A major concern of many cancer survivors is whether they will have to face cancer again. When a cancer comes back after treatment it is technically a “recurrence”. However some survivors may develop a new and unrelated cancer which is termed a “second cancer”.

Men who are being treated for prostate cancer can indeed get another cancer, and in fact they might be at higher risk for certain types including cancers of:

• The small intestine
• Soft tissue
• Bladder
• Thyroid
• Thymus
• Melanoma of the skin

In addition, men who are treated with radiation therapy also have a higher risk of:

• Rectal cancer
• Acute myeloid leukemia (AML)

It is believed that the higher risk could be related to the dose of radiation.

There are ways to lower the risk of getting a second cancer

Prostate cancer patients can take steps to lower their risk of second cancers. One example is that prostate cancer survivors should do their best to stay away from all tobacco products and tobacco smoke. Smoking has been shown to increase the risk of bladder cancer after prostate radiation, as well as increase the risk of many other cancers.

There are other steps to take to help maintain overall good health:

• Get to and stay at a healthy weight
• Stay physically active
• Eat a healthy diet focusing on fresh foods
• Limit alcohol to no more than two drinks per day

As an added bonus, taking steps may also lower the risk of other types of health issues.

There are decades of research that show that yoga can reduce the emotional and physical fatigue brought on by cancer treatment. Scientists reported in 2017 that this is also true specifically for men undergoing treatment for prostate cancer. Researchers found that men who took a yoga class twice a week during prostate cancer radiation treatment reported less fatigue, fewer sexual side effects, and better urinary functioning than men who did not.

The research team that studied this connection enrolled 50 men ages 53 to 85 who were diagnosed with early or advanced non-metastatic prostate cancer. Of them, 22 were assigned to yoga classes and the rest did not participate in yoga. All the men received scheduled radiation treatments; 29 of them were also on hormonal therapy, and 19 had been treated previously with surgery. The yoga and control groups were evenly balanced with respect to various cancer treatments as well as treatments for side effects.

Eischens yoga was the type of yoga assessed in the study. It focuses on holding and maintaining poses, and is accessible for all body types and experience levels. The yoga sessions each lasted 75 minutes. The men in the nine-week study were asked to rate their fatigue, sexual and urinary symptoms before, during and after the study ended.

The male participants in the yoga group reported improving or stabilizing symptom scores over time, whereas men in the non-yoga group reported worsening symptoms. The study authors speculated that yoga improves erectile and urinary function by strengthening core muscles and improving blood flow.

“If I eat a healthier diet can it help me fight prostate cancer?” This is a question men newly-diagnosed with prostate cancer often ask their doctors.

There have been several studies that have shown that in countries where men eat a typical “Western” diet containing a large amount of meat, the incidence of prostate cancer, especially aggressive prostate cancer, is higher than in countries where plant-based foods are a primary part of the diet.

Although researchers are currently studying the subject, there a no definitive answers between the correlation of prostate cancer and diet.

There was a federally-funded national study where investigators looked at whether a diet that’s higher in plant-based foods and lower in animal-based foods than the typical “Western diet would help control tumor growth in men with early-stage prostate cancer.

This study called The Men’s Eating and Living (MEAL), included men 50-80 years old who had small, low-grade tumors and who opted to have their condition followed closely (active surveillance) rather than undergoing immediate treatment. The researchers randomly assigned participants telephone counseling support to tell them how to achieve the dietary MEAL goals or to a control group that received standard dietary advice for Americans.

The study participants in the MEAL group were instructed to eat nine servings of fruits and vegetables daily — significantly more than the three to four servings consumed each day by the typical American man — as well as two servings of whole grains and one serving of beans or other legumes. The participants in the control group received information regarding a standard healthy diet.

The initial results of the study showed that men with prostate cancer can sustain a healthier eating pattern. However there was no significant effect of the MEAL diet on two-year clinical progression among men on active surveillance for prostate cancer. Longer term benefits are still possible.

