Prostatitis and Cancer Risk: Clarifying 7 Common Prostate Health Myths

The prostate, often referred to as the "life gland" for men, is crucial for men's health. It not only provides nourishment to sperm through the secretion of prostatic fluid but also plays a significant role in controlling urination. Given the prevalence of conditions such as prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer, many people are understandably confused about the relationships among these diseases. Here, we address seven common concerns to provide clarity.

Misconception 1: Chronic Prostatitis is Untreatable and Leads to Prostate Cancer

This conclusion is unfounded. The exact cause of cancer remains unclear, though factors such as race, genetics, environment, diet, and smoking are believed to play a role. Research indicates that dihydrotestosterone is crucial in the development of prostate conditions. Epidemiological studies suggest that being male, aging, and androgen stimulation are key factors.

Clinically, chronic prostatitis is more common among young and middle-aged men, whereas prostate cancer predominantly affects older men. Acute prostatitis can cause symptoms like fever and painful urination, as well as a temporary increase in PSA levels. However, with anti-inflammatory treatment, these symptoms and PSA levels usually return to normal quickly.

Chronic prostatitis does not affect the secretion and metabolism of androgens by the testes. Epidemiological studies have not found a direct link between chronic prostatitis and prostate cancer. Nonetheless, elderly patients should undergo regular PSA screenings to avoid missed diagnoses and delayed treatment.

Misconception 2: Prostate Biopsy is Extremely Painful and Requires Anesthesia

The pain associated with a prostate biopsy is minimal, and local anesthesia is usually administered. Most hospitals perform a transrectal biopsy with local mucosal surface anesthesia, while a perineal biopsy requires local infiltration anesthesia. The discomfort mainly comes from inserting the ultrasound probe and biopsy gun into the rectum, similar to a digital rectal exam, and most patients can tolerate it.

The puncture itself causes some discomfort when the needle passes through the rectal wall into the prostate, but because the needle is thin and the procedure is quick, the pain is usually bearable. Some patients may experience local pain after the biopsy, which can be managed with oral painkillers.

Misconception 3: Frequent Masturbation Leads to Prostate Cancer

Masturbation is a common phenomenon among men. While frequent masturbation can cause prostatic congestion, excessive abstinence can also lead to the accumulation of prostatic fluid. The psychological burden from frequent masturbation is often more significant than its physical effects. For most adult men, maintaining a moderate frequency of masturbation should not cause concern about triggering prostatitis.

In fact, moderate masturbation can help clear prostatic fluid, alleviate blood congestion, and contribute to prostate health. Therefore, there is no scientific basis for the claim that frequent masturbation leads to prostate cancer.

Misconception 4: Lycopene Prevents Prostate Cancer

Relying solely on tomatoes to prevent prostate cancer is not reliable. While lycopene has benefits, it is not sufficient on its own to prevent cancer. Eating more fruits and vegetables can lower the risk of prostate cancer, likely due to the micronutrients they contain. Carotenoids, a group of nutrients believed to have chemopreventive effects, include lycopene, which has potential antioxidant properties. Lycopene is found in many vegetables, with tomatoes being a common source. Cooking these foods and consuming them with fats makes lycopene more absorbable by the body.

However, current research analyzing published data finds insufficient evidence that lycopene reduces the risk of prostate cancer. The conclusion that lycopene supplements lower the risk remains to be proven.

Misconception 5: Selenium and Vitamin E Supplements Prevent Prostate Cancer

No, they cannot. A large randomized, placebo-controlled trial on the prevention of prostate cancer using selenium and vitamin E provided credible evidence regarding their effects. However, supplementing with vitamin E and selenium does not reduce the incidence of prostate cancer.

It is noteworthy that the increased risk associated with vitamin E was observed after discontinuing the supplement, suggesting that vitamin E may have long-term effects.

Misconception 6: Cancer Diagnosis is a "Death Sentence"

Prostate cancer typically progresses slowly, growing, spreading, and metastasizing at a much slower rate compared to tumors like lung or liver cancer.

Generally, prostate cancer does not significantly affect the patient's life expectancy. Most patients often die from other systemic diseases. In the United States, the five-year survival rate for prostate cancer can reach 99%, making its prognosis one of the best among various malignant tumors. For early-stage prostate cancer, the five-year survival rate after radical surgery is almost 100%, and the ten-year survival rate can reach 90%. For older patients or those in poor health who cannot tolerate surgery, radical radiotherapy can also achieve satisfactory results.

Therefore, after being diagnosed with prostate cancer, patients and their families should seek help from specialist doctors. The doctors will consider various factors such as the patient's life expectancy, tumor stage and grade, and the presence of distant metastasis to develop an individualized treatment plan. Additionally, technologies such as cryoablation and brachytherapy can be used for personalized treatment when appropriate.

Misconception 7: Removing the Prostate Will Lead to Loss of Sexual Function

Most patients will experience erectile dysfunction after surgery, but normal function usually returns within a year.

Erectile function is controlled by nerves located in a structure called the "neurovascular bundle" on the posterior lateral sides of the prostate. The nerves responsible for penile erection are part of this bundle.

Traditional radical prostatectomy often damages the neurovascular bundle in an effort to completely remove the cancerous tissue, leading to postoperative erectile dysfunction in most patients. However, in recent years, radical surgery techniques have evolved to aim at preserving the neurovascular bundle while ensuring complete tumor removal. This approach significantly increases the likelihood of retaining sexual function. As neurovascular bundle-sparing techniques have advanced, most patients can expect to regain normal sexual function within a year after surgery.