Prostate Cancer

Lose Weight, Lower Prostate Cancer Risk

Exercise and weight control can be useful ways to improve your health. It does not only have therapeutic potential; they are also preventative tools.

Controlling obesity reduces your cardiovascular risk and improves your heart health. It is useful to prevent diabetes and has mental health benefits, too.

But what about the prostate gland? Is losing weight useful to maintain prostate health? Would it reduce the incidence of prostate cancer? Is it helpful to control the symptoms of an enlarged prostate?

What is prostate cancer?

Prostate cancer is an enlargement of the male prostate gland. Unlike benign prostatic hyperplasia, prostate cancer is potentially dangerous and should be carefully evaluated and controlled.

Most prostate cancer cases are not aggressive, but others can spread prostate cancer cells to other parts of the body. This is metastatic prostate cancer. Thus, it is crucial to evaluate each patient according to his symptoms, age, and disease stage.

Most patients get prostate cancer at a late stage of their lives. Since most cancers in the prostate tissue grow slowly, mortality is limited.

In other words, these patients may not die from prostate cancer. That’s why screening with the PSA testing (Prostate-Specific Antigen test), a prostate biopsy, and other diagnostic tools are only recommended for some patients. They are more useful in patients with lower urinary tract symptoms or a higher prostate cancer risk.

Thus, let us dive deeper into the symptoms of prostate cancer and the risk factors.

Symptoms

The most important symptoms of prostate cancer are related to the urinary tract. They are also known as lower urinary tract symptoms. In men, they are caused by an enlarged prostate gland, prostatitis, urinary infections, and other problems. They are as follows:

  • Urinary urgency: It reflects a storage problem of the urinary bladder. Urinary urgency is a sudden urge to urinate. The patient goes from feeling fine to desperately searching for an available bathroom. It sometimes leads to urinary incontinence, too.

  • Higher urinary frequency: This is a ubiquitous symptom as we grow older. As the prostate grows, the available space for urine storage is reduced. Thus, you will need to pass urine more frequently.

  • Nocturia: This is waking up several times at night to pass urine. It is one of the most common symptoms of BPH and prostate cancer. 

  • Urinary incontinence: It is often due to urinary urgency or somewhat associated with this symptom. Thus, it is also known as urgency urinary incontinence.

  • Weak urinary flow: This is an obstructive symptom. It means that something is reducing the normal urinary flow. In this case, it is the enlargement of the prostate volume that gets in the way.

  • Urinary hesitancy: It is a voiding symptom of prostate cancer and BPH. It means not being able to start the urine stream. You feel the urge to urinate, but you need some time to begin doing so.

  • Urinary intermittency: This symptom is also prevalent. It means not having a continuous urine stream. Instead, patients report having a fluctuating stream that comes and goes.

  • Straining: Many patients report a prolonged urinary stream with straining. In other words, they need to push to keep on urinating.

  • Terminal dribble: When the urinary stream is about to finish, some patients have terminal dribble. They are continuous drops that follow the main stream, prolonging the urinary time.

  • Post-micturition dribble: There’s also a post-micturition dribble, which is not the same as a terminal dribble. A post-micturition dribble is experienced after urinating. When you’re finished urinating, there’s an involuntary volume loss in small drops. This often stains your clothes and causes foul odor if you’re not careful.

  • Sensation of incomplete emptying of the bladder: This is a common sensation, too. Patients feel they are not finished urinating, and it’s because their bladder is still not empty. They can’t achieve complete emptying of the bladder because the prostate is getting in the way.

Besides urinary symptoms, prostate cancer patients sometimes report additional problems. For example:

  • Blood in the urine or semen: This is an alarming symptom and may be caused by prostate cancer, kidney stones, and many other reasons. Prostate cancer recruits many blood vessels and creates new ones. These are very fragile and prone to bleeding.

  • Painful ejaculation: Some patients report painful ejaculation due to the inflammatory process in the prostate. This is not an early-stage symptom and may have other reasons doctors should also consider.

  • Lower sperm volume: In some cases, prostate cancer patients report a lower sperm volume. It is even more common after treating prostate cancer with radical prostatectomy. This is because the prostate is important to increase the volume of sperm.

