September was Prostate Cancer Awareness Month. The word “prostate” comes from an ancient Greek word that means “to stand in front of” or “guard,” and the gland is named for its place in front of the bladder. You too can “stand guard” for the prostate by making wise choices about screening tests and exams, diet, exercise, and other health behaviors.

 

The prostate is a walnut-sized gland in the male reproductive system that undergoes normal changes across the lifespan. It usually gets larger after age 40 and can grow from the size of a walnut to the size of a lemon. This is generally harmless but other changes can be more serious.

 

The prostate can also become infected or get cancer. Prostate cancer is one of the most common cancers among men and can often be treated if found early. Significant improvements in prostate cancer screening and treatment mean that more men survive prostate cancer and have fewer symptoms after treatment.

 

Knowing the symptoms of prostate cancer can lead to early discovery and treatment. Some early symptoms include a weak urine stream, frequent urination, difficulty urinating, and the feeling of not fully emptying the bladder while urinating. Other symptoms include pain, fever, and blood in the urine or semen. Below are some risk factors for prostate cancer:

 

Non-Changeable Risk Factors

These groups, broken down by different categories, have higher rates of prostate cancer:

• age: men over 50

• race and ethnicity: men of African ancestry

• family history: men whose fathers or brothers had prostate cancer, especially if they were diagnosed at a young age

• genetic predisposition:  men with certain genes

 

Changeable Risk Factors

These groups, broken down by different categories, have higher rates of prostate cancer than others:

• diet: men who maintain a diet high in animal products (meat, milk), sugar, and processed food, and low in plants, (vegetables, fruits, beans, nuts, seeds, whole grains)

• weight and physical activity: men who are overweight/obese and sedentary

• smoking: men who smoke and men who smoke and have prostate cancer are more likely to die from it than men who do not smoke.

 

Other Potential Factors

These groups, broken down by different categories, may have higher rates of prostate cancer:

• hormone levels: men with high levels of testosterone

• environmental factors: men who have been exposed to certain chemicals or substances

• inflammation and infection: men with chronic inflammation of the prostate

 

Regular screening tests can find prostate cancer before symptoms appear. Your doctor will recommend the best tests based on risk factors like age, race, and family history. One example is the prostate-specific antigen (PSA) blood test that measures the levels of a protein that can indicate the presence of cancer.

 

The second is a digital rectal exam, where the doctor assesses the size and shape of the prostate. If these tests show signs of cancer, a doctor might do further tests like an MRI scan, CT scan, or a biopsy to confirm the diagnosis and determine the cancer’s stage. Many men avoid prostate cancer screening, and especially the digital rectal exam because it can be uncomfortable and they are afraid of what they might find out. This fear is a major barrier to participating in screening and educational programs.

 

Treatment for prostate cancer varies. For low-risk cancers, a doctor might do frequent imaging scans or digital rectal exams to monitor over time. For other cancers, they may use radiation therapy (external or internal) to kill cancer cells, and systemic therapies like hormone therapy, chemotherapy, and immunotherapy for advanced or recurrent cancers. The approach depends on the cancer’s stage, risk level, and the patient’s other conditions.

 

Prostate cancer and treatments can lead to difficulty maintaining erections (erectile dysfunction) and difficulty controlling urine (incontinence). Other common side effects include fatigue, changes to bowel movements, hot flashes, and psychological distress like anxiety. Management strategies involve lifestyle changes, medication, and social support including support groups.

 

While Prostate Cancer Awareness Month is over, it is important at any time of the year to make realistic changes to your risk factors for all cancers, including eating habits, exercise, and alcohol and tobacco use.

 

To request a workshop on prostate cancer or any health topic in your community, contact Carlos Tejeda at ctejeda@montefiore.org. To schedule a prostate cancer screening or get care for any medical concerns, call (800) 636-6683 or visit https://www.montefiore.org/general-internal-medicine.

 

Carlos Tejeda is a community health specialist at Montefiore’s Office of Community and Population Health.