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What you need to know about prostate cancer

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Prostate cancer affects about 1 in 8 Americans in their lifetime. Here’s what you need to know about how it develops, how to manage it — and how to prevent it.

For the first half of your life or so, you probably never gave your prostate a thought. If you were born a male, you may know you have one. You might even know it’s a gland that sits between your bladder and penis. Its usual job is to help produce semen (the fluid that has sperm). And that’s probably all you need to know.

But once you hit your 40s or 50s, it’s time to start paying attention. As you get older, your risk of prostate cancer can begin to rise. About 1 in 8 people with a prostate will be diagnosed with it during their lifetime. And about 34,500 Americans die from it each year.1

Some good news: If your doctor finds prostate cancer early enough, they can do something about it. And you can do several things to lower your risk of it before it has a chance to grow.

Find out about prostate cancer, its dangers and how you can stay healthy, even if you have it.

What is prostate cancer and why might you be at risk?

Prostate cancer starts when cells in the prostate become abnormal and begin to grow out of control. Eventually, those abnormal cells form a lump.

Often, the cancer grows slowly. Doctors can find it before it becomes a serious problem. But some are at higher risk than others. Here are the most common risk factors:

  • Age. As you get older, your prostate cancer risk increases.

  • Family history. If people in your family have prostate cancer, you’re more likely to get it, says Jeffrey Lumerman, MD. He’s a urologist at ProHEALTH, part of Optum, in Long Island, New York. You’re two to three times more likely to get prostate cancer if your father or brother has the disease.2

  • Race. In the U.S., if you’re Black, you’re 50% more likely to get prostate cancer than others. You’re also twice as likely to die from it.3

How do you know if you have prostate cancer?

That’s not such an easy question to answer. There are no symptoms for early stages of prostate cancer, says Dr. Lumerman. So finding it is hard without getting screened. But the testing guidelines aren’t exactly straightforward either.

The American Cancer Society recommends that you talk to your doctor about prostate cancer screening. This conversation should happen at these ages, depending on your risk:

  • Age 50 if you’re at average risk and expected to live at least 10 more years.

  • Age 45 if you’re at high risk. This includes people who are Black or have a close relative who had prostate cancer before age 65.

  • Age 40 if you’re at the highest risk. This includes people with more than one close relative who had prostate cancer at an early age. You should also start at this age if you've been diagnosed with a genetic mutation that increases your risk of prostate cancer. 

If you and your doctor decide that screening is the right choice, you’ll likely have one or both of these tests:

  1. Prostate-specific antigen (PSA) blood test. This measures your levels of PSA. It’s a type of protein made by the prostate. Those with a healthy prostate typically have a low amount. But higher levels can signal that something may be wrong.

  2. Digital rectal exam (DRE). This is a physical exam of your prostate. Your doctor inserts a finger into your rectum. This lets them check the area for lumps.

Sometimes the results of these two screenings aren’t always clear. If that’s the case, you may have one of these tests:

  • Magnetic resonance imaging (MRI). An MRI uses a powerful magnet and radio waves to take pictures of your prostate.

  • 4KScore® test. This blood test checks for four proteins (biomarkers) that can help doctors better assess your risk. 

  • Biopsy. Your doctor removes a small piece of tissue from your prostate and checks it for cancer cells. This tissue sample is the only way to be sure of a diagnosis, says Dr. Lumerman.

Does prostate cancer ever have symptoms?

Symptoms are rare, but they can develop in later stages. If you experience any of the following, check in with your doctor4:

  • Difficulty starting to pee
  • Weak or difficult flow of urine
  • Needing to pee a lot, especially at night
  • Difficulty emptying your bladder completely
  • Pain or burning during peeing
  • Blood in your pee or semen
  • Pain in your back, hips or pelvis that doesn’t go away
  • Painful ejaculation

Keep in mind that these symptoms can also be signs of an enlarged prostate — a common but benign condition. 

How do you manage prostate cancer?

If you’re diagnosed, your doctor will come up with a customized plan to manage it. They will consider your age, any existing health conditions and the stage of your cancer.

If your cancer is low risk, your doctor may just keep a close eye on you, notes Dr. Lumerman. That might mean you’ll take a PSA blood test once every six months or so. You may also have an MRI and additional biopsies at regular intervals. Your doctor may do even less, depending on your health.