  • Erectile dysfunction: This is an unlikely symptom in nonmetastatic prostate cancer. However, it is still possible in aggressive cases, when cancer is spreading cancer cells to the erectile structures of the penis.

  • Bone pain: It is also uncommon in localized prostate cancer. It only appears in metastatic prostate cancer (bone metastases).

  • Rectal pain: The prostate is adjacent to the rectum, and a significant enlargement pushes this structure away. Inflammation may also trigger pain signals in nerve terminals in the area. This causes a dull sensation of pain, fullness, or discomfort.

  • Leg numbness or swelling: In very severe cases, prostate cancer may grow bigger and invade other tissues. When the nerves or lymphatic drainage are compromised, prostate cancer patients may also report swelling or numbness.

Risk factors

We have many studies on prostate cancer. Some of them show an association between prostate cancer and certain habits.

For example, according to some studies, people who eat red meat every day may have a higher prostate cancer risk. But risk factors of prostate cancer are established in the scientific community. They only take into consideration those factors that clearly predict prostate cancer and its aggressiveness. The list includes the following:

  • Age: It is known that prostate cancer risk is higher as we grow older. After age 50 years old, there’s an acutely increased risk. Around 80% of cases of cancer are men 65 years or older.

  • Race: African American males have a higher risk of prostate cancer as compared to white men. When they get cancer, it is more likely to become aggressive. Thus, they are more likely to die from complications of prostate cancer.

  • Family history: Having a close relative with prostate cancer increases the risk, too. 20% of cases are familial prostate cancer, which means it has a likely genetic predisposition. Indeed, you need to have the genes and the environmental conditions to trigger cancer. When ovarian and breast cancer are common in the family, prostate cancer can be common as well. This is the hereditary breast and ovarian cancer syndrome. It affects women and may lead to aggressive prostate cancer in men, too.

  • Eating habits: There is some evidence that eating and exercising have a role in prostate cancer. However, eating habits are considered an additional risk factor with an indirect effect on prostate cancer.

Weight and prostate cancer

Weight is not considered a determinant risk factor for most urologists. For example, they won’t screen men for prostate cancer only because they are obese. However, it does affect prostate cancer onset and progression. Obesity is also a relevant health condition if you want to control your prostate cancer symptoms.

Obesity and weight gain are global concerns, not only in the United States but also in most developed countries. In older adults with prostate cancer, being obese is associated with a higher chance of a fatal outcome. According to several studies, the survival rate reduces, and the recurrence of prostate cancer is higher.

Some studies even suggest that changing your weight when you’re still young may prevent prostate cancer. It may reduce the incidence of fatal prostate cancer in later years. But this association is not reproduced by every author. That’s why it is essential to differentiate between short-term and long-term weight changes.

Short-term weight change is widely studied and known to help patients with prostate cancer. However, these patients have already been diagnosed with the disease. There’s no turning back in this particular health outcome. But this short-term weight change improves their symptoms and may reduce the aggressiveness of prostate cancer.

Weight loss leads to a mechanical relief of the symptoms. That’s because obesity increases the abdominal pressure and works against the bladder. It aggravates the urinary symptoms already present in patients with prostate cancer. Thus, weight reduction results in significant improvements in the quality of life in prostate cancer survivors.

Long-term weight change takes many years, from early adulthood into a man’s midlife. According to studies, when patients try to lose weight before being diagnosed with prostate cancer, they have a lower risk of aggressive or advanced prostate cancer. This means that, if they ever get a prostate cancer diagnosis, it would likely be slow-growing instead of fatal. This association is stronger in people who smoke cigarettes.

Another determinant is race. In white males, obesity may predispose to more aggressive or advanced prostate cancer. In African American males, obesity predisposes to both slow-growing and aggressive prostate cancer. The obesity-aggressive prostate cancer association is more relevant in black males. In other words, they would get an even higher risk of prostate cancer if they are obese.

How to aim for a healthy weight

Both short-term and long-term weight changes have a positive outcome in prostate cancer.