Patients who have suffered a heart attack and plan to undergo prostate cancer treatment, may want to weigh the risks and benefits of androgen deprivation therapy (ADT). ADT decreases the amount of androgens in the body, which prostate cancer needs to grow and survive. This therapy is also often used in combination with radiation therapy. The combination of these two therapies has been shown to prolong survival in men with unfavorable-risk prostate cancer—defined as cancer with two or more high-risk factors, such as a PSA level between 10 and 40 ng/mL, a Gleason score of 7 or higher, or biopsies with 50% or higher cancerous cells.

A study in The Journal of the American Medical Association suggests that men who had a prior heart attack can experience increased risks of having another fatal heart attack if they undergo both radiation therapy and ADT.

Researchers compared overall survival and death from prostate cancer, fatal heart attack, and other causes in a group of 206 men with unfavorable-risk prostate cancer. The men received either radiation alone, or radiation and six months of ADT. The researchers also categorized the men into subgroups based on other health conditions, including heart disease.

After a 16-year follow-up, researchers found that among the subgroup who had a previous heart attack, treatment with both radiation and ADT reduced their 15-year survival rate to 8%, compared with 20% for those who were treated only with radiation.

These findings may suggest that doctors should rethink using this combination of therapies on men with known heart disease.

Your current health and your level of concern about cancer are both big factors in the answer to this question.

Despite what the experts suggest, many men are continuing to opt for annual PSA tests. Surprisingly this includes a large number of men in their 70s. According to a recent study, more than half of a group of men 75 and older in the study had PSA tests and biopsies.

Even though these men have placed their hope in the value of early diagnosis and treatment, they stand to gain less from PSA testing than younger men. Routine PSA screening across ALL ages leads to life-saving treatment for cancer in about one in every 1,000 men screened.

Guidelines for ages

American Urological Association (AUA) age guidelines: The AUA does not recommend routine PSA screening for men 70 or older or with a life expectancy of less than 10 to 15 years. Screening may be considered in men ages 55 to 69 with the knowledge that it will prevent about one cancer death for every 1,000 men screened.

Expert guidelines don’t recommend PSA screening in men 70 and older. Because of their more limited lifespan, these men are less likely to benefit from early detection of low-risk cancer. One reason is that there may be simply less time for the condition to become life threatening in most men.

American Cancer Society (ACS) age guidelines: The ACS does not recommend PSA testing for men with no symptoms who are not expected to live more than 10 years (because of age or poor health).

Having a chronic health condition also reduces the potential benefit of early diagnosis and treatment even further, since it tends to shorten lifespan. In contrast, an exceptionally healthy man in his 70s may choose to keep having PSA tests, betting on a longer life-span that provides more time to benefit from early detection.

Some patients find that adjusting to a “new normal” after treatment can be challenging

The end of cancer treatment is often a time to rejoice. Patients are relieved to be finished with the demands of treatment and are looking forward to putting the experience behind them. When the treatment ends it can still take time for patients to recover. They may have permanent body scars, and many patients are not able to do some of the things that they easily did in their “pre-cancer” life.

However, even though their treatments are “over”, many patients continue to feel sad and worried. They are focused on concerns about whether the cancer will come back. Emotional scars from going through so much trauma are common. Cancer patients many times view themselves “differently” and think that friends and family members also look at them in a new way.

Here are some tips that cancer patients may find helpful in dealing with the “new normal”:
1. Get good follow-up care from your physicians
2. Ask for help developing a wellness plan that includes ways to take care of your physical, emotional, social and spiritual needs.
3. Consider complementary/alternative medicine to prevent illness, reduce stress, or prevent or reduce side effects and symptoms.
4. Some patients find that couples counseling, faith or spiritual counseling or family support programs are helpful.
5. State and local governments offer many services that include home care services that help with housework or cooking.
6. Strength-building exercises can help you feel better and can improve mood.
7. Exercise of all types can help people reduce stress and feel less tense and happier.
8. Cancer support groups can help you share feelings and concern and can reduce the feelings of loneliness.

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.