PSA tests (prostate-specific antigen) are widely used in the United States to help identify men who may have a higher risk of prostate cancer. A recent study published by JAMA Oncology has described a unique new way to use the PSA test. The hope is that men who are likely to die early from prostate cancer which returns after an initial treatment, are able to be clearly pinpointed.

Data from a randomized trial of 157 men whose localized cancer was treated either with radiation alone or radiation combined with six months of androgen deprivation therapy was used by the researchers. The participants were then followed for 18 years post-trial.

The data collected during this trial showed that a PSA nadir — the lowest level a PSA reading drops after treatment — greater than 0.5 ng/ml appears to identify men who are at high risk for dying early as a result of their initial treatment failing.

Approximately 66% of all prostate cancer deaths in this country occur in males with localized cancer that ultimately spreads to other places in the body. This new method of using PSA testing can help doctors identify men who may benefit from more aggressive secondary treatment. It also may help get them this treatment earlier.

Experts urge men to be cautious of employing natural remedies instead of medicine therapy.

It is never easy for men to cope with prostate cancer. Some find that established treatments are not all that effective, leading them to try other “more natural methods” for the treatment of the cancer. Men are cautioned, however, to talk to their doctors before taking new herbs or supplements.

It has been estimated that 33% of men in America who have been diagnosed with prostate cancer try at least one form of alternative/complementary medicine therapy which includes supplements and herbs. There are some studies that have suggested that the use of certain herbs and supplements might actually be beneficial to prostate cancer treatment and support. However, many doctors are concerned that certain herbs mixed with certain supplements can cause unwanted interactions. There have also been cases where herbs and supplements have reacted negatively with prescribed medications.

St. John’s wort is one example. It can affect the liver and can act on certain enzymes in the liver which metabolize drugs.

Many men have taken saw palmetto for benign prostatic hyperplasia (BPH). Others have tried melatonin supplements in the hopes that it will slow the progression of prostate cancer. Both saw palmetto and melatonin may increase a man’s risk of bleeding when taken with other drugs like aspirin, ibuprofen, naproxen, anticoagulants, or antiplatelet medications.

It has not been proven that any herbs or supplements actually protect against prostate cancer or slow its growth. Some think that the inverse may actually be true.

What’s the bottom line? Unfortunately herbs and supplements are not miracle workers. “Some” may benefit “some men” with prostate disease. To be safe, all men should consult with their doctor about whether the physician supports any alternative choice of treatment, management, and prevention.

Although the only way to fully conclude that prostate cancer is present, a new study has suggested that MRI (magnetic resonance imagining) can be an effective tool in identifying which patients truly need a prostate biopsy and which patients do not need one.

Published online February 22, 2018 by JAMA Oncology, the study included 651 men screened for prostate cancer with blood tests and digital rectal exams. Each participant in the study underwent three separate procedures. The first was an MRI scan, the second procedure was a biopsy guided by transrectal ultrasound (TRUS), and the third procedure was a biopsy that was guided by both MRI and TRUS.

After undergoing all three procedures, 289 of the male participants were identified as having significant prostate cancer, defined as a Gleason score of 7 or higher. Researchers concluded that using the MRI scans to determine the need for biopsy could have avoided 38% of biopsies and still identified 89% of clinically significant cancers. They also determined that having an MRI first may be a productive step in helping men decide whether they need a biopsy.

The prostate gland is an important part of the male reproductive system.

The prostate is a gland situated between the bladder and penis, just in front of the rectum, or lower end of the bowel.

The urethra, a narrow tube that carries urine and semen out of the body through the penis, runs through the center of the prostate, which is about the size of a walnut and weighs 1 ounce (30 grams).

The word “prostate” comes from the Greek word “prostates,” which means “one who stands before,” aptly describing the position of the gland.

That is, when viewed from below, the prostate “stands before” the bladder.

The Function of the Prostate

The prostate gland isn’t essential for life, but it is vital for reproduction and is part of the male reproductive system.

The function of the prostate is to produce a slightly alkaline (high pH) fluid that makes up part of the seminal fluid, or semen.

The rest of semen is composed of sperm cells from the testicles, fluid from the seminal vesicles, and secretions from the pea-sized bulbourethral gland.

The prostatic fluid contains substances that are important to the functioning and survival of sperm cells, such as the enzyme prostate-specific antigen (PSA), which thins or loosens up semen, helping the tadpole-like sperm cells swim freely to reach the egg.

During an orgasm, prostate muscles squeeze the gland’s stored fluid into the urethra, where it mixes with the sperm cells and other semen components.

This expulsive process also helps propel the semen out of the body during ejaculation.

Prostatitis

Prostatitis, or prostate inflammation, is the most common prostate problem for men under age 50, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

There are several types of prostatitis.

Prostatitis caused by bacteria is known as bacterial prostatitis, and it can be acute (short-term) or chronic.

