Your need-to-know prostate health guide

Health stats for men in New Zealand make depressing reading. Statistically, a boy born today is predicted to live nearly four years less than a girl born in the room next door. He will be more than 20 per cent more likely to die of a heart attack than the girl, and almost 30 per cent more likely to get diabetes. Worse, he is three times more likely to die by suicide. We are putting the spotlight on men’s health issues in the lead up to Movember, focusing on what guys need to know and need to do to ensure they can live well for longer. This article on prostate health is the first in our series.

It starts out the size of a walnut, but the prostate can cause big health problems for men, especially in mid to later life. As part of our men’s health series, we look at what can go wrong with this gland in the male reproductive system, symptoms that can indicate there is an issue, diagnosis and treatment and prevention.

Common prostate problems
The three most common prostate problems are inflammation (prostatitis), enlarged prostate and prostate cancer.

Prostatitis (inflammation)

Prostatitis is an inflammation of the prostate gland that may result from a bacterial infection. It affects at least half of all men at some time during their lives. Having this condition does not increase your risk of any other prostate disease.

Symptoms include:

• Trouble passing urine
• A burning or stinging feeling or pain when passing urine
• Strong, frequent urge to pass urine, even when there is only a small amount of urine
• Chills and high fever
• Low back pain or body aches
• Pain low in the belly, groin, or behind the scrotum
• Rectal pressure or pain
• Urethral discharge with bowel movements
• Genital and rectal throbbing
• Sexual problems and loss of sex drive
• Painful ejaculation (sexual climax)

Your GP can diagnose this condition with a urine sample, blood test or digital rectal exam. Generally the treatment is a course of antibiotics.`

Enlarged prostate

Men in their 20s have a prostate the size of a walnut but by the time they hit 40, 40, it may have grown slightly larger, to the size of an apricot. By age 60, it may be the size of a lemon! This growth can affect the flow of urine and if left untreated can lead to a weak bladder, bladder or kidney infections, or even a complete block in the flow of urine leading to kidney failure.

This condition is not linked to cancer and does not increase the risk of getting prostate cancer—yet the symptoms can be similar. They include:

• Trouble starting a urine stream or making more than a dribble
• Passing urine often, especially at night
• Feeling that the bladder has not fully emptied
• A strong or sudden urge to pass urine
• Weak or slow urine stream
• Stopping and starting again several times while passing urine
• Pushing or straining to begin passing urine

If you start to experience any of these symptoms, it’s time to book an appointment with your GP to get it checked out. Some men with an enlarged prostate have only mild symptoms and don’t need treatment. Others can relieve or reduce their symptoms with medication or surgery.

Prostate cancer

Prostate cancer is one of the most common cancers among men worldwide. It’s estimated that over 1.4 million men are diagnosed with prostate cancer annually.

Here in New Zealand, every year more than 4000 men are diagnosed with prostate cancer and more than 700 die from the disease.

The good news is that despite the prevalence of prostate cancer, survival rates are high when it’s detected and treated early. The Prostate Cancer Foundation of New Zealand reports that while the number of men diagnosed in New Zealand is increasing, largely due to increased rates of testing, the death rate is slowly dropping, due to better outcomes from early diagnosis and improved treatments available.

The symptoms of prostate cancer are similar to other prostate or urinary function issues which is why it’s so important to get these checked out as soon as they occur. They include:

• Decreased force of the urine stream
• Pain and/or difficulty when passing urine
• Passing urine more frequently (especially at night)
• Blood in the urine or semen (never ignore this)
• Inability to pass urine (this can occur as the tumour enlarges, blocking the urethra).
• Pain in lower back, upper thighs or hips
• Bone pain
• Unexpected weight loss

Checks for prostate cancer symptoms normally involve a blood test, called the PSA test and a digital rectal examination (DRE).

Even if you don’t have any symptoms, talk to your doctor about when you should begin these tests as part of your routine healthcare regime. For most men, it’s at around the age of 50.

Your risk is higher if your father, brother or uncle had prostate cancer. It’s also higher if your mother or sister had breast or ovarian cancer. So if there’s a family history like this, start talking to your doctor about prostate cancer when you’re 40.

Race and ancestry also play a role Black men and men with African ancestry should talk to their doctor about testing at around 40.

Keeping your prostate healthy
There’s no guaranteed way to prevent prostate issues or prostate cancer. However, an active and healthy lifestyle may help reduce the risk. Here are a few things than can help.

Eat a healthy diet

Try to stick to recommended food guidelines. Eat more fruit and vegetables, whole grains, and lean proteins, and less processed food. Reduce your fat intake, especially trans fats and saturated fats. The antioxidant lycopene, which is plentiful in cooked or processed tomatoes, has been shown in some studies to slow the growth of prostate cancer cells. Cruciferous vegetables (e.g., broccoli and cauliflower) contain a compound called sulforaphane that may protect against cancer. Clinical trials have also suggested that soy may lower PSA levels

Watch your weight
This is good advice for staying healthy and preventing many types of cancers but it’s been shown that obesity can be a risk factor for developing more aggressive prostate cancer.

Drink less alcohol and more green tea
Alcohol is known to be inflammatory, and excessive consumption can increase prostate inflammation. Studies have also shown it can increase the growth rate of prostate tumours. The experts at John Hopkins says green tea and hibiscus tea are among the top drinks for prostate health. Both types of tea contain potent antioxidants. Studies show that green tea can help prevent prostate cancer from forming and may also slow the growth of aggressive prostate cancer. Studies show that green tea can also benefit men with an enlarged prostate and prostatitis.

Exercise, exercise, exercise
Regular exercise improves not only your physical health, but also helps with your general wellbeing. Aim for at least three hours a week.

Reduce stress
According to the Prostate Cancer Foundation, stress negatively affects prostate health. In fact, some men unknowingly tighten their pelvic muscles when stressed. This chronic tightening can create pelvic floor muscle problems and can be one of the causes of chronic prostatitis.

Stress can also affect men with an enlarged prostate. Stress can worsen symptoms such as urinary urgency, urinary frequency and pain.

Get checked
The most important thing you can do is take symptoms seriously. This means talking to your doctor, understanding the risk factors, and, if recommended, undergoing testing.

Te Atatu Toasted is supporting men’s health as part of the Movember movement. This article is part of our men’s health series.