Men can suffer from a variety of medical problems associated with the urinary tract and prostate. The prostate is usually the size and shape of a walnut and is responsible for making semen. It naturally gets larger as we age and is positioned underneath the bladder, and wraps around the urethra (the tube men urinate and ejaculate through). In terms of medical problems, the prostate can become inflamed (prostatitis), grow to be too large (benign prostatic hypertrophy), or become cancerous. These conditions have different causes and presentations, although there is often some degree of overlap in their symptoms. Therefore whenever men get any change in urinary or sexual function, it is important to seek medical advice early.
There are around 130 new cases of prostate cancer every day in the U.K. However, more than 84% of men will survive for 10 or more years under current treatment regimes. The key to beating prostate cancer is catching it early. Symptoms of prostate disease include:
- Poor urinary flow
- Hesitating starting
- Going more frequently
- Feeling as if you have not emptied completely
- Dribbling afterwards
- Blood in the urine
- Ejaculation pain
Investigations for prostate cancer include blood tests, examinations, scans, or even biopsy, as required. However, the most important message on this page is to not ignore your symptoms. Recent advances in imaging and diagnosis, mean that by using focused MRI scans, testing for prostate cancer is now less invasive and there are fewer complications seen from biopsies. By working closely with local urologists, we can significantly reduce the time from diagnosis to effective treatment.
Should I have a PSA screening test?
There is currently no national screening process for prostate cancer. This means, we currently rely on a combination of symptoms, PSA testing, and physical examination, to see if you should be referred for biopsy/imaging. The problem comes with the fact that many prostate cancers are asymptomatic until the late stages, which poses the question “should patients with no symptoms be screened with a PSA test?”. Overall, the evidence is mixed. The PSA result has both false positives and negatives, can result in needless testing, but more worryingly, false reassurance. The best advice is to see your doctor and discuss the pros and cons of having the test. There are several interesting and practical ways prostate cancer might be screened for in the near future, but for now it is far more complex then a “yes” or “no” test.
Can I reduce my risk of prostate cancer?
Lifestyle and weight
The latest research suggests that being overweight or obese probably increases your risk of aggressive or advanced prostate cancer. A balanced diet and regular exercise can help you stay a healthy weight, so these may be important for lowering your risk. Overall, we know that men in western countries, such as the UK, are more likely to get prostate cancer than men in east Asian countries such as China and Japan. And that when Asian men move to western countries, their risk of prostate cancer increases. This may be because of the western diet, which contains less fruit, vegetables and fish, and more meat, dairy, sugar, fat and processed foods
Studies of exercise and prostate cancer risk have mostly shown that men who exercise may have a reduced risk of prostate cancer. This fits with evidence that obesity can increase the risk of prostate cancer. Exercise has many other health benefits and may reduce your risk of heart disease and other cancers. The aim should be to achieve 30 minutes of intense exercise most days of the week.
Dairy and calcium
Overall, current evidence suggests that there is a small increase in the risk of developing prostate cancer in people who have very high intakes of dietary calcium. In practice, this means to sticking to no more than 4 servings of dairy products a day (a serving is some milk with porridge, in tea and coffee, a matchbox sized serving of cheese or a small pot of yogurt).
Whilst prostate cancer has been detected in higher numbers of men with raised cholesterol, it’s hard to establish which came first, the cholesterol or the cancer. Interestingly, there is some evidence that men with raised cholesterol are at greater risk of developing high-grade prostate cancer, the rapidly growing type, but not at an increased overall risk of prostate cancer.
Should I take supplements?
There are a range of supplements that claim to help reduce the risks of developing prostate cancer. However, there are no credible studies that have shown any benefit from over the counter medications in reducing prostate cancer risk.
There is a lot of information available on the internet with regards prostate cancer and prostate health. Not all of it is credible, but I have provided links to some of the more informative and legitimate sites. If in doubt, contact me for further information, or if you have any questions with regards prostate health.