Prostate Conditions: Myths & Misconceptions

As prevalent as prostate cancer and enlarged prostates are among older men, there's a surprising amount of misinformation and misunderstanding about how the prostate works and what problems look like when they appear.

Here are a few common myths about prostate conditions and what you need to know about how they present themselves.

Myth: I'll automatically know if I have prostate cancer.

Reality: Prostate cancer often presents with zero symptoms until advanced stages. The cancer generally affects the peripheral zone of the gland, meaning the outside portions. Since these areas are not in contact with the urethra and don't cause urinary difficulties, many people fail to realize they have prostate cancer for a long time. In fact, the vast majority of people who develop prostate cancer show no symptoms in early stages.

Symptoms, especially in later stages, include:

• Blood in the urine or semen
• Urinary trouble such as a weak stream or increased need to urinate
• Difficulty achieving or maintaining an erection
• Pain in the hips, back or chest once it has spread to the bones
• Weakness or numbness in the feet and legs
• Loss of bladder or bowel control

Myth: An enlarged prostate is an inevitable function of aging and there's nothing I can do about it.

Reality: While it's true 50 percent of men in their 50s develop an enlarged prostate, about 50 percent don't. Many treatment options are available. Typical symptoms of an enlarged prostate, known as benign prostatic hyperplasia (BPH), include urinary issues such as:

• A frequent and/or urgent need to urinate
• Feeling as though your bladder is always full
• A weak stream or dribbling as you finish
• Trouble starting to urinate

For men who have mild symptoms, watchful waiting is often the first choice with BPH.

You can also incorporate natural treatments and lifestyle changes, such as cutting out beverages—caffeine and alcohol in particular—before bed. Some over-the-counter medications, such as antihistamines and decongestants, can exacerbate prostate problems.

Men with moderately to severely enlarged prostate glands have several classes of drugs available to help: alpha blockers, 5-alpha reductase inhibitors (5-ARIs) and phosphodiesterase 5 inhibitors (PDE5 inhibitors).

If BPH leads to the inability to urinate, kidney damage or constant urinary tract infections (UTIs), minimally invasive surgical options are also available.

Myth: A prostate cancer diagnosis means immediate surgery is needed.

Reality: Prostate cancer is slow-developing and is often left for long periods of observation, or "active surveillance."

A diagnosed prostate cancer that isn't causing symptoms is often a type expected to grow slowly, is confined to the prostate, or is linked to a low prostate-specific antigen (PSA) score. In these cases, especially with older men, doctors may recommend periodic prostate exams such as PSA testing every six months, a digital rectal exam (DRE) every six months to a year, and biopsies every one to three years as the best course of action.

If someone younger develops prostate cancer, the push for surgery or radiation therapy is usually more urgent, since it's assumed the cancer will become a problem over the course of the next 20 to 30 years.

Myth: Vasectomies cause prostate cancer.

Reality: Getting snipped poses no additional prostate cancer risk. A persistent myth around vasectomies has been that they increase your chances of getting prostate cancer. A Harvard University study published in 1991 suggested an increased risk of advanced, aggressive prostate cancer in men who had vasectomies and was touted for many years as a warning.

However, multiple subsequent studies show the increased risk is negligible at best.

Choose the facts

Despite all the myths out there, one fact is certain: Males over age 50 should be proactive about discussing prostate screenings with their doctors. Given the overwhelmingly positive prognosis trend for people who detect prostate cancer early, testing is worth it.