this is but has to do with family history and genes. Asian men who live in Asia have the lowest risk, but their risk increases if they adopt a “modern Western lifestyle.”
- Obesity or being overweight. Certain studies have found that obese men have a greater risk for developing aggressive prostate cancers (but not slow-developing types), a more difficult time recovering from surgery and have a greater risk of dying from prostate cancer.
- Smoking, tobacco use and drug use.
- Poor dietary habits, especially eating a highly processed diet that includes refined/trans fats, lots of added sugar and processed carbohydrates. There also seems to be an association between a lack of vegetables in the diet (especially cruciferous veggies, like cauliflower and broccoli) and a higher risk of aggressive prostate cancer.
- Lack of exercise and a sedentary lifestyle.
- Low vitamin D levels. Due to little sunlight exposure, men who live north of 40 degrees latitude (north of Philadelphia or Utah in the U.S.) have the highest risk for dying from prostate cancer of any men in the United States.
- Excessive calcium intake, particularly from supplements.
- Exposure to certain toxic chemicals, including “agent orange,” herbicides and defoliant chemical that has a history of use among the U.S. military, especially during the Vietnam War.
- Possibly a history of inflammation of the prostate (prostatitis), although more studies are needed to confirm the connection between prostate enlargement, non-cancerous tumors in the prostate gland and the risk for prostate cancer.
- Tall height. It’s not exactly clear why, but bigger men (especially those who are tall and obese) develop prostate cancer more commonly.
The Prostate Cancer Foundation points out that there are many “myths” about other factors that some people claim can contribute to prostate cancer, but these have not been proven. Factors so far that have not been found to be connected to prostate cancer include high levels of sexual activity, frequent ejaculation, having a vasectomy, taking aspirin, use of statin drugs to lower cholesterol and consumption of alcohol.
Prostate Cancer Diagnosis and Staging
When doctors determine how much a man’s prostate cancer has spread — and, if so, how far and to what parts of the body — they are referring to”prostate cancer staging” (sometimes also called the level or grade of cancer). Determining a patient’s cancer stage is important for coming up with the best treatment plan possible.
Experts now believe that different stages of prostate cancer should basically be treated like different diseases, since there’s evidence that aggressive and fatal cancers have different underlying causes than slow-growing tumors.
Screening is crucial for prostate cancer because there’s a much greater chance of recovery and survival if the disease is managed effectively in its earliest stages. How do you detect prostate cancer early? Routine screenings for prostate cancer typically include digital rectal exams (DRE) and prostate specific androgen (PSA) tests. There is not total agreement in the medical community about when men should start being screened, but most medical organizations recommend men visit their doctors for prostate cancer screening in their 50s or sooner if they are at a higher risk.
Doctors use a wide range of tests to make a prostate cancer diagnosis, which can include blood tests, biopsy of tissue from the prostate, bone scan, CT scan, MRI and ultrasound.
Prostate Cancer Stages (Grades/Levels):
- Slow-growing prostate cancer is the type that’s confined to the prostate gland. This is easier to treat then aggressive prostate cancer, which can spread quickly.
- Where does prostate cancer spread to first?
- What are symptoms of prostate cancer that has spread to other parts of the body?
The most widely used system for classifying prostate cancer stages is the American Joint Committee on Cancer’s (AJCC) TNM system. (7) T stands for tumor category, N stands for nodes that are affected and M stands for metastasized (whether cancer has spread to other parts of the body). Another is the Gleason scoring scale, a system that is used to determine a patient’s prostate cancer stage on a scale from 2 (nonaggressive cancer) to 10 (very aggressive cancer). (8)
- According to the American Cancer Society, the main stages of prostate cancer according to the TNM scale range from I (1) through IV (4). Some stages are split further (A, B, etc).
- The lower the number, the less the cancer has spread. Stage IV means cancer has spread considerably.
- Within a stage, an earlier letter means a lower stage.
