How Are Prostate Cancer Stages Determined
Once all testing has been completed, your doctor will tell you the stage of your cancer, or how much it has progressed and whether it has spread beyond your prostate. The stage will help your medical team decide which treatment is best for you. The higher the stage, the more advanced your cancer. The most common way to stage prostate cancer is the TNM system, developed by the American Joint Committee on Cancer, which hinges on three important factors:
T : How much of your prostate the tumor affects
N : Whether the cancer has spread beyond your prostate to nearby lymph nodes
M : Whether your cancer has metastasized, or spread far beyond your prostate to your bones, to nearby organs such as your bladder or rectum, or to more distant organs like your lungs, liver, or brain.
The TNM system also includes your PSA level and your Grade Group, based on your Gleason score. With your stage designated, which is labeled in a range of T1 to T4 , a treatment plan can be developed.
Study Raises Biological Questions
Researchers say the findings raise several questions about the biological role of sexual activity and ejaculation in the development of prostate cancer.
Leitzmann says that until now, sexual activity had been associated with prostate cancer risk due to the hormone hypothesis. The male sex hormone testosterone is known to spur the growth of prostate cancer cells and it also fuels the male sex drive. Therefore, it had been proposed that very sexually active men had a higher risk of prostate cancer because they had higher testosterone levels.
But he says this theory has its shortcomings because testosterone levels alone do not predict prostate cancer risk and they do not appear to correlate with sexual desire as much as previously thought.
Instead, researchers say ejaculation may protect the prostate through a variety of biological mechanisms that merit further research, such as:
- Flushing out cancer-causing substances. Frequent ejaculation may help flush out retained chemical carcinogens in the prostate glands.
Reducing tension. The release of psychological tension that accompanies ejaculation may lower nervous activity associated with stress and slow the growth of potentially cancerous cells in the prostate.
Promoting rapid turnover of fluids. Frequent ejaculation may help prevent the development of mini-crystals that can block ducts within the prostate gland, reducing cancer risk.
Finding Could Lead To New Behavioral Or Medical Strategies For Prevention
The research found an association between higher rates of ejaculation and cells producing more citrate. Lower citrate production is a distinguishing feature of prostate cancer.
Higher frequency of ejaculation is associated with lower risk of prostate cancer, as a previous study led by a Boston University School of Public Health researcher confirmed.
Now, Jennifer R. Rider, BU assistant professor of epidemiology, and her colleagues have found a clue as to why, identifying molecular-level changes in prostate tissue.
The study, published in European Urology, finds evidence that more frequent ejaculation affects the expression of 409 genes and six biological processes. The study may support the prostate stagnation hypothesis, where carcinogens accumulate in the prostate between ejaculations and affect cells genome and metabolic processes.
These molecular changes in the prostate persist for many years, says Rider, who served as senior author on the study. Understanding the biological links between ejaculation and prostate tumor development could lead to new behavioral or medical strategies for prevention.
Rider notes the study used sample tissue only from men with a prostate cancer diagnosis. Next, she says, we are interested in looking at whether expression of the genes and processes identified in the current study are able to predict future risk of prostate cancer development.
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Less Sex For Prostate Cancer Prevention
Another study published more recently in the same journal found that men who have lots of sex in their twenties and thirties are more likely to get prostate cancer, especially if they masturbate a lot.
This study, done at the University of Nottingham in England, also relied on questionnaires. The study participants included 431 men with prostate cancer diagnosed before age 60 and 409 men without prostate cancer. Among its findings were that men with prostate cancer are more likely to have had female partners, more likely to have had a sexually transmitted disease, and more likely to masturbate.
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Another study found that young men who reported more sexual activity actually had a slightly higher risk of developing prostate cancer in their 20s and 30s. But then, more frequent sexual activity seemed to be protective against prostate cancer at age 50 and beyond .
A 2018 meta-analysis of 21 studies reported that moderate ejaculation was significantly associated with lower cancer risk, but that doesnt prove the risk was lower due to ejaculating more. Additionally, researchers found men who had fewer sexual partners or started having sex later in life had a lower chance of cancer .
However, you need to take care when interpreting this data. There is no proof that frequent ejaculation can help prevent prostate cancer. Some research is leaning that way, but contradictory results like those in the studies above show more research is needed.
Scientists arent sure why masturbation and ejaculation may affect prostate cancer. The theory is that ejaculating more often regularly empties the prostate of irritants and toxins, which might be beneficial in preventing prostate cancerthis is also called the prostate stagnation hypothesis .
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Risk Factors For Prostate Cancer
Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesn’t mean that you will get prostate cancer. It just means that your risk of the disease is greater.
- Age. Men who are 50 or older have a higher risk of prostate cancer.
- Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
- Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a man’s relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
- Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.
Frequent Ejaculation May Reduce Prostate Cancer Risk: How Orgasm Protects Against Disease
During this years annual meeting of the American Urological Association in New Orleans, researchers affirmed what may be the first modifiable risk factor for prostate cancer: ejaculation.
A modifiable risk factor refers to the risks people can prevent through healthy habits, such as diet and exercise. Most of the risk factors for cardiovascular disease, for example, are modifiable the Centers for Disease and Control Prevention reported healthy habits could prevent at least 200,000 of the deaths caused by heart attack and stroke. But for something like prostate cancer, the risks stem more from individual genes and family history.
A 2004 JAMA study was among the first to suggest a modifiable risk factor, finding high ejaculation frequency may be associated with lower risk for prostate cancer. The present research builds upon these findings with the high quality data collected from nearly 32,000 men participating in the Health Professionals Follow-up study the men were followed for a total of 18 years.
At the start of the study, men aged 20 to 29 and 40 to 49 were asked to calculate the average number of times they ejaculated per month, including the number of times they ejaculated during the previous year. Researchers then used both averages to compute a lifetime average.
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Active Sex Life Cuts Prostate Cancer Risk
Having an active sex life in their 50s could protect men against prostate cancer, say researchers.
But greater levels of sexual activity among men in their 20s could increase their chances of developing the disease in later life, they warn.
Men who are very sexually active in their 20s and 30s are more at risk, a study shows. Researchers at Nottingham University conclude that keeping up a regular sex life rather than excessive activity in younger years followed by a fallow period is best for mens health.
Dr Polyxeni Dimitropoulou, now at the University of Cambridge, said: We were keen to look at the links between sexual activity and younger men as a lot of prostate cancer studies focus on older men as the disease is more prevalent in men over 50.
Men who are sexually active in their 50s had some protection from prostate cancer, a study has found
Hormones appear to play a key role in prostate cancer and it is very common to treat men with therapy to reduce the hormones thought to stimulate the cancer cells.
A mans sex drive is also regulated by his hormone levels, so this study examined the theory that having a high sex drive affects the risk of prostate cancer.
Engaging in sexual activity more than 20 times a month between the 20s and 30s increased the risk of prostate cancer, says a report in this months issue of the British Journal of Urology International. But frequent activity in a mans 40s and later appeared to have little impact on their risk.
Will Treatment Cause Erectile Dysfunction
When youre sexually excited, nerves cause tissues in your penis to relax, allowing blood to flow into the organ. The nerves that control erection are very delicate. Surgery or radiation for prostate cancer may damage them enough to cause ED. When you have ED, you cant get or keep an erection.
Radical prostatectomy is a surgery to remove the prostate gland. When your surgeon removes the gland, they may damage the nerves and blood vessels that run along it. If theyre damaged enough, you wont be able to get an erection following the procedure.
Today, doctors can do nerve-sparing surgery, which helps prevent permanent ED. Your surgeon can still touch those nerves and blood vessels, causing ED as a temporary side effect. Many men have trouble getting an erection for a few weeks, months, or even years after their procedure.
Radiation therapy also damages blood vessels and the nerves that control erection. Up to half of men who have radiation for prostate cancer experience ED afterward. In some men, this symptom will improve with time. Sometimes radiation side effects dont appear until a few months after the treatment. If ED starts late, it may not be as likely to go away.
A few treatments can help with ED until youre able to have erections on your own again.
Additional treatments include the following:
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What Is Prostate Cancer
Prostate cancer is the most common cancer among American men, right behind skin cancer. Prostate cancer is also the second most deadly cancer in American men. Prostate cancer is more frequent among African American men than it is among white men. Furthermore, African American men are more likely to die of prostate cancer than are white men.
The vast majority of prostate cancers are a type of cancer called adenocarcinoma. Adenocarcinomas arise from cells that produce fluids like mucus.
Does Sexual Activity Improve Prostate Health
Regular ejaculation enhances the immune systems response to the presence of cancer cells.
According to a report published in JAMA, men who reported having more than 20 ejaculations per month were 33% less likely to develop prostate cancer.
These measured ejaculations included sexual intercourse, nocturnal emissions, and masturbation. Researchers evaluated nearly 30,000 patients, of whom 1,449 developed prostate cancer.
Assuming the men answered the survey questions honestly, the results indicated that active sex life is not associated with higher cancer risk in most men.
An Australian study of 2,338 men also came to a similar conclusion. This study found that men who averaged 4.6 to seven ejaculations a week were 36% less likely to be diagnosed with prostate cancer before the age of 70 compared to men who ejaculated less than 2.3 times a week on average.
