Navigating life and living with prostate cancer

Author: Joh-Ann Gouws

Physiotherapist with a special interest in pelvic health

Prostate cancer is one of the most common cancers affecting men (people with a penis) worldwide. Even though survivorship has increased over the years, it is still responsible for many cancer-related deaths. In New Zealand, it is the second most common cancer resulting in death in men, after lung cancer only. With advancements in detection and treatment, the hope is that more men will be diagnosed in the early stages while curative treatment has better outcomes.

The prostate is a gland situated below the bladder and is responsible for producing seminal fluid that nourishes and transports sperm. Not all prostate problems are related to cancer, sometimes enlargement in this land can lead to serious problems too.

Prostate cancer is diagnosed when the cells of the prostate gland grow and divide uncontrollably, forming tumours. Cancer can come in many shapes and sizes, some will grow slowly and some will grow really aggressively, sometimes spreading to areas outside of the prostate. When you and your doctor discuss appropriate treatment options, your doctor will need to understand the type of cancer, the growth rate and if the cancer is localized inside the prostate or has spread to other areas in the body.

How will you know you have prostate cancer?

In many people diagnosed with prostate cancer, there are no signs or symptoms present. The only way to know if you have prostate cancer is to screen for it.

Routine screening in the right cohort of the population is the most effective way to detect prostate cancer early, when treatment has better outcomes.

Screening is done through a simple blood test measuring PSA levels. This measures your Prostate-specific antigen. Levels that are high, could be an indicator of prostate cancer, although other factors can also elevate your PSA levels. This is the reason why this blood test may sometimes be repeated or considered in relation to other medical tests and information.

Some practitioners will still do a digital rectal exam, where one gloved and lubricated finger is inserted to feel for tissue changes in the prostate.

If prostate cancer is suspected, other scans like and MRI is useful to detect suspicious areas and a tissue biopsy will be done to look at the changed tissue under a microscope and confirm the type of cancer present.

Are some people more at risk than others?

Certain factors increase the risk of developing prostate in men (people with a penis), including:

Family history: Having a direct family member with prostate cancer or hormone regulated breast cancer increases your risk of developing prostate cancer.

Age: The risk of being diagnosed increases significantly after the age of 50. It is therefore important for all men to have a routine annual PSA screen after the age of 50. If you have a family history, it is recommended you start screening at the age of 45.

Race: African-American men are at a higher risk and are often diagnosed with more aggressive or more advanced forms of disease.

Diet and Lifestyle: A diet high I fat, obesity and a sedentary lifestyle can contribute to an increased risk.

What are your options to treat prostate cancer?

Treatment options should be individualized to your own circumstances and requirements. Your doctor will consider the stage of cancer, your age and general health to narrow down the options available to you. You should however have a thorough discussion on all the options available to you, be informed of the risks and benefits and expected outcomes of each treatment and given time to make an informed decision.

Some options include the following amongst others:

Active surveillance: If you are on this pathway, your cancer will be closely monitored over time and further options will be considered as needed.

Surgery: Removing the prostate surgically may be an option if the cancer has not spread outside of the prostate itself.

Radiation therapy: This can be done in different ways to target the cancer cells.

Immunotherapy and hormone therapy: Other treatments to target cancer cells or slow down the rate of growth.

Not all of these options are necessarily used and available in every country. It is therefore essential to discuss the options available to you.

Are there any lifestyle changes you can make to reduce your risks?

Not all risk factors can be controlled or changed, we can’t for example change our age or genetics but others can be lowered with lifestyle changes.

Eating a healthy diet with enough fruits, vegetables and whole grains and that is low in red meat and high fat foods is encouraged to help mitigate the risk.

Regular physical activity helps with general health but also helps to maintain a heathy weight. Obesity has been linked to more aggressive forms of prostate cancer and therefore, weight management is vital in navigating this risk.

Limiting alcohol and quit smoking if needed can contribute to lowering cancer risk.

What can you do to cope with a prostate cancer diagnosis?

Receiving a prostate cancer diagnosis can be overwhelming and there will be many variables that are completely out of your control, but using support services and coping strategies can help you through this time.

It is helpful to take a support person with you to your healthcare appointments. Having another set of ears to hear all of the information said and talk it over with after appointments can be a good way to ensure you don’t miss or misinterpret health information.

It may also help to take a list of questions with to your appointments so you know that you get all the information you need and write down important information during these appointments or ask your provider for a printout of what you need to know.

Having knowledge empowers you. Many countries will have charitable organizations dedicated to prostate cancer in the form of a foundation or society where you can access good quality information and other resources. Look up an organization like this in your country and use the sources they make available.

Joining a support group can connect you and even your family with others facing similar experiences and challenges. It is also a good way to connect socially, have a safe space to unload emotionally and get guidance on the specific aspects you may need help with during this journey.

Prostate cancer affects many men and navigating the journey from diagnosis to treatment and beyond may come with challenges for you and your loved ones. Understanding your unique risk factors and ways to reduce this is one step in improving overall health. Equipping yourself with the knowledge needed to make an informed decision when discussing treatment is a way to empower yourself in this shared decision-making process. Although it can be frightening to face a prostate cancer diagnosis, with support and the right treatment for you, you can be proactive in living the life you would like to.