How Do Doctors Diagnose Prostate Cancer
Ok, by now, youve been screened. Your PSA score and/or your DRE have raised concerns. Whats next?
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Multiparametric magnetic resonance imaging . This useful imaging test produces different types of scans to give your doctor a fuller picture of your prostate. Your doctor can then target suspicious areas for biopsy and testing.
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Transrectal ultrasound. Your doctor inserts a finger-sized probe into your rectum. The probe emits waves of sound that bounce off your prostate. Those waves create images, called sonograms, that help your doctor evaluate your prostate and spot abnormalities. This procedure is frequently done as part of a biopsy.
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Biopsy. This procedure removes tissue from your prostate. Images from the multiparametric MRI are matched to images created by the ultrasound to pinpoint exact the spots that need to be tested.
Before your biopsy, your doctor will numb the area around your prostate so you dont feel pain. However, you may experience some discomfort or feel pressure during the procedure. Then, a thin, hollow needle is inserted into your prostate to remove small tissue samples. Its most often guided by an ultrasound probe thats inserted into your rectum. The whole thing takes about 20 to 30 minutes.
A Chicken And Egg Situation
Sadly, this is a chicken and egg situation. For men facing lower urinary tract symptoms of frequency, urgency, slow flow, and dribbling, the first-line treatment are alpha-blockers. They are known to relax the prostate to ease urine flow.
If medications do not work, doctors will try surgical methods starting with minimally invasive techniques. However, they may sometimes recommend removing the prostate altogether.
This is known as radical prostatectomy. Transurethral resection of the prostate is a surgical procedure that is known to relieve symptoms of BPH.
Men who have this procedure often experience sexual side-effects after surgery. According to the Harvard Medical School, between 50 to 75% of men who underwent TURP experienced retrograde and dry ejaculation.
Most men will experience relief of urinary problems. Some even experience improved blood pressure.
One of the complaints encountered by sufferers is retrograde ejaculation. This is caused by the easing of the prostatic sphincter, resulting in the semen going backward.
The operation to correct the BPH can either be carried out with TURP or laser done by simply coring out a cavity to allow a better flow of urine with minimal resistance.
The adverse effect of retrograde ejaculation is both undeniable and unavoidable. But the degree of compromise on erectile rigidity is still unclear and hotly debated.
For more information on prostate surgery click here.
Symptoms Of Prostate Cancer
In its early stages, prostate cancer doesnt necessarily cause symptoms. Men with prostate cancer might experience some of the following symptoms:
- needing to pee frequently or suddenly
- finding it difficult to pee, including trouble getting started or maintaining a strong or steady flow
- feeling like you havent completely emptied your bladder after going to the toilet
- pain, burning or discomfort when peeing
- blood in pee or semen
- or pain in the lower back, upper thighs, hips or chest
- feelings of weakness or numbness in the legs or feet
- unexplained weightloss
- feeling tired, short of breath or dizzy
- a rapid heart beat
- pale skin.
Youll notice a lot of these symptoms are similar to symptoms of other conditions, including an enlarged prostate or prostatitis, which is why its important to always see your doctor if you notice any of these symptoms or changes.
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Can Anything Be Done For Erectile Dysfunction Caused By Prostate Cancer Treatment
Yes, there are things you can try if you have erectile dysfunction after your prostate cancer treatment. You should keep in mind that the following things will affect your ability to have an erection after your prostate cancer treatment:
- How good your erections were before your treatment
- Other medical conditions you have like high blood pressure or diabetes
- Some types of medicines you may take such as medicines for high blood pressure or antidepressants
- Things you do in your life such as drinking or smoking
- Your age
- The type of prostate cancer treatment you had
It is important that you and your partner speak with your doctor or healthcare team about what you can do. Your doctor or healthcare team will speak with you about what might work best for you if you have erectile dysfunction. It is important that you speak with them since some treatments for erectile dysfunction can affect other medical problems you may have.
Types of treatment for erectile dysfunction include:
How Does The Treatment For Bph Cause Erectile Dysfunction
Alpha-blockers
Alpha-blockers including alfuzosin, doxazosin, tamsulosin and silodosin relax smooth muscles, especially in the bladder neck and prostate which can improve urine flow. However, while they can be helpful in relieving BPH symptoms, in some patients they may also cause unwanted side effects such as impotence , dry orgasm , and a decrease in the production of seminal fluids.
5-alpha reductase inhibitors
Research has shown that men who take these drugs for an enlarged prostate could be at higher risk for sexual problems, especially erectile dysfunction , low libido, and trouble ejaculating.
5-alpha-reductase inhibitors represent a type of drug that is used to treat both BPH and androgenic alopecia . Two examples of 5-alpha-reductase inhibitors are dutasteride and finasteride. These drugs are considered safe and effective for these two conditions, but they could have sexual side effects.
