Patient advocate: The gland guys don’t want to talk about
For something the size of a walnut, the prostate looms large in men’s imaginations and concerns as they age. That said, a recently published report said only about 6% of men talk to their doctors about prostate cancer screening.
Now, obviously, I’m not a guy so I have no personal experience. But 40% of men who were surveyed in 2025 said they’d rather stew in traffic or watch their favorite sports team lose than talk about prostate health with their doctors, even though about one in eight men will be diagnosed with prostate cancer in their lifetime.
Some doctors feel that discussions regarding urinary symptoms and sexual health are very personal in nature and can sometimes make patients feel self-conscious.
So let’s demystify this little troublemaker and see if we can encourage greater awareness and conversation.
Where it is and what it does
The prostate is tucked below the bladder and is involved in urinary and sexual health. It adds fluid to semen and helps muscle it out of the urethra. It weighs about an ounce, and, though it starts out small, it tends to get larger as a man ages. This condition is called BPH, benign prostatic hyperplasia, which is believed to be brought on by hormonal changes.
The urinary symptoms that come with BPH are unpleasant: frequent need to urinate, especially at night; an inability to empty the bladder; possible urinary tract infections. So even if the symptoms aren’t particularly bothersome, you should still mention them to your doctor and head off more serious complications.
What about prostate cancer?
Prostate cancer is the second most common cancer in men, the first being skin cancer. As with most cancers, the earlier it’s detected the better the treatment outcomes. There’s a 97% survival rate, but treatments like surgery and radiation sometimes result in lifelong complications such as urinary incontinence and erectile dysfunction.
No wonder it’s something men don’t want to necessarily discuss. However, if you’re between the ages of 55 and 69, have a family history of prostate cancer or are African American, it’s wise to at least talk to your doctor about it or not brush it off if the doctor brings it up.
Why? Because in its later stages, the cancer can spread to the bones and lymph nodes. At that point, treatment focuses on managing symptoms and maintaining quality of life rather than attempting to cure the disease.
How it’s detected
Getting screened and treated for prostate cancer involves highly individualized decisions, ones that should be made in conjunction with a urologist rather than a family practitioner. A private patient advocate with medical expertise can help with such decisions because prostate cancer screening is not universally recommended.
The standard blood test, which looks for levels of prostate-specific antigen (PSA), is not a perfect indicator of cancer and can lead to unnecessary procedures, such as biopsies. There are now non-invasive MRI tests for the prostate that may be more reliable than PSA. Researchers are marrying MRI with ultrasound to provide more accurate biopsy results.
Also, many prostate cancers are slow-growing and may never become life-threatening, particularly if a man is 70 or older. In that case, a urologist may recommend active surveillance rather than treatment.
Treatments are evolving
As with many cancers, researchers are using hormonal, genetic and immune therapies to treat more advanced cases of prostate cancer. In 2023, the FDA approved enzalutamide for some men who are at high risk of their cancer spreading but don’t show signs that it’s come back. Research is ongoing into whether these therapies help men live longer with better quality of life.
On the genetic front, some people inherit factors that limit their body’s ability to repair DNA damage. Such tumors can be treated with PARP inhibitors, which “turn off” a specific enzyme. Researchers are also looking into vaccines and other forms of immunotherapy to help the body be more effective at killing prostate cancer cells.
The same things you do for overall health also help your prostate: good diet, exercise, no tobacco. Supplements advertised as supporting prostate health have not been studied extensively, so don’t expect much in the way of results.
But I think the most important thing men can do is talk to their doctors — and to each other — about prostate health.
• Teri (Dreher) Frykenberg, R.N., a registered nurse and board-certified patient advocate, is the founder of NurseAdvocateEntrepreneur.com, which trains medical professionals to become successful private patient advocates. She is the author of “How to Be a Healthcare Advocate for Yourself & Your Loved Ones” and “Advocating Well: Strategies for Finding Strength and Understanding in Health Care,” available at Amazon.com. Contact her at Teri@NurseAdvocateEntrepreneur.com to set up a free phone consultation.