With more aggressive disease, your doctor might take a more active approach. Treatments could include:

  • Cryotherapy. Your doctor freezes the cancer cells. 
  • Focal therapy. In certain cases, your doctor may target a small tumor with a focused therapy that can spare healthy tissue.
  • Hormone therapy. This stops your body from making testosterone that can fuel cancer growth.
  • Prostatectomy. This surgery removes your prostate.
  • Radiation. Your doctor kills your cancer cells with high-energy waves.

In advanced disease, your doctor may recommend: 

  • Chemotherapy. These medications can help kill cancer cells.
  • Immunotherapy. This medication helps your body fight off cancer cells.

Are there any side effects to treatment?

It depends on the treatment. Here are two of the most common side effects:

Erectile dysfunction (ED). Prostate cancer treatment can make it more difficult to get or keep an erection long enough for sex. You have nerves near your prostate that help your penis become erect. Certain treatments can damage them. Prostate surgery, radiation and hormone therapy can cause ED.5

Urinary incontinence. This means you may leak urine. If you’ve had radiation, it may irritate areas near your prostate that help you pee. In surgery, the muscles that control your ability to hold in your urine can be damaged. In some cases, you may have a hard time peeing, but it can get better in weeks or months. It can also get worse, so it’s a good idea to talk to your doctor if it doesn't improve.

The good news is that there are ways to make both conditions better. For example, you can get prescription medications to help with ED. Talk to your doctor about them.

You can have ED medications delivered straight to your door — no insurance required. Get started.

How can you lower your prostate cancer risk?

You can’t pick your age, family or race. But you can make food and life changes to help lower your prostate cancer risk. Some of them include:

1. Eat healthier

Stay away from foods high in saturated fat, says Dr. Lumerman. Those include red meat, butter and fried foods. “Eating more fruits and vegetables and focusing on healthy omega-3 [fatty acids] is important,” he says. Salmon, walnuts and soybeans all have healthy fats.

You also want to limit eating charred food, says Dr. Lumerman. Those blackened parts of food have chemicals that can increase your cancer risk.

Learn more about healthy eating.

2. Maintain a healthy weight

In general, it’s a good idea to keep your weight in a healthy range. Being overweight may increase your risk of more serious forms of prostate cancer. And some studies have linked diets high in dairy and calcium with increased prostate cancer risk.6

So it’s a good idea to not only eat well, but to also get regular exercise. If you can’t lose weight, your doctor may have you see a dietitian. They can help you eat healthier. Before you make any changes to what you’re eating, talk to your doctor.

3. Quit smoking

Smoking can be bad for every part of your body, including your prostate. If you’re a heavy smoker, your risk of prostate cancer may be double that of a non-smoker.7 It might also put you at a higher risk of dying from it.

If you quit smoking, within 10 years, your prostate cancer risk will decrease to that of a non-smoker the same age.8  

4. Drink less alcohol

Drinking too much alcohol can also be bad for your prostate. Compared to people who don’t drink at all, those who have more than seven drinks a week are three times more likely to get prostate cancer.9 They’re also more likely to die from it.10

Bottom line? Lowering your risk of prostate cancer isn’t much different from living healthier in general. If you have a strong family history of prostate cancer, be sure to talk to your doctor early and often. Learn more about lowering your risk of prostate and other cancers at Cancer Screen Week. 

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Sources

  1. American Cancer Society. Key statistics for prostate cancer. Published January 12, 2022. Accessed July 1, 2022.
  2. Urology Care Foundation. Prostate cancer. Published August 2018. Accessed July 1, 2022.
  3. JAMA Network. Prostate cancer–specific mortality across Gleason scores in Black vs nonblack men. Published December 18, 2018. Accessed July 1, 2022.
  4. Centers for Disease Control and Prevention. What are the symptoms of prostate cancer? Published August 23, 2021. Accessed July 1, 2022.
  5. University of Rochester Medical Center. Prostate cancer: Erectile dysfunction (ED) after treatment. Accessed July 1, 2022.
  6. American Cancer Society. Can prostate cancer be prevented? Published June 9, 2020. Accessed July 1, 2022.
  7. Urology Care Foundation. Prostate cancer. Published August 2018. Accessed July 1, 2022.
  8. Ibid.
  9. Cancer Prevention Research. Early-life alcohol intake and high-grade prostate cancer: Results from an equal-access, racially diverse biopsy cohort. Published August 23, 2018. Accessed July 1, 2022.
  10. Cancer Epidemiology. Post-diagnosis alcohol intake and prostate cancer survival: A population-based cohort study. Published February 13, 2018. Accessed July 1, 2022.

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