In a study published in 2016 by the Journal of Sexual Medicine, Chinese researchers analysed seventeen studies on 5-alpha reductase inhibitors and sexual function. The study included almost 17,500 men with an average age of 60 years. About 55% of men were treated with 5-alpha-reductase inhibitors while the rest received placebo.
Another study performed by the researchers from the Boston University School of Medicine showed that ED associated with long term use of finasteride for the treatment of BPH appears to worsen.
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What The Research Says
Steps to reduce cancer risk often include a lot of things you shouldnt do. So, it may be welcoming news to learn that something many men find pleasurable may help reduce your risk of prostate cancer.
Researchers dont understand exactly why frequent ejaculation might provide protection against prostate cancer. One theory is that ejaculation rids the prostate gland of cancer-causing materials, infection, and matter that can cause inflammation.
Despite strong evidence in favor of frequent ejaculation, the theory remains controversial. And there are . The greatest controversy regarding these studies is about the age when ejaculation occurs.
A 2008 determined that men were more likely to develop prostate cancer if they were very sexually active in their twenties and thirties. The study also found no conclusive evidence that masturbation provide greater risk than intercourse.
Prostate cancer is the second most common kind of cancer men get. Skin cancer is the most common cancer. In the United States, one in seven men will get prostate cancer at some point in their life.
The following factors affect your risk of getting prostate cancer:
You may also have an increased risk if youve had sex with 30 or more women or if youve had a sexually transmitted disease. This may be because of your sexual habits. Alternately, it could be that you have a stronger sex drive due to higher levels of male hormones, which can be a risk factor.
Frequent Sex May Be Protective
Hence, not until very recently, the mainstream hypothesis had been too much sex might provoke the development of prostate cancer but a recently published research study thinks the direct opposite, postulating that frequent sex may be a protective factor in prostate cancer.
The findings, published in the April 7 issue of The Journal of the American Medical Association and reviewed on webmd.com, are based on data collected from nearly 30,000 predominately white men aged 46 to 81.
At the start of the study, men provided information on ejaculation frequency in their 20s, 40s, and in the previous year . Ejaculation frequency included sexual intercourse, masturbation, and nighttime ejaculations that can occur during sleep. The men were then monitored for eight years.
Ordinarily, researchers found most categories of ejaculation frequency were unrelated to prostate cancer risk. But when they looked at men in the highest category of ejaculation frequency , they found evidence of a protective effect.
According to Michael Leitzmann, MD, an investigator at the National Cancer Institute in Bethesda, USA, who conducted the research during a post-doctoral fellowship at Harvard University, when you look at the data in a little bit more detail, you do see that not only is there not an increased risk, but there is potentially even the possibility of a slight decrease in risk with high ejaculation frequency.
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Ways An Enlarged Prostate Could Affect Your Sex Life
Prostate enlargement and erectile dysfunction are separate problems. Both increase with age, but one causes problems in the bathroom and the other in the bedroom. However, the two are somewhat linked.
Certain treatments that relieve enlarged prostate can cause ED and other sexual side effects. On the other hand, treating ED can improve enlarged prostate symptoms.
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1. Postsurgical problems Prostate enlargement can interfere with urination. It can cause sudden urges to urinate, urinary frequency, inability to empty the bladder, or a weak urine stream. A surgery called transurethral resection of the prostate can help relieve these symptoms. But, men who have this procedure often experience sexual side effects after surgery.
Between 50 and 75 percent of men experience retrograde ejaculation after TURP. This means that semen released during orgasm enters the bladder rather than exiting the penis. Retrograde ejaculation, sometimes called dry orgasm, is not harmful but can impair male fertility.
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2. BPH Treatment and Erectile Dysfunction Some men who have the TURP procedure also experience erectile dysfunction, the inability to achieve or maintain an erection. This is not a common side effect of the surgery, but it is possible in 5 to 10 percent of men who have TURP.
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Prostate Cancer And Sexual Health
A prostate cancer diagnosis can leave you feeling anxious, frustrated, and depressed.
It may also leave you wondering about your ability to have sex. You may also be questioning how prostate cancer treatment can affect your sex life.
Prostate cancer rarely causes problems with sex, but the treatments for prostate cancer often affect penile function and reproduction.
Prostate surgery and radiation are the two most common treatments for prostate cancer. Both of these can affect the nerves in your penis and could cause sexual problems like erectile dysfunction .
Cryotherapy and ultrasound therapy can also cause ED. Your doctor may recommend hormone therapy or radiation therapy, as well. This therapy can lower your sex drive.
Radical prostatectomy is the most effective nerve-sparing surgery for prostate cancer. It can substantially limit the duration of post-surgical ED but requires a surgeon to be highly skilled and trained in the process.
In this type of procedure, the surgeon takes care not to damage the erectile nerves that surround the prostate as it is removed.
However, if cancer has infiltrated these nerves, it may not be possible to save them.
Preventing injury to these nerves dramatically improves the chances of a man recovering erectile function within two years of the surgery.