- For example, the stage “cT1, N0, M0” means a tumor cannot be felt or seen on ultrasound, the cancer has not spread to nearby lymph nodes [N0] and the cancer is not anywhere else in the body [M0]. The stage “Any T, any N, M1” means the cancer might be growing into tissues near the prostate [any T], it may have spread to nearby lymph nodes [any N] and it may be in the bones or other organs [M1].
What is survival rate of stage 4 prostate cancer? Survival rates for prostate cancer depend on a number factors, including the patient’s access to health care, insurance, prostate cancer screening, appropriate treatment and follow-up once a diagnosis has been made, history of other medical conditions that can hinder recovery, and socioeconomic factors.
Conventional Treatment for Prostate Cancer and Prostate Cancer Symptoms
Following prostate cancer diagnosis, treatments for prostate cancer and prostate cancer symptoms can include a combination of the following:
- “Active surveillance” (no treatment right away) for men with low-risk, slow-growing prostate cancer. Progression of the cancer is monitored, but sometimes treatment is not needed.
- Hormone therapy to reduce production of testosterone. Research has shown that prostate cancer seems to to be fueled by the hormones testosterone and DHT (dihydrotestosterone), which is why treatment in early stages sometimes involves lowering these hormones. Luteinizing hormone-releasing hormone (LH-RH) agonists prevent the testicles from making testosterone. Hormonal drugs can include those called leuprolide (Lupron, Eligard), goserelin (Zoladex), triptorelin (Trelstar) and histrelin (Vantas), ketoconazole and abiraterone (Zytiga). Other drugs that can stop testosterone from feeding cancer cells include (Casodex), nilutamide (Nilandron) and Xtandi.
- Radiation therapy to target and kill cancer cells. This is usually involves undergoing treatments about five days a week for several weeks.
- Chemotherapy, which can be administered through a vein in your arm, or taken in pill form to target and kill cancer cells. Chemo is usually recommended after hormone therapy doesn’t work or if the cancer has spread to other parts of the body.
- Cryosurgery or cryoablation to freeze and destroy cancer cells.
- Biological therapy (immunotherapy), which uses your body’s immune system to fight cancer cells. One example is a therapy called sipuleucel-T (Provenge), which is recommended for advanced, recurrent prostate cancer.
- If you’re at an increased risk for prostate cancer, your doctor might recommend you take medications called 5-alpha reductase inhibitors, including finasteride (Propecia, Proscar) and dutasteride (Avodart) that can control prostate gland enlargement. Use of medications called finasteride and dutasteride, which lower DHT levels and are often used to treat men with the noncancerous condition BPH. Studies have found that these drugs may reduce the chances that a man will be diagnosed with prostate cancer. The Prostate Cancer Prevention Trial, a very large study that involved more than 18,000 men followed for over a decade, found evidence that finasteride may reduce prostate cancer risk by about 25 percent. (9)
- Surgery to remove the prostate gland (called a radical prostatectomy), surrounding tissue and lymph nodes if needed. What happens when you have your prostate removed? There’s a chance this will cause problems with urination and sexual function. This is why surgery is usually not the first treatment approach that is recommended.
- Dietary and lifestyle changes to support recovery and prevent cancer from returning.
- “Integrative therapy,” a holistic treatment approach that combines standard medical care with Complementary and Alternative (CAM) medicine practices, is now becoming more popular in the treatment of cancer. This approach can involve mind-body exercises like meditation, exercise, physical therapy, etc., to help cope with stress and support the immune system.
4 Natural Ways to Help Ease Prostate Cancer Symptoms Treatment
1. Cope with Stress
Dealing with prostate cancer symptoms and undergoing treatment can be very stressful, reducing quality of life and increasing anxiety and/or depression.
Some of the ways you can cope with stress include mind-body practices, such as yoga, dance or movement; other types of exercise; acupuncture; breathing exercises; and mediation. Other relaxing hobbies and practices include prayer/spirituality, art therapy, music therapy, spending time in nature, journaling, reading and biofeedback training.