Non-bacteria microbes may cause chronic prostatitis, also known as chronic pelvic pain syndrome, which may develop as a result of chemicals in the urine, a urinary tract infection, or pelvic nerve damage.

Symptoms vary depending on the type of prostatitis, but can include urination problems, pain, fever, and body aches, among other things.

Some people develop asymptomatic inflammatory prostatitis, in which the prostate is inflamed but doesn’t produce any symptoms or require treatment.

Benign Prostatic Hyperplasia (BPH)

Prostate enlargement is the most common prostate problem for men over 50 years old, according to the NIDDK.

It’s not well understood what causes prostate enlargement, also known as benign prostatic hyperplasia (BPH), but research suggests age-related hormonal changes may be to blame.

In men with BPH, the prostate presses into and pinches the urethra.

This pressure can negatively affect the urine-holding bladder, which is connected to the urethra, by weakening it and preventing it from emptying completely.

Prostate enlargement can cause a number of related urination symptoms, including increased urinary frequency and urgency, weak or interrupted urine stream, and urine with an unusual color or smell.

Prostate Cancer

Aside from prostatitis and BPH, another common prostate issue is prostate cancer.

Excluding skin cancer, prostate cancer is the most common type of cancer affecting American men, and one of the leading causes of cancer deaths in American men, according to the American Cancer Society.

The risk of developing prostate cancer is higher for men who are over age 65, African American, and have a family history of the disease.

Most often, prostate cancer develops slowly, but some men develop an aggressive form of prostate cancer.

Symptoms generally develop as the disease progresses, and include urination issues, erectile dysfunction, bloody semen, and bone pain.

New research suggests that prostate cancer may be more aggressive in men who are deficient in vitamin D.

A study of nearly 200 men having their prostate removed found those with low vitamin D levels were more likely to have rapidly growing tumors than those with normal levels of the “sunshine” vitamin.

Some physicians think that if men with vitamin D deficiency are more likely to have more advanced disease at the time of prostate surgery, that it is possible men should be tested for this when they are diagnosed with prostate cancer. They have suggested that it might be a good idea to supplement the patients with vitamin D if they are deficient.

However, many other physicians believe that there is not enough evidence to recommend vitamin D supplements to either prevent prostate cancer or make it less aggressive.

The human body gets vitamin D from certain foods. These include fortified products (such as milk, orange juice and cereal), and certain fish (such as salmon), according to the U.S. National Institutes of Health. The body also makes the vitamin when the skin is exposed to sunlight. Dark-skinned people have more melanin, which prevents burning.

The study included 190 men having prostate surgery. The researchers found that nearly 46 percent of the men had aggressive cancer, and these men had vitamin D levels about 16 percent lower than men with slower-growing tumors.

After accounting for age, PSA levels and abnormal rectal exams, researchers found that vitamin D levels below 30 nanograms per milliliter (ng/mL) of blood were linked to higher odds of aggressive prostate cancer.

The report was published in the Journal of Clinical Oncology.

Researchers find that men who exercised the most had the best outcomes.

A new study suggests that sticking to a moderate or intense exercise regimen may improve a man’s odds of surviving prostate cancer.

The study, conducted by the American Cancer Society, included more than 10,000 men, aged 50 to 93, who were diagnosed between 1992 and 2011 with localized prostate cancer, which means that it had not spread beyond the gland. The men in the study provided researchers with information about their physical activity before and after their diagnosis.

According to the team of researchers, men with the highest levels of exercise before their diagnosis were 30 percent less likely to die of their prostate cancer than those who exercised the least.

The men who had the highest level of exercise seemed to confer an even bigger benefit: these men had the highest levels of exercise after diagnosis were 34 percent less likely to die of prostate cancer than those who did the least exercise.

The study results support evidence that prostate cancer survivors should adhere to physical activity guidelines, and suggest that physicians should consider promoting a physically active lifestyle to their prostate cancer patients.

The researchers also examined the effects of walking as the only form of exercise. They found that walking for four to six hours a week before diagnosis was also associated with a one-third lower risk of death from prostate cancer. But timing was key, since walking after a diagnosis was not associated with a statistically significant lower risk of death.

The American Cancer Society recommends that adults engage in a minimum of 150 minutes of moderate or 75 minutes of vigorous physical activity per week. Physical activity has been found to help all aspects of health.

Study also suggests that cholesterol-lowering drugs may help counteract harmful effect.

A new study suggest that what men eat; particularly fatty meats and cheese, may affect how quickly their prostate cancer progresses.

A recent study showed that high dietary saturated fat content was associated with increased prostate cancer aggressiveness. It may suggest that limiting dietary saturated fat content may also have a role in prostate cancer.

However, the study did not prove that diet directly affects prostate cancer behavior, only that there is a link between those factors.

The researchers looked at more than 1,800 men from North Carolina and Louisiana. All had been diagnosed with prostate cancer between 2004 and 2009. They were asked about their eating habits and other factors at the time of their diagnosis.

