By Dr. Aldo Moran, Market Medical Director, Flagship Health

Prostate health is a critical but often under-discussed part of senior men’s well-being. While conditions like heart disease, diabetes, and arthritis are commonly addressed in older age, the prostate—despite its vital role in urinary and sexual function—is frequently overlooked.

As men age, changes to this small gland can affect comfort, independence, and long-term health. With the right knowledge and support, senior men can take an active role in protecting their prostate health and aging with confidence.

This guide explores what senior men need to know: the most common prostate conditions, early warning signs, screening recommendations, and lifestyle habits that can help reduce risk and support long-term wellness. 

Why prostate health matters more with age

The prostate gland is roughly the size of a walnut and located just below the bladder, surrounding the urethra. It produces seminal fluid, which nourishes and transports sperm. Because of its location, even small changes in size or function can interfere with urination and sexual health—two functions that deeply affect quality of life for many older men.

As men age, hormonal shifts—such as declining testosterone and increased estrogen activity—can lead to a gradual enlargement of the prostate. Meanwhile, decades of accumulated cellular wear and chronic, low-grade inflammation may contribute to abnormal cell growth or increase the gland's vulnerability to infection and inflammation. These biological changes set the stage for three major prostate conditions: benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer.

According to Yale Medicine, around 50% of men aged 51 to 60 develop BPH, with that number rising to 70% between ages 60 and 69, and reaching 80% in men over 70. Prostate cancer risk also climbs with age. The American Cancer Society projects around 313,000 new cases in the U.S. in 2025, with about 60% of diagnoses occurring in men 65 and older. The average age of diagnosis is 67.

These changes don't happen in isolation—prostate issues can amplify other age-related health concerns, such as sleep disturbances, frequent nighttime bathroom trips, reduced mobility, and emotional distress. That’s why awareness, early screening, and preventive strategies are essential for men in their later years.

Common prostate conditions in older men

Understanding the most common prostate issues can empower men to recognize symptoms early and seek care promptly—before complications arise.

1. Benign Prostatic Hyperplasia (BPH)

BPH is the non-cancerous enlargement of the prostate. As the gland grows, it can compress the urethra, making it harder for urine to pass and causing a range of uncomfortable symptoms.

Prevalence

Yale Medicine estimates that BPH affects about 70% of men between 60–69 and over 80% of men aged 70 and older.

Symptoms may include:

  • Frequent or urgent need to urinate, especially at night
  • A weak or interrupted urine stream
  • Difficulty starting urination
  • Feeling like the bladder isn't fully emptied

Why it happens

As testosterone decreases and estrogen levels remain steady or increase slightly, this hormonal imbalance can cause the prostate to grow. Aging cells in the prostate may also become more sensitive to growth signals. 

Treatment

Options include lifestyle changes (e.g., reducing caffeine and alcohol), medications like alpha-blockers and 5-alpha-reductase inhibitors, or procedures such as transurethral resection of the prostate (TURP) to remove excess tissue.

2. Prostatitis

Prostatitis is inflammation of the prostate gland and can be caused by a bacterial infection or occur without an identifiable source (non-bacterial). While it can affect men at any age, older adults often experience a chronic, non-bacterial form that may be harder to diagnose and treat.

Prevalence

Although prostatitis is more commonly diagnosed in younger men, the chronic forms—particularly chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)—are increasingly reported in men over 65, often under-recognized due to overlapping symptoms with BPH or bladder conditions.

Symptoms may include:

  • A persistent sense of pelvic discomfort or pressure
  • Painful urination or burning sensation
  • Difficulty fully emptying the bladder
  • Pain during or after ejaculation
  • General fatigue or mild flu-like symptoms (in acute cases)

Why it happens

In men over 65, the prostate may already be enlarged due to BPH, and immune function tends to decline, which can complicate the body's response to infections. Comorbidities like diabetes or reduced mobility may also increase the risk of recurrent or lingering inflammation.

Treatment

Treatment depends on the type of prostatitis. For bacterial forms, antibiotics are the first line of defense. However, chronic or non-bacterial prostatitis in older men often requires a more holistic approach:

  • Alpha-blockers to relax the prostate and bladder muscles
  • Anti-inflammatory medications to reduce discomfort
  • Pelvic floor physical therapy to address muscular tension
  • Warm baths, hydration, and stress management techniques
  • Careful medication review to avoid drug interactions common in seniors

Note: Because prostatitis symptoms in older adults can overlap with signs of prostate cancer or BPH, proper diagnosis through a urologic evaluation is essential.