2. Take Care of Yourself
In general, try to take care of yourself by getting enough sleep, rest throughout the day, social connection, sunlight, movement and healthy foods. Aim to eat a nutrient-dense diet that helps stabilize your mood and gives you energy. Include a variety of fruits and vegetables, clean protein sources, probiotics, high-fiber foods and healthy fats.
Try to exercise most days of the week if you have the energy, but also be gentle with yourself and consider napping and getting extra sleep if needed. Exercise is beneficial for boosting blood flow and fighting depression, which may help reduce some symptoms of erectile dysfunction.
3. Educate Yourself About the Disease
Learning about your disease, potential prostate cancer symptoms you might experience and the latest treatment options can help you feel more in control. You can read plenty about the newest treatment approaches online or ask your doctor or nurse to explain them to you. There are also many online support groups, forums and books available that can offer insights and support.
Connecting with other cancer patients and survivors will make you feel less alone and is a great way to learn about what has worked for other people in your same situation. You might look to the American Cancer Society’s website, which offers online chat rooms and discussion forums. Feeling like your disease is a less of a mystery and hearing from others who have survived should help ease some of your worry and distress.
4. Lean on Your Spouse, Family, Friends and Community for Support
You might not feel like talking about your disease with others, but being open with a therapist, your family and friends will reduce feelings of isolation. Don’t be afraid to ask for help if you’re overwhelmed, fatigued and unable to keep up with everyday tasks. For example, your spouse or a friend can help you stay on track and organized in terms of cooking, cleaning and taking care of family obligations if appointments are taking up lots of time.
Many men going through prostate cancer struggle sexually, such as with erectile dysfunction. Experts recommend communicating to your spouse/partner about how you’re feeling so he or she understands. Even if you’re not able to intimate for some time, massaging, touching, holding, hugging and caressing are ways to stay connected.
Talking with a professional, a therapist or counselor about your worries is also a good idea. It’s understandable to feel angry, anxious and many other difficult feelings, but having someone to speak with about your grief can ease your mind and increase hope.
6 Tips for Preventive Care
1. Eat a Healthy Diet and Manage Your Weight
Many studies have evidence that lifestyle changes, especially diet modifications, can decrease the chances that you’ll develop prostate cancer, reduce cancer recurrence and help slow the progression of cancer. A healthy, unprocessed diet is also important for preventing obesity, a known risk factor for prostate cancer.
- Get an idea for how many calories you need to maintain your weight. Try not to exceed this amount, perhaps by keeping a food journal temporarily.
- Limit your consumption of processed meats, factory-farm meats and conventional dairy products (opt for organic, unsweetened dairy instead).
- Avoid all trans fatty acids (found in many fried foods, fast food, highly processed foods and margarine).
- For the most protection, eat about 2.5 cups or more of veggies every day as part of an anti-inflammatory diet. Try to include a variety of veggies in your diet, especially leafy greens and cruciferous vegetables (like broccoli, cabbage, kale, Brussels sprouts and cauliflower), which have recently been connected to cancer prevention. (11)
- Eat wild-caught fish, which provide omega-3 fatty acids.
- Include a variety of high-antioxidant foods in your diet, including all types of leafy greens, orange and yellow veggies and fruits, berries, citrus fruits, carrots, avocado, sweet potatoes, tomatoes, asparagus, bell peppers, mushrooms, sea veggies, herbs and spices, olive oil, green tea, cocoa, spirulina, and others.
- Eat foods high in zinc and selenium, which support prostate health. These include grass-fed beef, lamb, liver and organ meats, sardines, turkey, Brazil nuts, pumpkin seeds, dark chocolate, sesame seeds, wheat germ, chickpeas.
2. Get Enough Exercise
Studies suggest that people who are more physically active have better protection against developing many types of cancer, as well as overall improvements in health and better protection against obesity. Getting daily exercise has numerous benefits, both for your mind and body. Exercise helps reduce inflammation, improve circulation, support the immune system and can help you control your weight. It can also improve feelings of well-being and reduce stress, depression or anxiety.
