Know The Symptoms and Risk Factors For Prostate Cancer!

This series of articles is informational only and not intended to be a substitution for your doctor’s advice, so make sure that you seek a professional opinion if you feel that you may have prostate issues.

In the previous article, we looked at three common problems with the prostate gland.

In this article, we will look at some additional symptoms as well as the risk factors associated with the disease, screening options and treatment modalities.

We will also look at the role of fats, as well as recent research on testosterone and testosterone replacement therapy.

A quick biology lesson

The prostate is a small, walnut-shaped sex gland in men that produces the seminal fluid; this fluid nourishes and transports sperm.

The growth of the cells in the prostate gland is stimulated by the male sex hormone called testosterone.

Diagnosis and treatment can be scary

Though its causes are unknown, prostate cancer is a frightening prospect for men. This cancer threatens not just their lives, but also their sexuality, as well as their self-concept and self-perception.

Even if treatment has been successful in saving a person’s life, possible consequences of such treatment might include

• erectile dysfunction,
• bowel issues, and
• bladder control problems.

The Prostate Cancer Foundation provides useful information about the possible side effects of the different treatment options for prostate cancer.

Early detection vs late detection

Prostate cancer progresses very slowly and the early stages show little or no symptoms.

If detected early, effective treatment with minimum side effects is possible. Once the cancer spreads (metastizes) treatment becomes more difficult.

Your vulnerability to prostate cancer increases with age.

Most often, prostate cancer is detected very late and people who lose their lives do not die from prostate cancer, but die WITH prostate cancer.

Signs and symptoms

As the cancer develops, it eventually squeezes the urethra, which surrounds the prostate. This is when signs and symptoms begin to appear:

• Urgency in urination
• Difficulty in starting urination
• Dull, persistent ache in the lower pelvic area
• Painful urination, a very slow flow (almost like a dribble)
• Intermittent urine flow, and a sensation that the bladder is not empty
• Frequent urination, sometimes including blood Painful ejaculation
• Persistent pain in the bones, lower back, hip and thighs
• General ill health, loss of appetite, and decline in weight

If the cells from the cancerous prostrate break away, the cancer will spread. Most commonly, prostate cancer spreads to the lymph nodes, bones in the hips or the lower back, lungs, and sometimes even the brain.

Risk factors:

In an online article published by the Prostate Cancer Foundation in 2018, three well-established risk factors were noted:

• The risk of prostate cancer increases with age.
• As with almost any other cancer, heredity may also play a role.
• For reasons unknown, men of color, of African origin (race), seem to have a higher risk of prostate cancer.

Poor dietary habits which include eating processed foods often contribute to cancers in general, and prostate cancer, in particular.

What about a sedentary lifestyle?

The jury is still out as to whether or not a sedentary lifestyle also contributes to the risk of developing prostate cancer.

A sedentary lifestyle is defined in the medical literature as “sitting time”.

For example, recent research shows that patients with sedentary jobs who presented for prostate biopsy had a lower risk. Several years prior to this research, a sedentary lifestyle was considered to be a chronic disease risk factor.

A meta-analysis by German researchers found that, while sedentary behavior was not a single contributor to prostate cancer, prolonged behavior could increase the risk for aggressive prostate cancer.

This behavior might, perhaps, be linked with obesity.

What about fats and testosterone?

Fats have had a very bad rap. Our bodies need dietary fats in order to

• produce and balance testosterone and other hormones,
• provide energy for the body,
• form cell membranes,
• give us that full feeling when we eat dietary fats,
• transport the fat-soluble vitamins (A, D, E, and K), and
• manage inflammation.

These are just some of the important functions of fats in your body.

Influx of low-fat foods

A major result of the discouragement against high-fat diets (in particular) has been the influx of low fat foods with increased amounts of

• sugar,
• artificial sweeteners, and
• industrially-processed substances.

We will have a look at diet and nutrition in another article.

Let’s talk about testosterone.

I want you to bear in mind that the cause, or set of causes, for the development of prostate cancer are still largely unknown.

So it is probably natural for myths to abound. Especially myths based on assumptions and insufficient evidence.

Myths such as “testosterone causes prostate cancer“. This one goes right back to the 1940s, where researchers argued that castration and estrogen therapy treatments for men would reduce their risk for prostate cancer.

This ONE study based on ONE castrated male subject has had an impact on subsequent medical health professionals assuming that testosterone itself promotes prostate cancer.

As an aside, another myth which has since been disproven: having a vasectomy results in prostate cancer.

Some recent research on TRT

In 2017, Canadian researchers conducted a systematic review and network meta-analysis of trials and studies involving hypogonadal men given testosterone replacement therapy.