The study found no connection between prostate cancer and the number of sex partners.
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Ejaculation May Lower Prostate Cancer Risk
The findings, published in the April 7 issue of The Journal of the American Medical Association, 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.
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.
“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,” says researcher Michael Leitzmann, MD, an investigator at the National Cancer Institute in Bethesda, Md. Leitzmann conducted the research during a post-doctoral fellowship at Harvard University.
Leitzmann says researchers suspected that ejaculation frequency might be a marker of a healthier, more active lifestyle. But when they accounted for diet, exercise, and other risk factors for prostate cancer, the link between frequent ejaculation and lower prostate cancer risk remained.
When Should You Get Tested For Prostate Cancer
A blood test known as Prostate-Specific Antigen was once routinely given to all men over age 50 to check for elevated levels of a substance in the blood that might indicate prostate cancer. That recommendation was withdrawn in the early 2010s, because the test is imprecise and could lead to overdiagnosis and overtreatment. But in May 2018, the US Preventive Services Task Force issued its latest recommendation : Between the ages of 55 and 69, men should individually decide whether to screen for prostate cancer with a PSA test, after consulting with their doctor. Prostate cancer screening is not recommended after age 70 since there is no evidence it results in an increased lifespan.
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Can Frequent Ejaculation Protect Men From Prostate Cancer
Studies have found a link, although how frequent ejaculation may protect against prostate cancer is not well understood.
A number of studies have found a statistical connection between relatively frequent ejaculation and a reduced risk for prostate cancer. In one of the most comprehensive of these studies, from 2016, researchers at Harvard Medical School, Harvard T.H. Chan School of Public Health and Boston University School of Public Health found that men who ejaculated 21 times a month had a 20% reduced risk of developing prostate cancer compared with men who orgasmed four to seven times a month.
The researchers wrote that ejaculation frequency may be inversely related to the risk of prostate cancer. In other words, the more often a man orgasms, the less likely he is to develop prostate cancer. They followed 31,925 men from 1992 through 2010 3,839 were eventually diagnosed with the disease.
In 2018, a meta-analysis of 22 studies, published in the Journal of Sexual Medicine, confirmed the dose-response statistical association and provided additional findings. The researchers concluded that men with fewer sexual partner numbers, older age at first intercourse and moderate frequent ejaculation were associated with a significantly decreased risk of prostate cancer.
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Prostate Cancer Diagnoses And Treatment
All cancer is complex, but prostate cancer testing and treatment is particularly complicated.
In some men with prostate cancer, the cancer will grow very slowly, and wont significantly affect them during their lifetime. Other mens prostate cancer can grow and spread very quickly. At the moment, there is no test that can tell what type of prostate cancer a man has when he is diagnosed.
Because some treatments for prostate cancer can cause side effects which might impact on quality of life, its important for men to discuss with their doctor all their options for testing and treatment, and to discuss these with their partners and families. These might include watchful waiting, which means waiting to see what the cancer does over time, radiation, surgery or taking medications.
You can read more about what kinds of questions to ask your doctors about prostate cancer testing and treatment on the Cancer Council website.
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The Benefits And Drawbacks Of Frequent Sexual Intercourse
Lets take a look at both the benefits and the potential drawbacks that frequently participating in sexual intercourse may have in store for a man.
It is important to consider both the benefits and the drawbacks because ultimately, this will also help a man discover the potential pros and cons of frequent ejaculation.
Are Frequent Ejaculators Bacchanalian
A study on ejaculation and prostate cancer risk, which made a big splash at last years annual meeting of the American Urological Association , was March 29 in European Urology.
The publication provides greater detail on the main finding: that men might be able to lower their risk for prostate cancer by ejaculating frequently.
This large prospective study provides the strongest evidence to date of a beneficial role of ejaculation in prevention of prostate cancer, write the researchers, led by Jennifer Rider, ScD, MPH, a cancer epidemiologist at the Boston University School of Public Health.
However, another expert threw the requisite cold water on any firm conclusion.
Association does not mean causation, so one has to be cautious about interpretation, Janet Stanford, PhD, MPH, a prostate cancer researcher at the Fred Hutchison Cancer Research Center in Seattle, who was not involved in the study, said about the observational data.
The data come from 31,925 men in the prospective Health Professionals Follow-up Study, who were followed from 1992 to 2010. The average age of the men in 1992 was about 59 years.
During the 18-year follow-up, 3839 men were diagnosed with prostate cancer, and 384 of those cases were lethal.
In a 1992 questionnaire, men were asked to report their average monthly ejaculation frequency during three periods: age 20 to 29 years, age 40 to 49 years, and the previous year.
Safe sexual activity could be good for prostate health.
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