3. Prostate Cancer

Prostate cancer occurs when abnormal cells in the prostate begin to grow uncontrollably. It is the second most common cancer among men, and senior men—particularly those over age 65—account for the majority of diagnoses.

Prevalence

According to the American Cancer Society, approximately 60% of prostate cancer cases occur in men aged 65 and older, with the average age of diagnosis being 67. One in eight men will be diagnosed during their lifetime, and the risk increases significantly with age.

Symptoms may include:

  • Difficulty starting or stopping urination
  • Weak or interrupted urine flow
  • Blood in the urine or semen
  • Erectile dysfunction
  • Pain or stiffness in the lower back, hips, or pelvis
  • Unexplained weight loss or fatigue (in advanced cases)

Why it happens

With age, cellular repair mechanisms weaken, and DNA damage accumulates, increasing the chance of genetic mutations that can lead to cancer. In addition, long-term exposure to hormones such as testosterone may contribute to abnormal cell growth in the prostate. Chronic inflammation and underlying conditions like obesity, metabolic syndrome, or diabetes—more common in older adults—may further increase risk.

Treatment

For senior men, treatment decisions often depend on age, overall health, cancer stage, and life expectancy. Many early-stage prostate cancers grow slowly and may not pose an immediate threat, which is why active surveillance is a common strategy for men in their mid- to late 60s and beyond.

Other treatment options include:

  • Surgery (radical prostatectomy) for eligible, healthy older men
  • Radiation therapy (external beam or brachytherapy), especially for those seeking non-surgical alternatives
  • Hormone therapy to slow cancer growth in advanced cases
  • Watchful waiting, a less intensive monitoring approach for men with limited life expectancy or non-aggressive cancer

What increases your risk?

Several factors influence a man’s likelihood of developing prostate issues:

  • Age: Risk rises sharply after 50. Cellular repair slows, inflammation accumulates, and hormonal changes alter prostate function.
  • Family history: A father or brother with prostate cancer significantly raises your risk.
  • Race/ethnicity: African American men face significantly higher risks when it comes to prostate cancer — they are about 1.7 times more likely to be diagnosed and roughly 2.1 times more likely to die from the disease compared to white men.
  • Diet: Diets high in red meat, processed foods, and saturated fats have been associated with higher prostate cancer risk, while plant-forward diets rich in antioxidants may offer protective benefits.
  • High BMI, obesity, and inactivity: Carrying excess weight—especially in men with a high BMI or classified as obese—can lead to hormone changes and chronic inflammation that increase prostate cancer risk. Being inactive, such as sitting for most of the day or skipping regular exercise, can compound these effects.
  • Smoking and alcohol: Toxins from smoking can damage DNA, while heavy alcohol use may affect hormone metabolism and immune surveillance.

Should you get screened?

Screening helps detect prostate cancer early, often before symptoms appear. But screening isn’t appropriate for everyone, which is why shared decision-making is critical.

Screening options:

  • Prostate-Specific Antigen (PSA) Test: A blood test that measures PSA levels. Elevated PSA may signal cancer, but also BPH or prostatitis.
  • Digital Rectal Exam (DRE): A physical exam in which a doctor checks for lumps or hardness in the prostate via the rectum.

What the CDC recommends:

  • Men aged 55 to 69 are encouraged to have an informed discussion with their healthcare provider about PSA screening for prostate cancer. This conversation should cover the potential benefits—such as early detection of cancer when it’s most treatable—as well as the risks, including false positives, overdiagnosis, and potential side effects from unnecessary treatment. Personal factors like family history, race, overall health, and individual preferences should be considered when deciding whether to proceed with screening. The goal is to make a shared, personalized decision based on a man’s unique risk profile and values.
  • Men over 70 are not routinely recommended for prostate cancer screening, because the potential risks—such as false positives, unnecessary biopsies, or treatment side effects—often outweigh the benefits at this age. However, if a man is in excellent health and has higher risk factors (such as a family history of prostate cancer or being African American), screening may still be considered after a thoughtful discussion with a healthcare provider.

Benefits of screening:

Early detection allows for less invasive treatment, preserves quality of life, and may improve survival.

