What is the Prostate?

The prostate is a small gland located just below the bladder, in front of the rectum and surrounding the urethra (urinary tube).

This tiny organ is responsible for regulating the flow of urine and producing semen, the liquid which carries sperm. Prostate problems are common, especially in older men. Two of the most prevalent prostate diseases that men are likely to encounter are benign prostatic hyperplasia and prostate cancer. Monitoring your prostate health, especially after the age of 50, is extremely important in preventing serious prostate diseases.

What is benign prostatic hyperplasia?

BPH, or enlarged prostate, is the most common of the prostate diseases. Most men will experience some degree of prostate enlargement as they age. As the prostate increases in size, it places pressure on the urethra, causing unpleasant urinary issues. Approximately 1/3 of men with benign prostatic hyperplasia experience symptoms severe enough to require treatment.

What are the symptoms of BPH?

The most common symptoms of enlarged prostate include:

  • Frequent urination;
  • Urgency - the sudden need to urinate;
  • Slow urine stream or dribbling;
  • Difficulty starting a urine stream, or a stream that starts and stops;
  • The need to urinate two or more times during the night.
As prostate growth advances, several complications may occur if the condition is left untreated:

  • Incontinence;
  • Bladder infections;
  • Bladder stones;
  • Kidney damage;
  • Blockage of the urinary tube (this condition, known as Acute Urinary Rentention, or AUR, is a medical emergency requiring immediate surgery).

How is enlarged prostate diagnosed?

During a prostate exam, your doctor will perform a digital rectal examination to check for any abnormalities in the prostate gland, such as increased prostate size or hardened areas which may indicate cancer. If anything seems abnormal during your initial prostate exam, your doctor will order a variety of tests to determine the whether you have certain prostate diseases: 

  • Urinalysis;
  • A urinary flow test;
  • A study that measures how much urine remains in the bladder following urination;
  • A survey known as the BPH Symptom Score Index - a series of questions used to determine the severity of your prostate symptoms;
  • The PSA (Prostate Specific Antigen) test - a blood test used to measure protein levels that may indicate certain prostate diseases.

What causes BPH?

Enlarging prostate is mainly linked to aging; about 50% of men will have enlarged prostate symptoms by age 60, and by age 85, an estimated 90% of all men will have some signs of prostate disease.

Another factor in enlarged prostate is the male sex hormome DHT (dihydrotestosterone). Men with enlarged prostate tend to have elevated levels of DHT; hormone levels continue to increase as the prostate gland grows to an unhealthy size.

Does an enlarged prostate increase the risk for prostate cancer?

According to current research, BPH does not indicate an increased risk factor for prostate cancer. However, prostate cancer symptoms are very similar to those caused by an enlarged prostate, and it is possible to have prostate cancer along with benign prostatic hyperplasia. All prostate cancer warning signs should be taken seriously, and men should begin screening yearly after the age of 50 for signs of prostate disease. Men who have a family history of prostate cancer should begin screening by the age of 40.

How is benign prostatic hyperplasia treated?

If your symptoms are not causing you much discomfort, your doctor may advise what is known as "watchful waiting," which basically means keeping an eye out through a regular prostate exam schedule. If treatment becomes necessary, there are several options; your doctor will discuss these with you and help you decide which is best for you:

- Medicines:

There are two types of prescription drugs which are used for treating BPH.

* 5ARIs (short for 5-alpha-reductase inhibitors) decreases the levels of DHT in the prostate. These
drugs shrink the size of the prostate gland and improve urinary symptoms, often eliminating
the need for surgery.

* Alpha-blockers relax the muscles of the bladder, causing an immediate improvement in urine flow.
However, they do not shrink the prostate gland.

- Surgery

Patients who do not respond to medications may require surgery. There are several options for prostate
surgery; the method that your doctor will use depends on the extent of the enlargement and other health

* Transurethal surgery is a technique by which the surgeon accesses the prostate through the urethra to
remove excess tissue without cutting into the skin.

* Laser surgery involves inserting a laser fiber through the urethra, then using bursts of intense energy to
destroy the unwanted tissue.

* Open prostate surgery, or prostatectomy, is used in cases where the prostate is extremely enlarged. By
this method, the prostate gland is removed through an incision.


What is prostate cancer?

Prostate cancer is the abnormal overgrowth of cells in the prostate gland; it is the most common type of cancer in men in the United States. Because this cancer is slow-growing, it is often caught and treated successfully in the early stages. Prostate screening after the age of 50 is important, especially if you are experiencing any of the prostate cancer warning signs.

What are the most common prostate cancer symptoms?

Typical prostate cancer warning signs are similar to those of enlarged prostate. In the early stages, there may be no symptoms at all; because of this, a yearly prostate exam is critical to early detection and preventing problems with your prostate health. Prostate cancer symptoms include:

  • Frequency of urination, especially at night;
  • Difficulty starting a urine stream;
  • Burning or pain during urination or ejaculation;
  • Blood in the urine or semen.

What causes prostate cancer?

Medical experts are not yet certain of the exact cause of prostate cancer. However, there are several factors which are closely linked with the incidence of prostate cancer:

  • Diet: a diet high in animal fats, especially red meat, is a known contributing factor;
  • High testosterone levels are associated with cancer;
  • Family history is a significant factor; men who have a family background of prostate problems are much more likely to develop prostate cancer symptoms themselves.

What are the prostate cancer treatment methods most often used?

Your prostate cancer treatment depends on how advanced the cancer is, your age and general state of health, and your own preferences. Surgery, radiation therapy, and hormone treatments are typical techniques for prostate cancer treatment; your doctor may recommend one of these, or a combination.

Your prognosis depends on many factors, including the stage of the disease and whether it has spread. For this reason, monitoring your prostate health is crucial. You should be aware of the common prostate cancer warning signs, and make sure you schedule an annual exam.

With early detection, prostate cancer can be successfully treated, leaving you to enjoy a long and fulfilling life.

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