A diagnosis of prostate cancer is not a death sentence. It may strike fear in the heart of a man when he hears those words, but current statistics can help dispel that fear. Prostate cancer often grows slowly (1), so in many cases, there is time to get a second opinion and formulate a plan. However, even if you do get a diagnosis of prostate cancer, the chances are it will be a slow-growing variety, and your doctor may encourage you to adopt “watchful waiting” (2).
However, the best case scenario is to take action to prevent prostate cancer (or any cancer) from happening in the first place. We highly encourage a proactive approach to reduce your risk of any cancer, as detailed in our article, “Can We Prevent Cancer?” This article will not repeat that information but will instead focus on some details specific to prostate cancer; healing paths that functional medicine can offer for prevention, complementary therapies during treatment, and post-treatment strategies.
The Prostate: The Little Gland with a Big Impact
The prostate is a small gland that is part of the male reproductive system. It lives below the bladder and wraps around the urethra, which is the tube leading from the bladder and out of the penis. The prostate’s function is to produce a fluid that carries sperm out of the body during ejaculation. Because it wraps around the urethra, the first symptom that something might be awry is the inability to have a steady flow of urine. When the prostate is swollen with inflammation or a tumor is growing there, it can constrict the urethra in such a way that it affects the normal flow of urine. Your bladder may not feel like it is completely emptied, and no urine flows, though you still feel the urge to urinate.
It’s very important to see a doctor when symptoms first occur, to determine the degree of seriousness. There are less serious conditions, such as prostatitis (inflammation of the prostate) and Benign Prostatic Hyperplasia (enlargement of the prostate that is non-cancerous), that have similar symptoms to prostate cancer. Prompt attention could relieve painful symptoms quickly and help rule out a more serious root cause.
Prostate cancer occurs when the cells of the prostate gland multiply at an abnormal pace and do not undergo their normal rate of cell death. This can cause the gland to grow, create a tumor, and even clamp the flow of all fluids from the urethra. These abnormal cells can break off and invade nearby lymph nodes or travel to other parts of the body, including the spine and the brain. This is called “metastasis.”
Prostate Cancer Risk Factors and Statistics
Many factors increase the risk of having prostate cancer. While about 1 out of 8 men may receive a prostate cancer diagnosis in their lifetime, only about 1 in 41 will actually succumb and pass away from it. It is estimated that there will be 268,560 new prostate cancer cases diagnosed in the U.S. in 2022 (3). Roughly speaking, the odds are you won’t get prostate cancer, and if you do get it, odds are it won’t be fatal.
AGE
Age is a big factor, as most diagnoses happen in the mid-60s. It’s rare for a man younger than 40 to be diagnosed with prostate cancer, and most diagnoses happen in men over the age of 65, with the average age of diagnosis being about 66 years of age (4). While cancer isn’t the norm for the body, when it does occur, it’s often contained and eliminated by the immune system. However, as we age, the immune system may not catch and conquer all the overgrowths of cells.
FAMILY
Genetics is thought to play a role, as having a brother that is diagnosed with prostate cancer triples the risk, even more so than having a father with the diagnosis, which only doubles the risk (5). (Having multiple members of the family with a diagnosis increases risk as well.)
RACE
One’s race can make a difference in risk. For instance, African American men carry more risk than men of other races. When prostate cancer is found in African American men, it tends to be a later stage, more severe, and in younger men than in other races (6).
LIFESTYLE FACTORS
The American Cancer Society uses a rather neutral language in regard to lifestyle factors (diet, obesity, smoking) that contribute to prostate cancer risk by stating these are still being studied, with some studies showing correlations to higher risk, and others not. They do state that men who eat dairy are slightly more at risk for getting prostate cancer, as are firefighters who are exposed to toxic chemicals regularly.
As for obesity, heavier men have a lower risk of getting the slow-growing variety of prostate cancer but have a higher chance of getting the fast-growing variety (7). Meanwhile, more studies continue to pile up in medical journals showing correlations between lifestyle factors and prostate cancer risk. Admittedly, it’s hard to tease out a particular lifestyle factor and be able to prove that this factor alone contributes to prostate cancer when so many factors are occurring at the same time. Stress, poor diet, and the inflammation associated with obesity can all affect hormones, and hormones can influence cancer growth (8).
Symptoms of Prostate Cancer
Please do not hesitate to go see a doctor if anything out of the ordinary happens with your reproductive organs, even if it doesn’t make sense or seems to fall into a category of disease. Don’t let days, months, and years slide by while you suffer with something you know is out of the ordinary. This could be valuable time, and the stakes could be high. Many of the symptoms for non-serious ailments can overlap with cancer signals, so the symptoms may not indicate anything serious. However, for the very small number of people who would be found to have cancer, early intervention could save their lives. If you are in that small group, it suddenly matters very much. That said, here are the most common symptoms of prostate cancer (9, 10):
trouble urinating (slow, halting, or weak stream)
increased episodes of waking at night to urinate
difficulty achieving an erection
signs of blood in the semen or urine
unexplained bodily pain (for example, pain in the hips, back, chest)
numb or weak feet and/or legs
pain upon ejaculation or decreased amount of ejaculate
swelling or “bone pain” in the lower half of the body, especially if also experiencing issues with urinating, maintaining an erection, or ejaculating.
Testing for Prostate Cancer
PSA Blood Test
By far, the easiest test for prostate cancer is the Prostate-specific Antigen (PSA) blood test, which can be added to your usual blood tests during a physical. This test detects a protein in the blood that is made by the prostate, whether it is healthy or contains cancer. A high score can be an early warning signal that a situation is brewing. Typically, if a score is abnormally high or rises over 25% within a year (even within the normal range), it can signal a need for more investigation. There is some debate about the usefulness of PSA because it was originally designed to monitor men who had already been diagnosed with prostate cancer and its utility as a screening tool has been scrutinized in the medical literature. Using PSA screening testing is something that should be discussed with your physician prior to making a decision.
Statistically speaking, those with scores between 4.0 and 10.0 have about a 1 in 4 chance of having prostate cancer (11). One option is to start screening with annual physical exams beginning at about 50 years of age, or earlier if you are African American or have a family history of prostate cancer.
Other tests - There are other types of exams for detecting prostate issues, such as the “Digital Rectal Exam” (DRE) or an expanded PSA blood panel called the “4K.” The DRE can also be used to cause prostate cells to be released into th