Men’s Health Month: Prostate Cancer

I must first state that I’m not a medical doctor. However, I aim to help men become better men, which starts by maintaining our health.

In this current series, I described why I’m participating in No-Shave November this year to help “change the face” of men’s health. My effort comes by writing about some serious health issues specific for men, but also by growing a beard for the first time ever!

In my initial posts, I explained that organizations like Movember and No-Shave November tell why men’s health month is so important. I also wrote about the rise in suicide rates among men and about cancer in general.

Now, I’ll explain some cancers specific to men, such as prostate and testicular cancer, and what we can do to help prevent those. 

Why Men Die Earlier than Women

On average in the U.S., women live 5 years longer than men. About 57% of adults age 65 are female which increases to 67% by age 85. Worldwide, men live nearly 7 years shorter than women.

There are many reasons why men live shorter lives than women. According to this article on Harvard Health Publishing, men tend to:

US Army Photo
  • take bigger risks. 
  • have more dangerous jobs. 
  • die of heart disease more often and at a younger age. 
  • be larger than women. 
  • commit suicide more often than women. 
  • be less socially connected. 
  • avoid doctors. 

While there’s only so much we can do about these factors, we can improve our success in beating cancer by educating ourselves and visiting the doctor when needed.

So let’s learn a bit about these cancers and get some practical ideas to help reduce our chance of dying of them.

About Prostate Cancer 

The Movember website indicates that 1 in 9 U.S. men is diagnosed with prostate cancer at some point in their lifetime. It’s the most commonly diagnosed male-only cancer and the third most common cancer in the United States. Globally, more than 1.3 million men are diagnosed with prostate cancer each year. 

The American Cancer Society (ACS) describes prostate cancer, which begins when cells in the prostate gland start to grow out of control. 

The prostate gland is located below the bladder (the hollow organ that stores urine) and in front of the rectum (the last part of the intestines). Just behind the prostate are glands called seminal vesicles that produce most of the fluid for semen, which carries sperm from the testicles. The urethra, which is the tube that carries urine and semen out of the body through the penis, goes through the center of the prostate.

color illustration showing the prostate and surrounding area (including the location of the urethra, penis, scrotum, rectum, bladder and seminal vesicle)
Source: American Cancer Society

On a very basic level, prostate cancer is caused by changes in the DNA of a normal prostate cell. 

Almost all prostate cancers—more than 99 percent—are adenocarcinomas, which is cancer that forms in mucus-secreting glands throughout the body. This type of tumor is found in many common cancers, including breast, lung, and colorectal. Other prostate cancer types include:

  • Transitional cell carcinomas
  • Sarcomas
  • Small cell carcinomas
  • Neuroendocrine tumors

Causes of Prostate Cancer

Several factors such as age, ethnicity, geographic location, and family history affect a man’s risk of getting prostate cancer, according to the ACS.

Prostate cancer is rare in men younger than 40, and the chance of having prostate cancer rises rapidly after age 50. About 60% of cases are found in men older than 65.

Source: Zerocancer.org

Researchers don’t know exactly what causes prostate cancer but they are learning how risk factors cause prostate cells to become cancer cells.

Having prostate risk factors does not mean that you will get the disease. Many people with one or more risk factors never get cancer, while others who get cancer, may have few or no known risk factors. 

Prostate cancer develops more often in African-American men and in Caribbean men of African ancestry.  The reasons for these racial and ethnic differences though are not clear. Prostate cancer is most commonly found in men who live in North America, northwestern Europe, Australia, and on Caribbean islands, likely due to factors such as lifestyle differences (diet, etc.). 

There is also an inherited or genetic factor since prostate cancer seems to run in some families.  Most prostate cancers occur in men without a family history of it so having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. (The risk is higher for men who have a brother with the disease than for those who have a father with it.) 

Several inherited gene changes (mutations) also seem to raise prostate cancer risk These include the BRCA1 or BRCA2 genes, also linked to an increased risk of breast and ovarian cancers.

Additionally, men with Lynch syndrome (known as hereditary non-polyposis colorectal cancer) have an increased risk for a number of cancers, including prostate cancer.

Symptoms of Prostate Cancer

The size of the prostate changes as a man ages. In younger men, it is about the size of a walnut, but it becomes much larger in older men.

Older men will often hear from their doctor about “age-appropriate” enlargement of the prostate gland, which causes us to get up to urinate frequently in the middle of the night. 

In most cases, symptoms of prostate cancer are not apparent in the early stages of the disease. 

Because of the proximity of the prostate gland to the bladder and urethra, prostate cancer may be accompanied by a variety of urinary symptoms, especially in the early stages. Depending on its size and location, a tumor may press on and constrict the urethra, inhibiting the flow of urine. 

Some early prostate cancer signs include burning, pain, or difficulty starting or stopping while urinating; blood in the urine (hematuria) or semen; and difficulty getting or keeping an erection (erectile dysfunction).

Screening and diagnosis

Of course, you should talk with your doctor about the symptoms and examinations for prostate cancer.

According to the Cancer Treatment Centers of America, more than 90% of prostate cancers are found when the disease is in an early stage, confined to the prostate and nearby organs. 

Prostate cancer is typically detected and diagnosed early with routine screenings like prostate-specific androgen (PSA) tests and digital rectal exams (DRE) are very important.

Other treatment options are considered if a patient’s PSA level is high, or his doctor finds abnormalities from a DRE.

Because prostate cancer often grows slowly, active surveillance is the preferred treatment option for some men. In general, active surveillance is the best option for patients whose prostate cancer is:

  • Not causing symptoms
  • Expected to grow slowly
  • Small and contained within the prostate

Patients under active surveillance receive regular PSA tests and biopsies every one to two years.

Your oncologist will closely monitor the disease with tests and consider other treatments at a later date that includes:

  • Surgery
  • Chemotherapy
  • Immunotherapy
  • Radiation therapy

Older men are more likely to be candidates for active surveillance because treating them with surgery or radiation has not been shown to help them live longer. 

There’s Good News

Nowadays, more than 3 million men in the U.S. are living with prostate cancer. It’s one of the slowest growing forms of cancer and very treatable when discovered and treated early.

Cancer Screening – iStockMovember2011

Even better, not all medical institutions agree that a digital rectal exam (DRE) is necessary each year.

The ACS feels a DRE is less effective than a PSA test, but it can occasionally find cancers in men with normal PSA levels.

Educate and Talk

So again, talk to your doctor about the benefits and risks of regular examinations and tests to help you stay ahead of any health issues.

You may also be surprised by how many guys have a family history of prostate cancer. God Buddies demonstrate vulnerability when they talk openly, yet confidentially about their experiences with cancer.

My dad is a prostate cancer survivor treated with laser-radiation. (BTW, happy 82nd birthday dad!) I also have a good friend who has spoken openly about his prostate cancer that’s monitored with active surveillance since it’s currently in remission.

So open up with your GB about your anxieties with health issues. He just may be the “kick in the pants” that convinces you to see your doctor before it’s too late.

Next week, I will write about another cancer specific to men: Testicular Cancer. 

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