March is Prostate Cancer Awareness Month, a celebration of the prostate gland; that mysterious, deep-seated male pelvic organ that is the source of curiosity, anxiety and fear. The prostate lives at the crossroads of the male urinary and reproductive systems; the center of gravity of men’s pelvic health. Nestled behind the pubic bone and in front of the rectum, the prostate envelops the inner part of the urethra (urinary channel).
Prostate cancer is the most prevalent male cancer aside from skin cancer. The commonplace process of benign enlargement often causes urinary troubles as voiced by one of my patients: “My urinary channel has become welded shut like a lug nut, causing me to pee in chapters.” Inflammation or infection of the prostate, prostatitis, is also a not infrequent male affliction.
After the age of 40, an annual prostate exam is highly recommended. Easily accessible to this brief physical examination with a gloved, lubricated finger placed in the rectum, your doctor can determine valuable information about your prostate health.
Curious Prostate Cancer Facts
- The purpose of the prostate is to produce part of the ejaculate, a milky fluid that serves as a nutrient vehicle for sperm.
- Prostate “massage” is sometimes done by urologists to “milk” fluid out of the prostate to obtain a specimen for laboratory analysis.
- The prostate has a growth spurt at puberty and a second growth spurt around age 40, when under the influence of aging, genetics and testosterone, it often enlarges and constricts the urethra, causing annoying symptoms.
- In the absence of testosterone, the prostate never develops.
- The prostate is 70% glands and 30% muscle; muscle fibers contract at with sexual climax to squeeze prostate fluid into the urethra. Excessive prostate muscle tone, often stress-related, can cause identical symptoms to benign enlargement.
- Benign prostate enlargement and prostate cancer are unique to humans and dogs, sparing most other species.
- Women have a female version of the prostate, the Skene’s glands.
Prostate Cancer Statistics
- One man in seven will be diagnosed with prostate cancer during his lifetime, but only 3% of men will die of the disease; there are 2.5 million American men diagnosed with prostate cancer who are alive today.
- In 2015, an estimated 221,000 American men were diagnosed and about 28,000 men died of the disease.
- The average age at diagnosis is the mid 60’s.
- Although many with low-risk prostate cancer can be managed with observation, those with high-risk disease need more aggressive treatment.
- The number 1 cause of death in men with prostate cancer is heart disease, as it is in the rest of the population.
LUTS May Indicate Prostate Trouble
It is vital to understand that the absence of symptoms is not the absence of disease. In fact, prostate cancer often causes NO symptoms in its earliest stages and clues to its presence are often revealed by a simple prostate exam and PSA blood test.
Lower Urinary Tract Symptoms (LUTS) are symptoms that can be on the basis of benign enlargement or adaptive changes in the bladder muscle due to benign enlargement. LUTS can run the gamut from urinary incontinence to urinary retention. Between these extremes, there are many possibilities, broadly classified into “irritative” and “obstructive” LUTS:
• Frequency – urinating much more often than normal
• Nocturia – awakening from sleep to urinate
• Urgency – the sudden and strong desire to urinate
• Urgency incontinence – the sudden desire to urinate with the inability to get to the toilet in time to prevent leakage
• Hesitancy – a stream that is slow to start
• Weak stream – a stream that lacks force
• Narrow caliber stream – a thin stream
• Spraying stream – an imprecise, multi-directional, splattering stream
• Intermittency – a stream that starts and stops
• Straining – the need to use abdominal muscles to urinate
• Prolonged emptying time – excessive voiding time
• Incomplete emptying – the sensation of urgency after completing urination
• Double voiding – the need to urinate a second time to empty completely
Other symptoms that potentially indicate problems are:
- inability to urinate
- blood in the urine or in the semen
- pain with urination – often indicative of a urinary infection
- bed-wetting – a type of incontinence often due to “overflowing”
- post-void dribbling – an annoying after-dribble
Not all men with benign enlargement need to be treated. In fact, many can be observed if the symptoms are tolerable. There are several classes of effective medications for benign prostatic hyperplasia (BPH) and numerous surgical means of treating BPH, the most popular uses laser energy to vaporize a channel through the obstructed prostate gland.
The Secrets To Prostate Health
Exercise has been shown to lessen one’s risk of developing BPH1 and prostate cancer2, and in decreasing the death rate of those who do develop prostate cancer.3
Exercise in general and pelvic floor muscle exercises in particular benefit prostate health by increasing pelvic blood flow and minimizing inflammatory chemicals and the tone of the sympathetic nervous system (the part of the nervous system that is stimulated by stress), which can aggravate BPH. Additionally, a pelvic floor muscle training program such as the PelvicRx will strengthen the muscles surrounding the prostate so that, if you were to develop prostate cancer and require treatment, you will experience a more rapid recovery with respect to urinary control and sexual function.
In terms of diet, vegetables are exceptionally anti-inflammatory and consumption of those that are rich in lutein (including kale, spinach, broccoli, and peas), those that are rich in beta-carotene (including carrots, sweet potatoes, and spinach), and those rich in lycopene (including tomatoes), can lower the risk of BPH.
A Western diet has clearly been associated with prostate cancer, so avoiding highly refined, over-processed, nutritionally-empty foods and decreasing the amount of animal fat in your diet will prove advantageous.
The bottom line is that, a healthy lifestyle, including a heart healthy diet and exercise program can lessen one’s risk of chronic diseases, including prostate cancer.4
|↑1||Parsons, J. Kellogg. “Benign prostatic hyperplasia and male lower urinary tract symptoms: epidemiology and risk factors.” Current bladder dysfunction reports 5.4 (2010): 212-218.|
|↑2||Antonelli, Jodi A., et al. “Exercise and prostate cancer risk in a cohort of veterans undergoing prostate needle biopsy.” The Journal of urology182.5 (2009): 2226-2231.|
|↑3||Kenfield, Stacey A., et al. “Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study.” Journal of Clinical Oncology 29.6 (2011): 726-732.|
|↑4||Colli, Janet. “Can men reduce the risk of prostate cancer through lifestyle changes?.” The Journal of urology 182.5 (2009): 2101-2102.|