The prostate is a small gland with a big impact on men’s health. Globally, prostate cancer is the second most common cancer among men, with thousands of new cases diagnosed each year. In the Philippines, it remains a growing concern, often detected late due to limited awareness and hesitation to seek medical help.
It is often overlooked until problems arise. Prostate health is not just about aging gracefully — it’s about safeguarding quality of life, vitality, and longevity.
In this article, CGHMC’s Urologist, Dr. Juliano Panganiban, sheds light on what every man should know about his prostate — from its function and common conditions to risk factors and preventive steps. His insights aim to empower men and their families with knowledge, encouraging proactive care and timely medical consultation.
Know Your Prostate
- What exactly does the prostate do, and why is it important?
The prostate is a small gland found in males, about the size of a walnut, located below the bladder and in front of the rectum. It surrounds part of the urethra, the tube that carries urine and semen out of the body.
Its main functions are to:
- Produce fluid that nourishes and protects sperm
- Help propel semen during ejaculation
- Contribute to male fertility
As men age, the prostate usually enlarges, which can affect urination even when no cancer is present.
- How common is prostate cancer among men?
Prostate Cancer is one of the most common cancers affecting men worldwide.
- Approximately 1 in 8 men will be diagnosed during their lifetime.
- The risk increases significantly after age 50.
- Many prostate cancers grow slowly and may never cause symptoms, while others are more aggressive and require prompt treatment.
- In the Philippines, the statistics show that it is the 3rd most common cancer in males afterlung and colorectal cancer.
Early detection improves the chances of successful treatment.
While the incidence in the Philippines is lower than North America or European countries, the mortality is relatively high and may be due to:
- later stage diagnosis
- lower screening rates
- delayed access to specialist care
- unequal access to advanced treatments
- What are the early warning signs or symptoms I should watch out for?
Early-stage prostate cancer often causes no symptoms at all. When symptoms occur, they may include:
- Frequent urination, especially at night
- Difficulty starting or stopping urination
- Weak or interrupted urine flow
- Feeling that the bladder does not empty completely
- Blood in the urine or semen
- Pain or burning during urination
- Erectile dysfunction
- Persistent pain in the hips, back, ribs, or pelvis (which can indicate advanced disease)
These symptoms are not specific to prostate cancer and may also be caused by noncancerous prostate enlargement or what is called Benign Prostatic Enlargement or infection/Prostatitis.
Screening and Diagnosis
- At what age should men start screening for prostate cancer? Most experts recommend discussing screening with a healthcare provider at:
- Age 50 for men at average risk
- Age 40 for men at higher risk, including:
- Men with a father or brother diagnosed with prostate cancer
- Men with multiple affected relatives
- For men with a strong family history or known inherited genetic mutations (such as BRCA2)
Screening decisions should be individualized based on overall health, life expectancy, and
personal preferences.
- What types of screening tests are available?
Common screening tests include:
- Prostate-Specific Antigen (PSA) blood test
Measures the level of PSA, a protein produced by the prostate.
- Digital Rectal Examination (DRE)
A healthcare professional gently inserts a gloved finger into the rectum to assess the size,
shape, and texture of the prostate.
- Multiparametric MRI (mpMRI)
MRI is not usually used as an initial screening test for everyone but is increasingly used to evaluate men with:
- Elevated PSA levels
- Abnormal DRE findings
- Previous negative biopsy with persistent concern MRI helps identify suspicious areas that may need targeted biopsy.
- How accurate are these tests, and what do the results mean?
No screening test is perfect.
PSA test
- PSA levels generally increase with age.
- A higher PSA level does not necessarily mean cancer.
- Elevated PSA can also result from:
- Benign prostate enlargement
- Prostate infection or inflammation
- Recent ejaculation
- Recent prostate procedures
- Urethral catheter insertions
- Cysto-urethroscopies
Many clinicians consider:
- PSA below 4 ng/mL: often considered reassuring, although cancer can still occur
- PSA 4–10 ng/mL: intermediate risk
- PSA above 10 ng/mL: higher likelihood of cancer
Your doctor will also consider:
- PSA velocity (how quickly PSA rises)
- PSA density (PSA relative to prostate size)
- Free/Total PSA ratio
DRE
DRE can detect abnormalities that PSA testing may miss, but it cannot detect all cancers.
MRI
MRI improves the detection of clinically significant cancers and can help reduce unnecessary biopsies.
- If my PSA levels are high, what happens next?
An elevated PSA does not automatically mean cancer.
Your doctor may recommend:
- Repeating the PSA test after a few weeks or months
- Reviewing possible causes of PSA elevation
- Performing a DRE
- Obtaining additional blood or urine tests
- Ordering a multiparametric MRI
- Recommending a prostate biopsy if suspicion remains high
A biopsy is the only way to confirm a diagnosis of prostate cancer.
Risk Factors and Prevention
- What factors increase my risk—age, family history, diet, or lifestyle?
Risk factors for prostate cancer include:
- Increasing age, especially after age 50
- Family history of prostate cancer
- Inherited genetic mutations, such as BRCA1 and BRCA2
- African ancestry
- Obesity
- Smoking
- Diets high in processed foods and saturated fats
- Lack of regular physical activity
Having one or more risk factors does not mean you will develop prostate cancer, but it may
influence screening recommendations.
- Are there steps I can take to lower my risk?
There is no guaranteed way to prevent prostate cancer, but healthy habits may reduce your risk and improve overall health.
Consider:
- Maintaining a healthy weight
- Exercising regularly (at least 150 min minutes of moderate-intensity activity per week)
- Eating a diet rich in fruits, vegetables, legumes, whole grains, and fish
- Limiting processed meats and excessive saturated fats
- Avoiding tobacco use
- Limiting alcohol intake
- Keeping chronic conditions such as diabetes and hypertension under control
- Discussing screening with your healthcare provider
Treatment Options
- What are the main treatment options if cancer is detected?
Treatment depends on:
- Cancer stage and grade
- PSA level
- Overall health
- Life expectancy
- Personal preferences
Common options include:
Active surveillance
For low-risk cancers (Gleason Group Grade 1 – 3+3) that are unlikely to grow quickly. Monitoring includes periodic PSA tests, MRI scans, and repeat biopsies every 2 years.
Surgery
Radical prostatectomy removes the prostate gland and nearby tissues ( Robotic, Laparoscopic, Open)
Radiation therapy
- External beam radiation therapy (EBRT)
- Brachytherapy (internal radiation)
Hormone therapy
Also called androgen deprivation therapy (ADT), it lowers testosterone levels that fuels prostate cancer growth which combines Injections (GnRH agonists or antagonists) or bilateral orchiectomy with oral 1st or 2nd (Novel Hormone Therapy) anti-androgens.
Chemotherapy
Used mainly for advanced or hormone-resistant disease.
Targeted therapy and immunotherapy
May be appropriate for selected patients with specific genetic changes or advanced disease.
Many men diagnosed with prostate cancer live long, healthy lives—especially when the disease is detected early and managed appropriately.
SEE YOUR UROLOGIST REGULARLY.