Bearing in mind that there were conflicts of interests with some members of the group, the overall observation was that there was no statistically increased risk of adverse events, including prostate cancer, stroke, heart disease and diabetes.

Safe with short term use?

For high-risk prostate cancer survivors, there does not appear to be any increase risk of recurrence for patients taking testosterone, according to a group of UK researchers.

Chinese researchers conducted a literature view in 2014 and found that TRT was indeed safe with short term use and advocated for the need for long-term studies.

So it does seem, then, that testosterone replacement therapy has benefits and, with short-term use, does not contribute to development of prostate cancer.

Perhaps cycling your TRT is beneficial here? Do discuss this with your doctor.

Screening options

A routine screening test may reveal the beginnings of prostate cancer.

Tests that are generally undertaken include:

• a DRE (Digital Rectal Examination), which involves inserting a gloved finger into the rectum, helps the doctor to examine the prostate. Any change in shape or size of the gland may mean trouble.
• the prostate-specific antigen (PSA) test analyzes a blood sample for the levels of PSA. If a higher than normal level is detected, a prostate infection or cancer may be suspected.
• a transrectal ultrasound helps to further evaluate the prostate using sound waves. If initial tests produce positive results, a prostate biopsy may be done to verify the presence of cancer.

If cancer is confirmed, the next step is to investigate the spread of the cancer. A bone scan, CT scan, and Ultrasound scan may be used for this.

Getting a second opinion

As an aside (THIS IS IMPORTANT): according to an information summary from the National Institute of Health published in February this year, there is insufficient evidence that prostate-specific antigen (PSA) or digital rectal exam (DRE) reduces mortality from prostate cancer.

In addition to this, the report notes that screening with either or both techniques results in over-diagnosis.

This is not to discourage you from getting screened.

If you have been screened recently and diagnosed with prostate cancer, do not allow this diagnosis to overwhelm you. Get a second opinion.

Mode of treatment

The mode of treatment directly depends on how aggressive the cancer is.

For most men, a combination of treatments (surgery, radiation paired with hormone therapy, chemotherapy) may prove effective.

Reducing your risk

The best way to reduce your risk from prostate cancer is to have a diet that is

• rich in nutrients and
• includes fruits and dark leafy green vegetables.

Regular exercise also helps.

In the next article, we will look at diet and nutrition.

To a better, wiser, stronger – YOU.

Sources:

Photo by Anna Tarazevich: https://www.pexels.com/photo/prostate-cancer-text-8016907/

Prostate Cancer Side Effects. Located at Prostate Cancer Foundation, https://www.pcf.org/about-prostate-cancer/prostate-cancer-side-effects/ [Accessed September 18, 2022]

Berger FF, Leitzmann MF, Hillreiner A, Sedlmeier AM, Prokopidi-Danisch ME, Burger M, Jochem C. Sedentary Behavior and Prostate Cancer: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Cancer Prev Res (Phila). 2019 Oct;12(10):675-688. doi: 10.1158/1940-6207.CAPR-19-0271. Epub 2019 Jul 30. PMID: 31362941.

Elliott J, Kelly SE, Millar AC, Peterson J, Chen L, Johnston A, Kotb A, Skidmore B, Bai Z, Mamdani M, Wells GA. Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis. BMJ Open. 2017 Nov 16;7(11):e015284. doi: 10.1136/bmjopen-2016-015284. PMID: 29150464; PMCID: PMC5701987.

Teeling F, Raison N, Shabbir M, Yap T, Dasgupta P, Ahmed K. Testosterone Therapy for High-risk Prostate Cancer Survivors: A Systematic Review and Meta-analysis. Urology. 2019 Apr;126:16-23. doi: 10.1016/j.urology.2018.07.064. Epub 2018 Sep 21. PMID: 30244116.

Cui Y, Zong H, Yan H, Zhang Y. The effect of testosterone replacement therapy on prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2014 Jun;17(2):132-43. doi: 10.1038/pcan.2013.60. Epub 2014 Jan 21. PMID: 24445948.

Morgentaler A. Testosterone and prostate cancer: an historical perspective on a modern myth. Eur Urol. 2006 Nov;50(5):935-9. doi: 10.1016/j.eururo.2006.06.034. Epub 2006 Jul 27. PMID: 16875775.

Tip: TRT Causes Prostate Cancer? Nah. The Opposite. Located at T-Nation (online), https://www.t-nation.com/sex-hormones/tip-trt-causes-prostate-cancer-nah-the-opposite/ [Accessed September 19, 2022]