Prostate Cancer: Treatment Options, Diet, and Essential Medical Information

Prostate cancer is one of the most common types of cancer and one of the most prevalent diseases among men over 50. In fact, one in ten men over the age of 50 in the country (and one in six worldwide) will develop prostate cancer, and by age 90, the incidence is almost 100%. However, under the age of 40, the disease does not occur at all.

(Un)pleasant to meet: What is Prostate Cancer?

A few words about cancer in general: Cancer is a phenomenon where one of the cells in a tissue reproduces incessantly. Each cancerous cell divides again and again without stopping, forming a mass of cancer cells in one place in the body. The cells in the cancerous mass destroy the healthy tissues adjacent to it, and if not treated, the cancer cells spread outside the primary organ where they developed. They tend to reach areas such as lymph nodes, lungs, bones, and more. This spread is called "metastasis."

The prostate is a gland belonging to the male reproductive system. It is located at the base of the bladder and surrounds the urethra, which carries urine from the bladder out of the body. The prostate's role is to produce part of the seminal fluid.

Prostate cancer, unlike most types of cancer, is one that develops slowly. The rate of division of the cancer cells is slow, and therefore in most cases, it does not cause death. However, it is important to identify it early and treat it, as there are also more aggressive cases.

Diagnosis: How Do I Know I Have Prostate Cancer?

Sometimes there are symptoms indicating the possibility of prostate cancer, such as a frequent need to urinate, a weak and narrow urine stream, and pain during urination. In most cases, however, there are no obvious symptoms, and the cancer is discovered only in routine checks—or when the cancerous growth is already large and exerts pressure on the urethra. In cases of late discovery, the cancer can also send metastases, which may manifest as pain in the bones, hips, or lower back.

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Due to the difficulty of early detection, men over the age of 50 are recommended to undergo routine checks for the detection of prostate cancer. Through routine checks, signs of cancer development can be identified: enlargement of the prostate gland, which is detected in a manual examination by a doctor, or an increase in the frequency of PSA protein—a protein produced by the prostate gland, which is revealed in a simple blood test. However, all these symptoms and tests may also occur when there is a benign enlargement of the prostate gland. Therefore, when there is a suspicion of prostate cancer, a biopsy is performed. The biopsy is a test where samples of tissues from the gland are taken and examined in a special lab test. The tissue samples are usually taken under local anesthesia, and involve mild pain, which usually subsides within a few days.

So I Have Prostate Cancer. What Next?

First, it is important to know that the chances of recovery from prostate cancer are high, and in cases of early detection, they are around 90%. Additionally, as mentioned, it is often possible to live with prostate cancer for many years, without special treatment and in good health, due to its slow progression.

Therefore, in many cases, the doctor will recommend only observational treatment—meaning periodic monitoring of the cancer's development, without active treatment. The goal of observational treatment is to avoid active treatments as much as possible, which, as known, also cause side effects, sometimes severe, and even an increased risk of medical complications. Monitoring is important because if it is an aggressive case of cancer—active treatment is necessary, so there is a need to monitor and check the rate of cancer cell development.

However, observational treatment alone may create mental difficulty for the patient. The very knowledge that cancer exists in the body and is not being treated can cause stress and anxiety. Therefore, when considering treatment options, the mental aspect is also taken into account.

When there is a need for active treatment, there are several treatment options considered. The choice among the various options is made by the treating physician, tailored to the patient's personal medical condition.

Surgery—in the surgical option, the prostate gland is completely removed and then the bladder is reconnected to the urethra. The surgery can be performed using several methods, such as the abdominal method, the perineal method, or the laparoscopic method (which is still not common in the country). If a patient is advised for surgery, it is recommended to inquire about the different options for performing it, to ease recovery as much as possible.

Radiation treatment—radiation treatment aims to target the area where the tumor is located, while avoiding harm to other healthy areas. In the case of prostate cancer, there are two options for radiation treatment. The first option is external radiation, also known from other types of cancer. The treatment is daily and lasts for several months, during which increasing amounts of radiation are given to the prostate area using 3D imaging and a computerized treatment plan. The treatment is done without anesthesia.

The second option is brachytherapy—internal radiation. In this option, radioactive material is implanted directly into the prostate. The implantation is a one-time treatment conducted under local or general anesthesia for about an hour. After about 24-48 hours, the patient can return to his daily routine, with the implanted material continuing to emit radiation for several months. The advantage of this treatment is the ability to give much larger amounts of radiation than with external radiation, while effectively preventing harm to adjacent organs.

Sometimes chemotherapy is also considered.

Nutrition: What Should I Eat If I Have Prostate Cancer?

It is worth knowing that studies show there is a connection between diet over a lifetime and the development of prostate cancer. According to the studies, men who consume a diet high in animal fat and trans fat increase their chances of developing prostate cancer. In contrast, men who eat a diet rich in fruits and vegetables, in vitamins E and D, selenium, lycopene, and omega-3, have a reduced risk of developing prostate cancer.

For those dealing with prostate cancer, a diet rich in carbohydrates from whole grains with a low glycemic index, containing a relatively low amount of proteins and fats, is recommended. In addition, it is recommended to increase the consumption of plant-based products at the expense of animal-based products.

There are many dietary recommendations, and it is important to tailor them to the patient and to his specific needs. Therefore, beyond these basic recommendations, it is advisable to consult personally with a doctor and/or dietitian to tailor a diet that will help the patient cope with the disease optimally.