Understanding Prostate Cancer: A Guide for the RemissionRoute Community

Introduction

Prostate cancer is one of the most common cancers in men, yet many people don't talk about it until it touches their lives or their family. In Canada, about 1 in 8 men will be diagnosed with prostate cancer during their lifetime, and it accounts for roughly one in five new cancer cases in men. While most men diagnosed with prostate cancer do not die from it about 1 in 30 will early awareness and timely action make all the difference. At RemissionRoute, we believe that knowledge is the first step toward prevention, early detection, and better outcomes.

What is prostate cancer?

  • The prostate is a walnut-sized gland below the bladder that makes fluid for semen.
  • Prostate cancer occurs when prostate cells grow uncontrollably. Many prostate cancers grow slowly; others are more aggressive.
  • It's one of the most common cancers in men, especially over age 50, but early detection and treatment often lead to very good outcomes.

Risk factors

  • Age: risk rises after 50; most diagnoses occur after 65.
  • Family history: having a father or brother with prostate cancer increases risk.
  • Genetics: BRCA1/2 and other inherited mutations can raise risk.
  • Race: Black men have higher incidence and may develop more aggressive disease.
  • Diet and lifestyle: obesity and certain dietary patterns may affect risk, though evidence is mixed.

Symptoms to watch for

Early prostate cancer often has no symptoms. When present, symptoms may include:

  • Frequent urination, especially at night
  • Difficulty starting or stopping urine stream
  • Weak or interrupted flow
  • Pain or burning during urination (less common)
  • Blood in urine or semen
  • Pain in the lower back, hips, or pelvis (may indicate spread)

Diagnosis and staging

  • PSA test: a blood marker (prostate-specific antigen). Elevated PSA may prompt further testing but isn't diagnostic by itself.
  • Digital rectal exam (DRE): a clinician checks the prostate for lumps or irregularities.
  • Prostate biopsy: the definitive test where tissue samples are examined for cancer cells.
  • Imaging (MRI, CT, bone scan): used to stage cancer and check for spread.
  • Gleason grade / Grade Group: describes how aggressive cancer cells look under a microscope important for treatment planning.

Treatment options (tailored to stage and patient priorities)

  • Active surveillance: monitoring with PSA tests, exams, and periodic biopsies often chosen for low-risk, slow-growing cancers to avoid overtreatment.
  • Surgery (radical prostatectomy): removal of the prostate; effective for localized cancer.
  • Radiation therapy: external beam radiation or brachytherapy (seed implants); localized control with different side-effect profiles.
  • Hormone therapy (androgen deprivation therapy, ADT): lowers testosterone to slow cancer growth often used for advanced disease or combined with radiation.
  • Chemotherapy and targeted therapies: for advanced or metastatic disease.
  • Clinical trials: an option worth discussing can provide access to new treatments.

Treatment choice depends on cancer stage, Gleason score, overall health, life expectancy, and patient preferences. Shared decision-making with your care team is key.

Managing side effects

Surgery (Radical Prostatectomy)

  • Urinary incontinence: Pelvic floor (Kegel) exercises, physical therapy, medications, or surgical options.
  • Erectile dysfunction: Medications (PDE5 inhibitors such as sildenafil), vacuum devices, injections, or penile implants.

Radiation Therapy

  • Bowel changes: Diarrhea, urgency, or rectal irritation can improve with dietary adjustments, medications, and sometimes procedures.
  • Urinary symptoms: Increased frequency or urgency often managed with bladder-calming medications.
  • Sexual side effects: Erectile dysfunction may occur over time; treatments similar to surgery apply.

Hormone (Androgen Deprivation) Therapy

  • Hot flashes and fatigue: Managed with lifestyle adjustments, medications, or supportive therapies.
  • Bone thinning: Prevented or treated with exercise, calcium/vitamin D, and medications like bisphosphonates or denosumab.
  • Metabolic changes (weight gain, cholesterol, diabetes risk): Regular monitoring, healthy diet, and exercise are key.

Emotional and practical support

  • A diagnosis affects mental health. Anxiety, depression, fear, and stress are common and valid.
  • Consider counseling, support groups, or peer mentors (in-person or online).
  • Caregivers need support too; involve family in planning and share responsibilities.
  • Practical matters: arrange transportation, organize finances, and plan time off work if needed.

Lifestyle and survivorship

  • Healthy diet and regular moderate exercise improve overall health
  • Bone health: weight-bearing exercise, calcium and vitamin D, and monitoring if on hormone therapy.
  • Ongoing follow-up: regular PSA checks and visits per your care team's plan.
  • Sexual health and intimacy can be rebuilt; honest communication with partners and specialists helps.

When to seek urgent care

Seek immediate medical attention if you experience:

  • Sudden, severe pain in the back or hips, sudden weakness, numbness, or loss of bladder or bowel control suggesting possible spinal cord compression
  • Severe blood in urine, urinary retention, or rapidly worsening lower urinary tract symptoms, which may signal obstruction or advanced local disease
  • Fever with urinary symptoms - possible infection

How RemissionRoute can help

  • Symptom and side-effect tracker (daily/weekly prompts)
  • Medication reminders and adherence logs
  • Appointment calendar with prep checklists and question prompts for clinicians
  • Secure document storage for lab results, biopsy reports, and treatment plans
  • Peer support matching and in-app counseling referrals
  • Personalized survivorship plans and wellness goals

Conclusion

A prostate cancer diagnosis changes your path, but it doesn't define your journey. With the right information, team, and tools like RemissionRoute you can make informed decisions, manage side effects, and focus on what matters most. Take things one step at a time, ask questions, accept help, and celebrate small victories.