This article is dedicated to my friend Cos. He had recently begun going to the gym and was excited to read Thrive After 50. Sadly, he died from prostate cancer before I had the opportunity to share it with him.
I offer this information in his memory, with the hope that it encourages other men to speak openly about prostate health, understand their personal risk, and have timely conversations with their healthcare professionals.
As men get older, conversations about the prostate become much more common. One friend may be waking up several times a night to urinate. Another may have a weak urine stream. Someone else may be facing prostate cancer.
These problems can sound alike, but they are not the same — and symptoms alone cannot tell you which condition is present.
Know your risk, know your PSA trend, and talk with your healthcare professional. That’s the single most important action in this article.
What is the prostate?
The prostate is a small gland located below the bladder. The urethra — the tube that carries urine out of the body — passes through it. As the prostate grows, it can squeeze the urethra and interfere with urination.
Three different prostate problems
1. Benign prostatic hyperplasia (BPH)
BPH means the prostate has enlarged, but the enlargement is not cancer. It is the most common prostate problem in men over 50. BPH can cause:
- A weak or interrupted urine stream
- Difficulty starting urination
- Dribbling after urination
- A feeling that the bladder did not empty completely
- Urgency or frequent urination
- Waking repeatedly during the night to urinate
BPH does not mean that a man has prostate cancer. However, BPH and prostate cancer can exist at the same time, so new or changing symptoms deserve medical evaluation.
2. Prostatitis
Prostatitis is inflammation of the prostate. It may cause pelvic discomfort, painful urination or ejaculation, fever, chills, or difficulty urinating. Some forms are caused by bacterial infection; others are not. Treatment depends on the cause.
3. Prostate cancer
Prostate cancer can range from slow-growing disease that may never threaten a man’s life to aggressive disease that can spread. Early prostate cancer frequently causes no symptoms, which is why waiting for symptoms is not a reliable detection strategy.
Who has a higher risk of prostate cancer?
Risk rises with age. Black men are more likely to develop prostate cancer, tend to develop it younger, and are more than twice as likely to die from it as other men. Risk is also higher when a father, brother, or son has had prostate cancer, particularly when several relatives were affected or a relative was diagnosed young. Certain inherited gene changes can also increase risk.
Every man should make sure his clinician knows his complete family history — including prostate, breast, ovarian, and pancreatic cancers on both sides of the family.
Talk with your clinician about PSA screening
A PSA test is a blood test that measures prostate-specific antigen. An elevated PSA does not automatically mean cancer. BPH, prostate inflammation, infection, recent ejaculation, and other factors can influence the result. There is also no single PSA number that proves or rules out cancer.
The American Urological Association recommends shared decision-making rather than silently testing — or never discussing testing at all. Its guidance supports:
- Offering screening beginning around ages 40–45 for people at increased risk, including Black men and those with a strong family history or certain inherited mutations.
- Regular screening, generally every 2–4 years, for people ages 50–69, with the interval personalized according to PSA, risk, health, and prior results.
- Individualized decisions for older men based on previous PSA results, overall health, and life expectancy rather than age alone.
Different medical organizations are not identical in their recommendations. That is why the right first step is a conversation about your personal benefits and risks — not a universal yes-or-no rule.
Questions to take to your appointment
- Based on my age, ancestry, family history, and health, should I have a PSA test?
- What is my current PSA, and how does it compare with my previous results?
- Could my medications or a prostate condition affect the result?
- If my PSA is elevated, should we repeat it before taking the next step?
- Would a urologist, MRI, another biomarker test, or biopsy be appropriate?
One abnormal PSA is not a diagnosis. The trend over time and the complete clinical picture matter.
If you have been treated for prostate cancer
Surgery or radiation does not end the need for follow-up. PSA monitoring can detect a recurrence months or years before symptoms appear. Keep every recommended follow-up appointment, know your PSA results, and ask what change should trigger imaging or additional treatment.
Do not ignore these warning signs
Arrange a medical evaluation for:
- Blood in the urine or semen
- A weak stream or increasing difficulty urinating
- Pain or burning with urination
- Persistent pelvic, hip, back, or bone pain
- Unexplained weight loss or unusual fatigue
- Fever or chills together with urinary symptoms
Seek urgent medical care if you cannot urinate at all or develop severe lower-abdominal pain. Acute urinary retention can be dangerous.
Can diet, lifestyle, or supplements help the prostate?
There is good reason for encouragement, but not for miracle claims. Practical habits can ease some urinary symptoms, and doctors have effective treatments for prostate enlargement. No particular diet, supplement, workout, or “prostate cleanse,” however, has been proven to prevent or cure prostate cancer.
Practical steps that may ease urinary symptoms
For men who have been evaluated and diagnosed with benign prostatic hyperplasia (BPH), these measures may reduce urgency, frequency, or nighttime bathroom trips:
- Drink fewer fluids during the two hours before bedtime or before going out — but continue drinking enough earlier in the day to avoid dehydration.
- Limit caffeine and alcohol, particularly later in the day, because both can aggravate urgency and frequency.
- Urinate when the urge appears and take enough time to empty the bladder. Some men find it helpful to wait briefly and try again, sometimes called “double voiding.”
- Stay physically active, maintain a healthy weight, and address constipation.
- Ask a clinician or pharmacist whether any medications could worsen symptoms. Some cold medicines and decongestants can make urination more difficult.
