For most of a man's life, this small, unobtrusive sex gland goes about its business in quiet anonymity. But as a man ages, the little gland called the prostate can become suddenly troublesome, demanding his attention.
Located just beneath the bladder, the prostate gland is an important part of the male reproductive system, producing a fluid that makes up about one-third of the volume of semen.
The gland can cause a variety of problems. One is prostatitis, or the infection or inflammation of the prostate. The symptoms of prostatitis are painful, urgent and frequent urination. The condition is usually treated with intravenous and oral antibiotics and an increase in fluid intake to help flush the urinary tract.
Another problem is when the prostate becomes enlarged, a condition formally known as benign prostatic hyperplasia. Prostate enlargement is a fairly common condition. As a man ages, the prostate tends to increase in size due to excessive tissue growth. The prostate normally starts out the size of a walnut, but by the time a man is 40, it may have grown to the size of an apricot. An enlarged prostate has the potential to cause problems because of its location in the body. As it increases in size, the prostate can press the bladder and the urethra, blocking urine flow.
While this can be merely irritating, it becomes cause for more concern if urination becomes difficult or painful. The good news is that, for some men, the symptoms of an enlarged prostate do not worsen and require little or no treatment. When treatment is required for an enlarged prostate, it can range from lifestyle changes to drugs to surgery. Changes to lifestyle may include cutting back on alcohol and coffee, or emptying the bladder completely when urinating.
Drug therapy is a preferred treatment for many patients. There are several types of medications available. One of the most common is the medication finasteride (Proscar), which helps reduce the influence of testosterone on the prostate gland without diminishing a man's sex drive.
While there are several surgical methods to treat enlarged prostate, a procedure known as TURP, or transurethral resection of the prostate, accounts for more than 90% of such surgeries, according the National Cancer Institute. It is also the second-most-commonly performed surgery on men over age 60 in the United States.
The 1994 U.S. Public Health Service guidelines for the treatment of enlarged prostate advises doctors to leave treatment decisions to the patient. Thus, you should discuss the options with your primary care doctor or urologist to determine what's best for you, based on your condition and medical history.
Another problem--and the most serious--is prostate cancer. It should be noted that neither prostatitis or an enlarged prostate is known to cause prostate cancer.
Prostate cancer is the most common cancer among men, and the second leading cause of death in men, according to National Cancer Institute statistics. As noted before, prostatitis and enlarged prostate are not necessarily causes of prostate cancer; however, a man can have one or both of those conditions and eventually suffer from prostate cancer as well.
Research has shown that there are several risk factors for this disease. Studies have shown that more than 80% of diagnosed prostate cancer cases occur in men age 65 or older, with the average age of diagnosis 72. African American men have the highest incidence rate of prostate cancer in the world, although it is not known why this is the case. Men whose fathers or brothers have been diagnosed with prostate cancer are also at higher risk of contracting the disease.
Prostate cancer has no specific symptoms, especially in its early stages; in some cases, men have no symptoms at all. Some symptoms that may signal a problem are painful or difficult urination or painful ejaculation. Early detection through screening may help identify prostate cancer early enough so that it may be easier to treat. The screening process consists of a rectal exam and a blood test called the prostate specific antigen, or PSA, test.
The American Cancer Society recommends an annual PSA test and rectal exam for men 50 and older. Men who are at high risk for prostate cancer should be screened beginning at age 45. It is best to discuss with your doctor your medical and family history so that he or she can determine whether annual screening is beneficial to you.
For information about prostate problems, call the National Cancer Institute's Cancer Information Service at (800) 4-CANCER or the American Cancer Society at (800) ACS-2345. Both organizations can provide important information that you can discuss with your doctor to help determine your risk for prostate cancer and the best course for prevention, early detection and treatment.
Kristl Buluran has a graduate degree in public health and is a clinical researcher in Los Angeles. She can be reached by e-mail firstname.lastname@example.org.