We All Have a Lot to Learn About Prostate Health

Despite being a male-only cancer—it affects the prostate gland, which only men have—prostate cancer is still one of the most common types of cancers in the world. The Centers for Disease Control and Prevention (CDC) estimates that 13 percent of men will get prostate cancer in their lifetime. Fortunately, the mortality rate is only about 2 to 3 percent for those diagnosed.

Prostate cancer has a range of aggressiveness. Some forms of the cancer stay in the prostate gland and can be removed, while some spread (or metastasize) slowly and are still easily treated. Others, though, spread quickly and become a larger, more deadly health concern.

We are still learning about many cancers and why some people are more susceptible to them. Prostate cancer specifically seems to be one that is very commonly surrounded by false information and controversial treatment options based on inconclusive studies.

Here are some facts you should know.

Dispel the misinformation

One of the common tests medical professionals use to test for prostate cancer is the prostate-specific antigen (PSA) screening, but this has become a controversial topic in medical fields. Too often, patients, and even doctors, take an elevated PSA as a definitive sign of prostate cancer. But that's an oversimplification: All men have varying PSA values, and PSA rises naturally with age.

PSA is a prostate-produced protein that can be detected in the blood. It is generated by all prostate cells, both cancerous and noncancerous. Doctors cannot always tell the difference between PSA levels that are normal and those that are indicative of cancer. The reason men should be tested for PSA levels regularly is so their doctor can monitor what is normal for each individual. Once those levels begin to change, physicians can monitor the absolute PSA values along with the rate of increase to help make treatment and management decisions.

Men between the ages of 55 and 69 may decide they want a test for PSA levels even if their doctor has not recommended it. Mention this to your doctor on your next visit if you're unsure how to proceed.

Again, this extremely common cancer may not need to be treated, making active surveillance an appropriate form of management.

Ejaculation and vasectomies

Prostate cancer has also been tied to frequent ejaculation. According to a Harvard Health study, which ran from 1986 through 2000, men who ejaculated 21 times or more per month were 31 percent less likely to be diagnosed with prostate cancer later. A 2016 update to the study confirmed its conclusions.

But this study, and many like it, are not determinative. While they do draw a correlation between ejaculation and prostate cancer, conflicting evidence exists.

Another common misconception is that having a vasectomy is associated with a higher risk of developing prostate cancer. But this is untrue; many studies conclude there is no connection between getting a vasectomy and developing prostate cancer.

Flaxseed supplements have been touted by some people as a way to keep PSA levels normal and, thus, prostate cancer at bay. Any such studies remain to be proved. A number of ongoing studies are exploring the impact that dietary supplements have on reducing prostate cancer risks, but much work remains to prove what does and does not work. You should also keep in mind that most supplements have not been tested or approved by the Food and Drug Administration (FDA).

Facts, risk factors & staying healthy

Age is a major factor in determining prostate cancer probability and its aggressiveness.

Think of prostate cancer as coming in two varieties: aggressive and not aggressive. Elevations in PSA at age 65 or younger or an abnormal acceleration in the rise of PSA can be indicators of a more aggressive type of cancer. Older men are more susceptible to the more aggressive version, so it's concluded that age is one of the most important determinants between the two types of prostate cancer.

Knowing your family history is another way to stay on top of your risk level. The chances of developing an aggressive form of prostate cancer go up significantly if a man has a close relative with an aggressive form of the disease.

Race is another potential risk factor. Black men are more likely to get prostate cancer and more likely to die from low-grade (less likely to grow and spread) prostate cancer. The reason for this is still unknown, but they are twice as likely to have prostate cancer than men from any other race. For this reason, it is especially important for Black men to speak to their doctor about family history and screening options.

Like with so many cancers, staying healthy and physically fit reduces your risk of contracting prostate cancer. Weight control, regular exercise and healthy habits are thought to be protective. In fact, one explanation for increased ejaculation frequency being protective is that men who have sex more frequently generally have healthier lifestyles than those who have less sex.

Consulting with your doctor about family history, developing and maintaining healthy habits, and getting regular PSA screenings beginning at age 55 (sooner if your risk factors are numerous) are presently the best ways to monitor prostate health. Also, as mentioned above, if your doctor has not recommended a test for PSA levels, you can suggest this as something you'd like to have.

Science is close to answering some of the questions regarding cause and best management strategies, but more time is needed. In the meantime, surveillance and self-education are the best preventive tools.