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Prostate Information - Enlarged ProstateThe prostate gland is part of the male reproductive system. About the size of a walnut, it sits just below the bladder and encircles the urethra as it leaves the bladder. The prostate gland produces fluid that makes up part of the semen in a male ejaculate. Being totally internal, prostate problems can sometimes be difficult to detect and diagnose. One common problem is prostatitis, wherein the prostate gets inflamed, causing it to swell and constrict around the urethra, making the flow of urine painful, difficult, and at times impossible. Urine and blood tests can be used to confirm prostatitis, and treatment normally includes antibiotics in addition to prostate massage. An enlarged prostate is a common condition in older men, called benign prostatic hyperplasia, which often requires medication or surgery to treat and alleviate symptoms. The prostate is normally check during a digital rectal exam during an annual physical. Any abnormalities can then be followed up with further testing.
Prostate CancerProstate cancer is the most serious prostate disease. About 37,000 men die from prostate cancer each year (as a man, you have about a 3% chance of dying from prostate cancer). It is also one of the most common cancers among older men, especially men over the age of 50. Like all cancers, if prostate cancer is not treated, it can spread to other parts of the body, including lymph nodes. What are the signs and symptoms of prostate cancer? Difficulty and pain during urination is the most common problem, along with bumps on the prostate gland. Other signs include frequent urination, inability to end the flow of urine, pain with ejaculation, and hip and back pain that does not go away. Prostate cancer is normally detected via a digital rectal exam (DRE) and the use of PSA tests (see below). What causes prostate cancer? The leading risk factors are age (70% of cases are in men over the age of 65). A family history of prostate cancer also raises your chances of getting it (genetic). Black men also have a higher rate of cancer incidence (Asians have the lowest). Diet can also be a factor, with excess animal fat raising the prostate cancer risk as well. If a DRE or PSA test indicates a possible problem than looks like cancer, a biopsy is normally performed to test the prostate cells for cancer. A prostate biopsy involved inserting a needle into the prostate and extracting a core sample of tissue for analysis. You can request your doctor use local anesthesia during the biopsy process, since many men find it very uncomfortable without it.Treating prostate cancer normally involves hormone treatments, radiation, and/or surgery. Unfortunately, do to the area in which the prostate is located, these treatments, especially surgery, ofter cause permanent problems related to incontinence and impotence, not something most men want to risk. Be sure to talk to your doctor about all the options, including doing nothing if it appears to be a slow growing cancer (the most prevalent type). What is a PSA test for prostate cancer?A PSA test stands for prostate specific antigen, and it is a test that measures the level of that particular protein in a man's bloodstream. It is only produced by the cells in the prostate gland. Having a high reading on a PSA test does not mean cancer - it can also indicate an infection or other benign prostate conditions, but it is a possible indicator of cancer. Normal PSA readings are very low. PSA tests can also be used to see if there is a possible recurrence of cancer. The test scores usually come back in readings of nanograms per milliliter of blood. A reading of 2.5 or below is considered low, while 2.6-10 is slightly elevated, 10-20 is moderately elevated, and 20+ is high. If no lumps or abnormalities are detected during the DRE, many doctors choose to wait and then do the test again 6-12 months later. Alternatively, urine and blood tests can be run for signs of infection, and ultrasound or cystoscopy can be used to get a closed look at the prostate and surround tissues.Advantages and disadvantages of PSA screening: PSA tests are recommended for all men over 50, and some doctors like to begin screening as early as 40 to establish baseline results for comparison and changes. One problem with PSA test is too many false positives and painful biopsies being performed. Of course, it is better to err on the side of caution, but someone who has a few negative biopsies done may be reluctant to get the next one done a few years later, when the cancer might be real. Another problem is that PSAs sometimes detect cancer that is so slow growing, that if it had not been detected, it would have never bothered the patient (who wants prostate surgery at 75 when you will be dead at 78 anyways?). Three of of four cases of prostate cancer are the slow growing type that normally require no treatment. Only 25-30% of men who have a biopsy for elevated PSA readings actually have cancer.
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