A review conducted at Stanford University, which looked at 27 studies conducted between 1976 and 2002, found that 16 out of 27 studies found that exercise significantly reduces a man’s risk for developing prostate cancer. The average risk reduction ranged from 10 percent to 30 percent. (12) The researchers stated, “The ability of exercise to modulate hormone levels, prevent obesity, enhance immune function and reduce oxidative stress have all been postulated as mechanisms that may underlie the protective effect of exercise.”
3. Treat Other Health Conditions and Check Your Medications
Many of the same lifestyle habits that lead to conditions like high blood pressure, diabetes, high cholesterol, heart disease and depression can also increase your cancer risk. These are also associated with worsened sexual function, including contributing to erectile dysfunction. Work on overcoming health challenges through diet and lifestyle changes as much as possible, then consider speaking with your doctor about other treatments or medications that can also help. Recovery from serious diseases, including cancer, is easier if your metabolically healthy and not battling other health problems.
If you’re taking any medications, it’s a good idea to speak to your doctor about how they may contribute to negative side effects. For example, some medications, such as SSRIs (used to treat depression), beta-blockers (used for high blood pressure), and medications used for insomnia and anxiety, can affect your prostate. These may have a negative impact on sexual dysfunction because they can cause decreased libido, impairment in arousal, erectile dysfunction, delayed ejaculation, and delayed or absent orgasm. (13)
4. Do Not Supplement with Calcium
Taking high doses of calcium may increase your risk, so talk to your doctor about whether calcium supplements are really needed. It’s advised that you avoid taking more than 1,500 milligrams of calcium from supplements per day, although calcium from food sources (like leafy greens and fermented dairy) are unlikely to be a problem.
5. Don’t Smoke
If you currently smoke, get help with quitting. For help quitting smoking, talk to your doctor about useful interventions, speak with a therapist or start an online program that specializes in smoking cessation, such as ones recommended by the Centers for Disease Control and Prevention. (14) Drink alcohol only in moderation and avoid use of recreational drugs.
6. Sleep Enough and Manage Stress
Find ways to relax, connect with others and wind down. If your job is a major source of stress on a daily basis, consider what you can do to change your situation. Take up hobbies, stay active and join groups in your community to connect with others. Studies have found that people with more social support tend to liver longer, happier lives.
If the prostate cancer symptoms described above sound familiar to you, don’t panic — there are other condition that can cause similar symptoms that are not very serious. Urinary symptoms can be due to prostatitis, or enlargement of the prostate. This is a common problem among older men but is usually not very difficult to treat.
Sexual dysfunction and nerve pain may also be caused by diabetes, a history of smoking, cardiovascular disease, depression or as a side effect of hormonal changes dye to getting older. Always see a doctor if your symptoms last more than one to two weeks. Your doctor can be sure to rule out other conditions that may be causing your symptoms, including sexually transmitted infections.
Final Thoughts on Prostate Cancer Symptoms
- Prostate cancer is one of the most common types of cancer in men. The prostate gland is a small, walnut-shaped gland in men that produces seminal fluid which mixes with semen from the testes.
- Prostate cancer symptoms and treatment depend on the stage of cancer that someone has. Prostate cancer symptoms are not always noticeable in all men, but when prostate cancer symptoms do occur they can include pain when urinating, abnormal urination, such as a weak stream or leakage, more frequent urination (especially overnight), pain in the pelvis, back and groin, erectile dysfunction and sexual problems.
- Risk factors for prostate cancer include being over 65, family history/genetic factors, obesity, poor diet, smoking, sedentary lifestyle, being African-American and toxin exposure.
- Natural ways to help cope with treatment include managing stress with mind-body practices, joining a support group, taking care of yourself with healthy diet and exercise habits, speaking with a therapist, and leaning on family and friends for support.
- Ways that you can help lower your risk for prostate cancer and prostate cancer symptoms include eating an anti-inflammatory diet, exercising, treating other health conditions, avoiding risky medications or supplements like calcium, quitting smoking, and managing stress.
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