The Prostate and Diabetes
Related Health Issues
The Eyes and Diabetes
The Kidneys and Diabetes
Weight and Diet
Exercise Your Heart
Diabetes and Coeliac Disease
Stress, Anxiety and Depression
The Prostate and Diabetes
Polycystic Ovarian Syndrome
Joint and Muscle Problems Associated With Diabetes
Women, Sex and Diabetes
Osteoporosis – Is There A Link with Diabetes?
An experience of the menopause
The Prostate and Diabetes
The prostate is a walnut-sized gland underneath the bladder in men that encircles the urethra [the tube that carries urine out of the body]. In adults the prostate often begins a new growth and tests have to be carried out to find out if this is benign or cancerous. If benign, it s called benign prostatic hyperplasia or BPH and if not, it is localised prostate cancer but to date no tests have been found to entirely reliable.
The pressure of the enlarged prostate may partially close the urethra causing various urinary problems, especially in older men.
A study published in the Journal of Urology, June 2000, shows that in men with diabetes the symptoms of BPH are worse than in men without diabetes. The research looked at the records of 1,290 men with diabetes and 8,566 men without diabetes all of whom were having drug treatment for BPH. They compared BPH symptoms before and after drug treatment and found that men with diabetes had more symptoms and slower urine flow rate than those without diabetes. It showed that men with diabetes have symptoms as severe as non-diabetic men eleven years older and a urine flow rate the same as non-diabetic men seven years older.
Facts about prostate cancer to put it in perspective
- Prostate cancer is slow growing so most men will die of something else before the cancer becomes a problem.
- It seems to occur in the majority of men as they get older but is not life threatening and remains localised in the prostate gland. Autopies have shown that 40% of men over the age of 50 have prostate cancer [and never knew] and the risk rises steadily with age so that by the age of 80 so that by 80, 70% of men have it.
- Surveys show that for the average 50year old man with a reasonable life expectancy of a further 25years, there is a 10% chance that he will develop clinically significant prostate cancer but only a 3% chance that he will die of it.
Symptoms of BPH and prostate cancer
- A weak or interrupted urine flow.
- Frequent urination during the night.
- Burning or painful urination.
- Urgent need to urinateUrine leakage.
- Feeling that the bladder is not empty even after urinating.
Ways to help the symptoms:
- Limit the amount of fluids before bed.
- Drink less alcohol and caffeine.
- Completely empty your bladder.
- Check with your GP that any other medicines you are taking are not aggravating the problems.
Consult your doctor -It may be that if the symptoms don’t cause any problems, then there may be no need for treatment other than regular check ups.
Drug treatment – There are two different kinds of tablets that can help, all with side effects. One type of drug relaxes the prostrate muscles and lets the urine flow more easily and the other shrinks the prostate over several months.
Radiotherapy – Treatment is applied externally by Xrays or internally by using radioactive implants but a study has shown that it has limited efficacy [Int Joun of Radiat Oncol Bio Phys 2002, 53]. It also causes a range of unpleasant side effects.
Surgery – This is often recommended for men with serious BPH problems and prostate cancer. Surgery can have both severe and debilitating side effects that can include incontinence and impotence with a risk that both BPH and prostate cancer can return. A statement from the US National Cancer Institute in July 2001 says that the rate of recurrence rises to 40% 10 years after surgery.
Doing nothing does not sound like a treatment option but it is and it may be the best option and one that certainly should be discussed with your doctor. If BPH or prostate cancer is not causing effects or symptoms that markedly affect quality of life, then doing nothing may be the right choice. All the above treatments cause side effects that may be worse than the symptoms.
Screening for prostate cancer
Research to demonstrate whether or not screening for prostate cancer beneficial is far from conclusive. In 2000 the US National Cancer Institute stated ‘It is not known if the benefits of prostate cancer screening outweigh the risks, if surgery is a better option than radiation or if treatment is better than no treatment’.
The PSA screening test
This is the test used to screen for prostate and cancer and it measures the levels of prostate-specific antigen [PSA] in the blood. PSA is a protein produced by the prostate and when the prostate is enlarged the PSA blood levels tend to rise. However this tests produces a lot of false positives, suggesting that cancer is present when it is not, and false negatives giving the all clear when cancer is actually present
[Urologe A, 2000;39:22-6]
There is also disagreement about what level of PSA is significant and ‘normal’ levels can vary according to different factors.
If a PSA is positive, then further tests have to be carried out and these can have adverse effects that are worse than the condition itself as most prostate cancers are slow growing and may be present for years before they cause symptoms.
When considering being screened for prostate cancer, it is essential that the risks and benefits of the PSA and any subsequent procedures are carefully considered.