Risks of screening:

False positives can lead to unnecessary biopsies or treatment. Some slow-growing cancers may never become dangerous but could still be treated aggressively.

Five ways to support prostate health

Even if you feel fine, adopting healthy habits now can support your prostate for years to come.

1. Eat for prostate health

Diet plays a significant role in prostate health—both in preventing disease and supporting overall wellness. Research consistently shows that a Mediterranean-style diet is associated with a lower risk of prostate cancer and slower disease progression in men who are diagnosed.

This eating pattern emphasizes:

  • Fruits and vegetables, especially leafy greens, berries, and cruciferous vegetables like broccoli and cauliflower
  • Whole grains such as oats, brown rice, and quinoa
  • Legumes like lentils, chickpeas, and black beans
  • Olive oil as a primary fat source
  • Fish, especially oily varieties like salmon and sardines, which provide omega-3 fatty acids

Lycopene, a powerful antioxidant found in tomatoes, watermelon, pink grapefruit, and guava, has been specifically linked to reduced prostate cancer risk.

Cut back on:

  • Sugary snacks and refined carbohydrates, which can spike insulin and contribute to inflammation
  • Excessive dairy consumption, which some studies suggest may increase levels of insulin-like growth factor-1 (IGF-1), a hormone associated with increased cancer risk

Takeaway:

Choosing anti-inflammatory, nutrient-dense foods supports hormonal balance and reduces oxidative stress—both of which are important in maintaining prostate health and lowering the risk of cancer.

2. Avoid or limit red and processed meats

Diets high in red and processed meats—such as bacon, sausage, hot dogs, and grilled or charred beef—have been linked to an increased risk of prostate cancer, particularly aggressive forms of the disease. Several studies suggest that compounds formed during high-temperature cooking, such as heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs), may contribute to cancer development by damaging cellular DNA.

Processed meats also often contain nitrates and nitrites, which are preservatives that can convert into carcinogenic compounds in the body. These substances may trigger inflammation or oxidative stress, both of which are factors in prostate tumor progression.

A meta-analysis found that men with the highest consumption of processed meats had a significantly greater risk of developing prostate cancer compared to those with the lowest intake. Other research from the World Cancer Research Fund has also emphasized limiting red and processed meats as part of a cancer prevention strategy.

To reduce risk:

  • Choose leaner, less-processed protein options such as poultry, fish, legumes, and plant-based sources.
  • If consuming red meat, opt for smaller portions, choose grass-fed or unprocessed cuts, and avoid charring or overcooking.
  • Consider Meatless Mondays or other simple ways to shift toward a more plant-based eating pattern.

Healthier alternatives include:

  • Lentils, chickpeas, black beans, and tofu
  • Nuts and seeds
  • Fatty fish like salmon, mackerel, or sardines, which offer heart- and prostate-friendly omega-3s

Takeaway:

Limiting red and processed meats helps reduce exposure to potentially cancer-promoting compounds and supports an overall anti-inflammatory, prostate-friendly diet.

3. Move your body regularly

Exercise plays a key role in maintaining prostate health. It reduces chronic inflammation, enhances circulation, regulates hormone levels (including testosterone and insulin), and strengthens the immune system—factors all linked to a lower risk of prostate conditions.

Tip:

Strive for at least 150 minutes of moderate activity each week, such as brisk walking, swimming, or cycling. Incorporating vigorous activity, like running or interval training, provides even greater protective benefits.

In a large-scale study published in the British Journal of Sports Medicine (2024), researchers followed more than 57,000 Swedish men over several decades and found that:

  • Those who improved their cardiovascular fitness over time had a 35% lower risk of developing prostate cancer.
  • Those with high fitness levels had a 50% lower risk of dying from the disease, regardless of their body weight.

This reinforces the importance of staying active—especially for older men—as fitness itself, not just weight, is a powerful predictor of prostate cancer risk and survival.

4. Quit smoking and moderate alcohol use

Smoking has been consistently associated with poorer prostate cancer outcomes. While it may not significantly raise the risk of developing the disease, research shows that men who smoke are more likely to develop aggressive prostate cancer and face lower survival rates.

In a Harvard study, men with prostate cancer who smoked had a 61% higher risk of death from the disease compared to those who never smoked. Current smokers were also significantly more likely to experience cancer recurrence. The good news: men who quit smoking saw meaningful improvements in their outcomes. After 10 or more years of cessation, their risk of prostate cancer mortality approached that of never-smokers.

