Prostate Cancer Archive

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Ask the Doctor

Q. I had a vasectomy many years ago, at age 45. I recently read that this increases my risk of prostate cancer. Should I be concerned?

A. Despite the reports you've heard about the connection between vasectomy and prostate cancer, the evidence is weak for a cause-and-effect relationship. Right now, this hypothetical risk should not cause you undue concern.

Q. Some of my friends take saw palmetto supplements to reduce urinary problems caused by an overgrown prostate, which I was recently diagnosed with. My friends swear by it, but is there any good evidence this stuff helps? Is saw palmetto safe?

A. The short answer is that we don't have great scientific evidence that taking saw palmetto truly reduces male urinary problems. On the other hand, it doesn't appear to cause major side effects either.

An approach called active surveillance allows some men with low-risk cancer to delay the decision to treat.

Biomarkers are "chemicals" that can indicate both normal and abnormal processes in the body. One of the most famous is prostate-specific antigen (PSA). The PSA test, which detects abnormally high blood levels of PSA, has been used for decades to screen for prostate cancer and potentially catch it early.

There are two problems with the PSA test. First, PSA levels can tell you that something is going on with the prostate — but that "something" isn't necessarily cancer. High levels may mean other benign prostate conditions. Second, when high PSA levels do turn out to be the result of prostate cancer, the PSA level alone won't tell you which cancers are aggressive and need treatment, and which are slow-growing and can be managed more conservatively.

Q. I am scheduled to have my prostate removed and am concerned about the risk of erectile dysfunction (ED) after the surgery. I've heard that taking an ED drug daily during my recovery could help. Do you recommend this?

A. About half of men lose some erectile function after radical prostatectomy, which removes the entire prostate gland. ED drugs help men to have erections after surgery, but so far research has not shown that taking it daily produces better results than taking the medication as-needed—when you anticipate sexual activity.

Here is what men need to know to minimize discomfort of a prostate biopsy and get the best results.

Age, family history, and race are the main influences.

Q. In the May 2014 issue, you reported on findings from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), which said that taking vitamin E and selenium raises the risk of prostate cancer. My multivitamin contains both of these nutrients. Should I worry?

A. Based on what we know right now, there is no reason to think that a multivitamin would raise your risk of prostate cancer. Standard multivitamins contain less vitamin E and selenium than men took in SELECT. Also, multivitamins have not been linked to an increased risk of prostate cancer. For example, in a study of over 14,000 male physicians, taking a multivitamin (compared to placebo) did not affect the risk of individual cancers, although it reported a very modest reduction in total combined cancers over 11 years. This effect has not been reproduced in other studies.

Taking daily doses of the erectile dysfunction drug tadalafil (Cialis) does not reduce erectile problems in men undergoing radiation therapy for prostate cancer, according to a clinical trial in the Journal of the American Medical Association.

Some men who have radiation treatment for prostate tumors later have trouble getting or maintaining erections. Researchers have explored using ED drugs early in hopes of preventing ED after radiation or surgery for prostate cancer.

The prostate is can be a troublesome little gland. It is prone to painful infections and inflammation (prostatitis), enlargement that interferes with urination (benign prostatic hyperplasia, or BPH), and cancer. Prevention is the best medicine, something exercise can help with. Exercise has also been shown to help treat various prostate-related conditions.

Although relatively few studies have looked at the impact of exercise specifically on prostate health, the ones that have suggest that regular physical activity can be good for this walnut-sized gland.