Higher intake of saturated fat from foods such as fatty beef and cheese was linked with more aggressive prostate cancer, the researchers found.

A diet high in saturated fat contributes to higher cholesterol levels, researchers said. They noted that the link between saturated fat and aggressive prostate cancer was weaker in men who took cholesterol-lowering statin drugs.

The researchers said that suggests that statins reduce, but don’t completely reverse, the effect that high amounts of saturated fat may have on prostate cancer.

The study also found that higher levels of polyunsaturated fats, found in foods such as fish and nuts, were associated with less aggressive prostate cancer.

Further research is needed to learn more about why a diet high in saturated fat is linked with more aggressive prostate cancer.

The researchers presented their findings April 18 at the annual meeting of the American Association for Cancer Research in New Orleans. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

According to a new study, a smokeless tobacco called snus may increase a prostate cancer patient’s risk of death.

Many people believe that smokeless tobacco is a less harmful alternative to smoking just because it lacks the combustion products of smoking that are most associated with cancer risks. Researchers have found that men with prostate cancer who were smokeless tobacco users were at risk of premature death.

Snus is readily available in the United States. Usually sold in tea bag-like sachets, the powdered tobacco product is placed under the upper lip for extended periods.

Researchers analyzed health check-up data from thousands of men. The investigators found that, compared with men who never used tobacco, those who used snus but did not smoke, had a 24 percent higher risk of death from prostate cancer during the study period. They also had a 19 percent higher risk of death from any cause.

Among patients whose cancer had not spread, those who used snus but did not smoke, were three times more likely to die from prostate cancer than those who never used tobacco, the study found.

The study was published in the International Journal of Cancer.

At the time of radical prostatectomy for prostate cancer, black men are more likely to have adverse pathologic features. Independent of socioeconomic and clinical factors, investigators came to this conclusion in a study presented at a Cancer Symposium.

According to researchers, these adverse pathologic features increase their risk of biochemical recurrence and more frequently lead to an indication for adjuvant radiation therapy.

Using the National Cancer Database, the investigators identified 313,013 men diagnosed with PCa from 2004 to 2014 and who underwent RP. The group included 256,315 whites (85%), 33,725 blacks (11%), and 12,973 patients of other races.

Significantly higher proportions of blacks than whites had Gleason grade group 2 cancer (46% vs 37.7%), PSA levels of 10 ng/mL or higher (18.5% vs 15.9%), and clinical stage T2b disease (17.8% vs 13.8%).

On multivariable analysis, the odds of having indications for adjuvant radiotherapy (pT3 disease or higher or positive surgical margins) were 21% greater among blacks than whites. Blacks had 26% greater odds of having positive surgical margins, but 23% lower odds of having pT3 or higher disease.

As for what might explain the findings, it was noted that black men may be more likely to harbor certain genetic polymorphorisms that give rise to more aggressive PCa. An autopsy study revealed that black men are more likely to have cancer in the anterior of their prostate, which could be a cause of pathologic upstaging. Another possibility is the low vitamin D, which has been linked to an increased risk of aggressive cancer. Black people in general have low vitamin D levels, possibly as a result of their darker skin.

According to the finding of three studies presented at the Genitourinary Cancer Symposiom, statins may improve overall survival among men with metastatic castration-resistant prostate cancer (mCRPC) and improve cancer-specific survival among those with high-risk prostate cancer (PCa).

In a post-hoc analysis of data from the randomized clinical trials COU-AA-301 and COU-AA-302, in which men with mCRPC were treated with prednisone plus placebo or abiraterone, researchers found that statin users had significantly better overall survival than non-users.

The reference group for both studies included patients in the placebo arm who did not use statins. Among statin users in the COU-AA-301 study, patients treated with prednisone plus abiraterone had a significant 29% decreased risk of death compared with the reference group. The investigators observed no significant decrease in death risk among statin users in the placebo arm.

In the COU-AA-302 study, statin users in the abiraterone and placebo groups had a significant 28% and 19% decreased risk of death, respectively, compared with the reference group.

In a completely separate study, researchers examined the effect of statin use on outcomes among patients with mCRPC receiving abiraterone, an anti-androgen that inhibits CYP17A1. Their analysis included 301 patients. Of these, 84 (28%) were statin users. The median overall survival for statin users and non-users was 16.2 and 11.3 months, a borderline significant difference in adjusted analyses.

The study authors concluded: “Although limited by sample size, our data showed a trend that statins may mildly enhance the anti-tumor effects of [abiraterone] in CRPC patients.”

The findings suggest that depletion of de novo cholesterol production may further limit androgen synthesis in concert with CYP17A1 inhibition.

In a population-based study of 12,700 men with high-risk PCa identified using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, researchers found that post-diagnostic use of statins is associated with a 47% lower risk of PCa mortality compared with patients with no documented statin use. Among obese patients, statin use was associated with a 62% decreased risk of PCa mortality. The investigators observed a synergistic effect of statins and metformin among patients with metastatic disease.