Alcohol, when consumed in excess, may also pose risks. While moderate drinking has not been definitively linked to prostate cancer, heavy or frequent alcohol consumption can affect hormone levels, impair liver function, and promote systemic inflammation—all of which may contribute to cancer development or progression.

According to some studies, heavy alcohol use was associated with a 20% increased risk of prostate cancer, particularly in men consuming more than three drinks per day.

Recommendations:

  • If you smoke, quitting is one of the most impactful things you can do to improve prostate health and long-term survival. Support programs, nicotine replacement therapy, and medications can help.
  • For alcohol, limit intake to no more than 1 drink per day for men over 65. For those at higher risk, abstaining altogether may be the safer choice.

5. Stay on top of regular checkups

Routine checkups are a cornerstone of proactive prostate care—especially for men 65 and older. As the risk of prostate-related conditions increases with age, regular visits to a primary care provider or urologist can help detect changes early, track symptoms over time, and guide timely intervention.

What to discuss at your annual exam:

  • Urinary symptoms: difficulty starting or stopping urination, weak stream, frequent nighttime urination, or feelings of incomplete emptying
  • Sexual health changes: erectile dysfunction or discomfort during ejaculation can be early signs of prostate issues
  • Family history and personal risk factors: including race, BMI, smoking status, and past prostate concerns
  • Screening decisions: such as whether to undergo a PSA test or digital rectal exam (DRE), based on your overall health, age, and personal values

Even if you're not experiencing symptoms, these checkups provide a valuable opportunity to monitor trends and make personalized decisions. In fact, many prostate conditions develop gradually and may go unnoticed until they become more advanced. Preventive care helps catch issues before they become disruptive—and supports broader health goals such as sleep quality, mobility, and independence.

If you're managing other chronic conditions like hypertension or diabetes, regular visits also allow your provider to assess how these may interact with prostate health and adjust your care plan accordingly.

Bottom line: Make prostate health a standard part of your annual wellness conversation. Personalized care—not one-size-fits-all recommendations—is the key to early detection, effective treatment, and long-term well-being.

When to see a healthcare provider

Don’t wait for symptoms to become disruptive before seeking medical attention. Many prostate conditions—especially prostate cancer—can develop silently in their early stages. If you notice any of the following signs, it’s important to speak with your healthcare provider promptly:

  • Difficulty starting or maintaining urination
  • Blood in your urine or semen
  • Pain or discomfort in the lower back, pelvis, or hips
  • Painful ejaculation
  • Frequent need to urinate at night (nocturia)

These symptoms could indicate a range of prostate-related conditions, including benign prostatic hyperplasia (BPH), prostatitis, or prostate cancer. While not all symptoms are cause for alarm, they should never be ignored.

Why it matters:

When detected early—while still confined to the prostate or surrounding tissues—prostate cancer has a five-year survival rate of nearly 100%, according to the American Cancer Society. Early diagnosis opens the door to a wider range of treatment options, many of which are less invasive and more effective. Recognizing symptoms early and acting on them can make a significant difference in your quality of life and long-term outcomes.

Final thoughts

Prostate health is a vital part of aging well. Conditions like BPH, prostatitis, and prostate cancer are common in older men—but many are treatable, and some can be prevented or caught early through healthy habits and regular care. Knowing your risks, speaking openly with your healthcare provider, and embracing healthier habits can help you stay in control.

At Flagship Health, we’re proud to support seniors and senior veterans through every stage of their health journey. Whether you're experiencing symptoms, considering screening, or simply want to stay proactive, our team is here to help.

To schedule an appointment or learn more about our senior health services, contact us today.

About Dr. Aldo Moran

Dr. Aldo Moran is the Market Medical Director for Flagship Health in San Antonio, Texas. He earned his Doctor of Osteopathic Medicine from Nova Southeastern University and completed his Internal Medicine Residency at the University of the Incarnate Word in Laredo, Texas. Before his medical career, Dr. Moran served seven years in the U.S. Army, including deployment during Operation Iraqi Freedom, where he was an infantry squad leader and the Non-Commissioned Officer in Charge of Nuclear, Biological, and Chemical Defense operations. Fluent in English and Spanish, he has been practicing since 2019, focusing on diabetes and metabolism disorders, cardiovascular disease prevention, and preventive medicine.