In addition to ED, you may also find that your orgasms are different after undergoing treatment for prostate cancer.
They may not feel as strong, and you will not see as much ejaculate.
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Does Having More Ejaculations Lessen The Chance Of Prostate Cancer
For reasons not fully known, ejaculating more may lower the risk of prostate cancer.
Ejaculating after all, based upon some studies, through sexual intercourse or masturbation, does not seem to protect against higher risk prostate cancers. The studies do not sort out between ejaculating during sexual intercourse or masturbation, and the effect of each on prostate cancer.
One study followed 32,000 men for 18 years. It found men who ejaculated the most had a 20% lower chance of prostate cancer vs. those who ejaculated 4 to 7 times a month. The more the number increased per month, the lower their risk. Other studies have found ejaculation rate has no impact on prostate cancer rates.
Ejaculation may protect the prostate by flushing out harmful chemicals that build up in semen. It is also possible ejaculation does not actually protect against prostate cancer. Men who ejaculate more may have healthier lifestyle habits;that decrease their odds of being diagnosed with the disease. Additionally, ejaculating may only reduce the risk in men in certain age groups.
The bottom line is more research is needed before we know for sure whether more ejaculation reduces the risk of prostate cancer.
Dr. Anne Calvaresi is the chair of the Urology Care Foundation’s Prostate Health Committee. She works in Philadelphia and specializes in urology and prostate health.
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Can Sex Increase The Risk Of Prostate Cancer
18 September, 2018
Number of sexual partners, age at first intercourse, and ejaculation frequency appear to influence a mans risk for prostate cancer, according to new research.
The notion that sexual activity might affect prostate cancer risk has been controversial. A meta-analysis published in 2002 reported that increased ejaculation frequency and having more sexual partners were associated with prostate cancer risk, but age at first intercourse was not.
Since then, more research has been conducted. The current study incorporated the newer studies and applied a dose-response analysis to the data to determine the roles of the above factors.
The research team searched relevant databases and identified twenty-two studies on the topic published through April 2018. Overall, the studies included 55,490 participants from nine countries. Most studies came from North America, but Europe, Australia, Asia, the Caribbean, and Cuba were also represented.
They found that men with fewer sexual partners were at lower risk for prostate cancer. For every 10 female partners the men had, their risk increased 1.10 fold.
First intercourse at an older age also seemed to lower prostate cancer risk, which was decreased 4% for every five years of delay.
However, hormonal levels, injury, and inflammation might also be involved, the authors noted.
Additional research is needed to validate these findings, the authors said.
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Common Causes Of An Enlarged Prostate
This information can best be found in more detail at the 3DProstate Clinic by Dr. Song, perhaps the best urologist in the world in this author’s opinion. I quote him here:
There are many reasons that can cause an enlarged prostate, and here are some of the most common:
1) Genitourinary infections, like prostatitis, seminal vesiculitis, urethritis, cystitis, verumontanitis can make the prostate tissue continuously congested,and result in prostate enlargement.
2) Excessive sexual activity and masturbation can cause the prostate tissue to congest repeatedly, with eventual prostate enlargement.
3) Chronic, long-term drinking and eating an excess of rich and spicy food will irritate the prostate, make it congested, and cause prostate enlargement.
4) Lack of exercise can lead to artery hardening and poor prostate blood circulation and can also result in prostate enlargement.
5) Long-term tension and pressure, and vegetative nerve dysfunction can also cause a microcirculation problem in the prostate, and result in prostate enlargement.
6) Retaining urine for too long makes urine highly concentrated with decreased frequency, leading to an ingress of toxins in the body, and urine reflux into the prostate during urination. Any pathogenic/toxic elements in the urine will affect the prostate and make it enlarged.
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Sexual Side Effects Include Erectile Dysfunction And Premature Ejaculation
An enlarged prostate is often treated with medication or surgery. However, these approaches can have sexual side effects that are not always discussed with patients, according to a recent report in the World Journal of Urology.
Many patients are unaware of the possible sexual side effects as a result of prostate cancer treatments.
The association was especially strong for younger and older men, the study found.
Erectile dysfunction and ejaculatory disorders like premature ejaculation are among the most common side effects.
When researchers surveyed 245 healthcare providers , they discovered that many did not discuss the sexual side effects of BPH treatment. In addition, many did not discuss treatment alternatives if their patients had sexual concerns.
Some treatments for an enlarged prostate and related urinary symptoms have sexual side effects. However, doctors dont always let patients know about them, according to a recent survey.
The medical term for an enlarged prostate is benign prostatic hyperplasia . As men get older, their prostate gland grows inward. For some men, the process causes urinary problems, since the enlarged tissue squeezes the urethra.
For the study, researchers surveyed 245 healthcare providers who were attending the 2015 World Congress of Endourology in London. Eighty-one percent of the respondents were urologists, specialists that typically treat an enlarged prostate.
The study was published online in April in the World Journal of Urology.
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