- If you take a diuretic or “water pill,” ask the prescriber whether its timing contributes to nighttime urination. Never change a prescription on your own.
These steps may improve comfort, but they do not determine whether the cause is BPH, prostatitis, cancer, a bladder problem, or something else. New or worsening symptoms still require evaluation.
A prostate-supportive eating pattern
There is no scientifically proven “prostate diet.” A sensible approach is an overall heart-healthy pattern that also supports body weight and metabolic health:
- Eat vegetables and fruits of different colors.
- Include beans, lentils, whole grains, nuts, seeds, fish, and olive oil.
- Choose adequate protein while limiting heavily processed meats.
- Reduce highly processed foods, sugary drinks, and excessive alcohol.
- Get nutrients primarily from food instead of high-dose antioxidant pills unless a clinician has identified a deficiency.
Tomatoes and other foods containing lycopene can be part of this pattern, but lycopene supplements have not been proven to prevent or treat BPH or prostate cancer.
What does the evidence say about prostate supplements?
Saw palmetto: Although widely advertised for enlarged-prostate symptoms, large, well-controlled studies found that saw palmetto was generally no better than a placebo — even at higher-than-usual doses.
Beta-sitosterol: Some older, short-term studies found modest improvements in urinary symptoms and urine flow. It has not been shown to shrink the prostate or prevent cancer, and good long-term evidence is lacking.
Pygeum: Some older studies suggest modest symptom improvement, but the research is limited and supplement products may not contain consistent preparations.
Pumpkin seed and pumpkin-seed oil: They are nutritious foods, and small studies and personal reports suggest possible symptom relief. The evidence is not strong enough to consider them proven BPH treatments.
Selenium and vitamin E: These should not be taken specifically to prevent prostate cancer. A major prevention trial found no protective benefit from selenium. Vitamin E taken alone was associated with more prostate-cancer diagnoses.
“Natural” does not automatically mean safe or effective. Supplements can interact with medications, affect bleeding, contain inconsistent amounts of active ingredients, and create false reassurance that delays diagnosis. Men should show their complete supplement list to their healthcare professional.
Anecdotes are not the same as proof
A friend may sincerely report that a remedy improved his urinary symptoms. That experience matters to him, but it cannot prove that the remedy caused the improvement. BPH symptoms can fluctuate, and changes in fluid intake, caffeine, medication timing, or expectations can all affect how a man feels.
If someone chooses to try a supplement after speaking with his clinician, he should treat it as a monitored experiment for diagnosed BPH — not as a substitute for PSA discussions, examination, testing, or cancer treatment.
Where safe strength training fits in
Men do not have to quietly accept worsening urinary problems as “just getting older.” Depending on the cause and severity, established medical options include watchful waiting, prescription medicines that relax the prostate and bladder outlet, medicines that gradually shrink certain enlarged prostates, daily tadalafil for appropriate patients, minimally invasive procedures, and surgery when obstruction is severe. Each option has possible side effects and interactions, and some prostate medicines can change PSA levels, so your prescriber needs to know everything you’re taking.
Alongside that medical care, regular exercise, maintaining a healthy weight, not smoking, getting adequate sleep, and eating a balanced diet support general health and may help a man tolerate treatment. Pelvic-floor and core-focused resistance work — done with joint-safe, low-impact movement patterns rather than heavy overhead pressing or high-impact loading — may also support recovery and continence when approved by your treatment team. This is exactly the kind of injury-conscious, body-first approach I build into every Silver Fit Plus program: strength training that respects what a 50+ body can safely handle, never the other way around.
Healthy living should complement appropriate screening and medical care — not replace them.
The Silver Fit Plus message
Men often stay silent about urinary changes because they are embarrassed, assume the problem is simply aging, or fear what testing might find. A better approach is straightforward:
Notice changes. Speak openly. Know your risk. Track your PSA. Keep your follow-up appointments.
Sharing this information with one friend may be the nudge that gets him to have an overdue conversation with his doctor.
Cos never got the chance to read Thrive After 50 — the book I wrote to help men build strength and longevity at this stage of life. If this article moved you, consider picking it up for yourself, or for a friend who needs the nudge Cos never got. Get Thrive After 50 →
Medical disclaimer: This article provides general education and is not medical advice, diagnosis, or treatment. Screening and treatment decisions should be made with a qualified healthcare professional who knows your medical history. Seek urgent care if you are unable to urinate or have severe pain.
Sources
American Urological Association — Early Detection of Prostate Cancer Guideline — https://www.auanet.org/guidelines-and-quality/guidelines/early-detection-of-prostate-cancer-guidelines
National Cancer Institute — Prostate-Specific Antigen (PSA) Test — https://www.cancer.gov/types/prostate/psa-fact-sheet
National Institute of Diabetes and Digestive and Kidney Diseases — Prostate Problems — https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems
National Institute of Diabetes and Digestive and Kidney Diseases — Enlarged Prostate (BPH) — https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia
National Center for Complementary and Integrative Health — Saw Palmetto — https://www.nccih.nih.gov/health/saw-palmetto
National Cancer Institute — Prostate Cancer Prevention — https://www.cancer.gov/types/prostate/patient/prostate-prevention-pdq
Centers for Disease Control and Prevention — Prostate Cancer Risk Factors — https://www.cdc.gov/prostate-cancer/risk-factors/index.html