It is better to prevent the disease, and reducing your weight can reduce the risk of aggressive or advanced prostate cancer in the future. But even if you already have prostate cancer, keeping a healthy weight is useful to improve your life quality.

Aiming for a healthy weight is possible regardless of your age and many other health conditions. All you need to do is choosing one or a combination of weight loss methods. The main pillars of weight loss are diet and exercise, but other alternatives are also available:

  • Dietary modifications: The diet is fundamental to lose weight. People are not obese by nature, and obesity was not a widespread trend throughout our history. As our diet changed, our weight started to increase. But we can reverse that by only adopting a series of dietary modifications.

    If you want to lose weight, a diet with a prevalence of fruits and vegetables is a must. It gives you enough nutrients while keeping you satiated for longer. It is also associated with significant improvements in several parameters, including our prostate health.

    Another dietary modification to control your weight is consuming more dietary fiber. This is found in unrefined products, whole-wheat cereals, and vegetables. Many fruits also contain plenty of dietary fiber. But above everything else, it is important to control food sizes and calories. At the end of the day, you need to consume fewer calories than you burn. That’s the only proven way to lose weight.

  • Physical activity: The second pillar of weight loss is physical activity. Exercise is an excellent preventative measure for almost anything you can think of. Prostate health and prostate-related symptoms are included, of course. Just be sure to use a prostate-friendly seat if you’re deciding on cycling. Physical activity increases your total number of burned calories. It facilitates a negative energy balance, which is fundamental to lose weight.

  • Lifestyle changes: Sitting for too long and living a sedentary lifestyle are common causes of obesity. By only modifying your sitting time, walking to the store instead of driving, and lifting the stairs instead of using the elevator, our non-exercise physical activity increases, and this turns out to be an excellent technique to achieve and maintain weight loss. Another important lifestyle change is sleep. An adequate sleeping time at night is an important step you need to do if you want to lose weight.

  • Natural alternatives: There are also natural alternatives to lose weight. For example, green tea can be a useful alternative. But every natural alternative works better if you modify your lifestyle, diet, and exercise.

  • Drugs and medical solutions: In some cases, and only when nothing else works, doctors may recommend drugs and medical solutions to lose weight. This is a suitable alternative when hormones and other physiological reasons are getting in the way. Hormone therapy may be recommended sometimes.

Questions to ask your doctor

Far from answering your every question, this article is meant to give you general advice and does not replace your doctor’s opinion.

Every patient has individualized needs, and the best recommendations should be given after a thorough evaluation of the patient, his risk factors, health concerns, signs, and symptoms. Thus, do not hesitate to ask questions to your doctor, such as:

  • Do I need prostate cancer screening? If so, when should I start screening?

  • Am I at risk? What does that mean?

  • Do I have hormonal problems delaying or hindering my weight loss goals? Do I need hormone therapy?

  • What is the best weight loss method for me?

Conclusion

Keeping a healthy weight is beneficial to prevent prostate cancer. It is also useful to control the urinary symptoms and improve the quality of life after diagnosis. Thus, even though obesity is not a direct risk factor for prostate cancer, patients are recommended to maintain a healthy weight to prevent aggressive cancer that requires surgery, chemotherapy, radiation therapy, hormone therapy, and other prostate cancer treatment options.

Sources

  1. Merriel, S. W., Funston, G., & Hamilton, W. (2018). Prostate cancer in primary care. Advances in therapy, 35(9), 1285-1294.
  2. Homma, Y., Gotoh, M., Kawauchi, A., Kojima, Y., Masumori, N., Nagai, A., … & Yamanishi, T. (2017). Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia. International Journal of Urology, 24(10), 716-729.
  3. Pernar, C. H., Ebot, E. M., Wilson, K. M., & Mucci, L. A. (2018). The epidemiology of prostate cancer. Cold Spring Harbor Perspectives in Medicine, 8(12), a030361.
  4. Dickerman, B. A., Ahearn, T. U., Giovannucci, E., Stampfer, M. J., Nguyen, P. L., Mucci, L. A., & Wilson, K. M. (2017). Weight change, obesity and risk of prostate cancer progression among men with clinically localized prostate cancer. International journal of cancer, 141(5), 933-944.

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