Men’s Health
The prostate gland is part of a man’s sex organs.
* It helps make semen, the fluid that contains sperm.
* It is under the bladder and in front of the rectum.
* It surrounds the upper part of the urethra. This tube empties urine from the bladder.
* It is about the size of a walnut in a young man and slowly gets larger with age.
Prostate Problems
1. Prostatitis (PRAH-stuh-TY-tis). With this, the prostate gland is inflamed or infected. This can be an acute or chronic problem.
2. Enlarged prostate. This is also called BPH. This stands for benign (be-NINE) prostatic (prah- STAT-ik) hyperplasia (HY-per-PLAY-sha). This is the most common prostate problem in men over age 50. BPH is not cancer. It just means the prostate keeps growing.
3. Prostate cancer. This is the second most common type of cancer that men get. (Skin cancer is the first.) Prostate cancer is much less common than BPH.
Signs & Symptoms
For Prostatitis
* Pain and burning when you urinate, have an erection, or ejaculate
* Strong urges to urinate. You urinate often, even at night.
* A hard time starting to urinate. You don’t empty your bladder all the way.
* Pain in your lower back and/or between the scrotum and anus
* Blood in the urine
* Fever and/or chills
For an Enlarged Prostate
* Increased urge to urinate.
* You urinate often, especially during the night.
* Delay in onset or decreased or slow stream when you urinate
* You don’t empty your bladder all the way.
For Prostate Cancer
Prostate cancer may have no symptoms until it is advanced. When symptoms occur, they include:
* Symptoms of an enlarged prostate
* Blood in the urine
* Swollen lymph nodes in the groin area
* Erectile dysfunction
What should you do if you have any of these signs?
If you can’t pass urine at all, get medical help right away. For other signs and symptoms, see your doctor.
Causes
For Prostatitis
The prostate is inflamed or infected. This can be an acute or chronic problem.
For an Enlarged Prostate
* Normal aging. More than half of men in their 60s have benign prostatic hyperplasia (BPH). Up to 80 percent of men in their 70s and 80s may have BPH.
* Prostate infections can increase the risk.
For Prostate Cancer
* Aging. After age 50, the chances increase rapidly. About 80% of all cases occur in men over age 65.
* Race. African American men are twice as likely to get prostate cancer as Caucasian American men.
* Family history. The risk is higher than average if your father or brother has or had prostate cancer.
* Diet. Studies have shown that a diet high in dairy foods, calcium, or calcium supplements may raise the risk. A diet high in certain fruits and vegetables, including cooked tomato products, may lower the risk.
Treatment
For Prostatitis
* Acute and chronic bacterial infections are treated with antibiotics.
* For an inflamed prostate without a bacterial infection, treatment depends on the cause. Medications to treat pain and other symptoms are part of the treatment.
For BPH
* Watchful waiting. When symptoms are minor, no treatment may be needed at that time. The BPH is monitored to see if it causes problems or gets worse.
* Medicine. One type helps relax the bladder neck muscle and the prostate. Another type causes the prostate to shrink.
* Surgery.* There are many types and many new procedures.
*{Note: Surgery for BPH can result in problems, such as impotence and/or incontinence. Discuss the benefits and risks of treatment options with your doctor. Most men who have surgery have no major problems.}
Treatment for Prostate Cancer
Treatment depends on the man’s age and general health. It also depends on how slow the cancer is expected to grow or if it has spread beyond the prostate gland.
Treatment includes:
* Watchful waiting. This is also called active surveillance. It means getting no treatment at that time, but having tests, such as every 3, 6, or 12 months, to check for changes that may need treatment. If changes occur or if symptoms worsen, you may choose to have treatment.
* Surgery. There are many types. Ask your doctor which one(s) best meet your needs. Discuss the pros and cons for each type with your doctor.
* Radiation therapy. With one type, radioactive material is placed inside the prostate gland. Another type uses a large machine outside the body to target the cancer cells.
* Hormone therapy. This uses drugs or surgery to keep prostate cancer cells from getting male hormones, such as testosterone, which can cause prostate cancers to grow.
* Chemotherapy. Drugs, often given through an IV, kill cancer cells.
* Immunotherapy. This uses your own blood cells to make a vaccine that stimulates your immune system to kill the cancer cells.
* Clinical trials. Find out about clinical trials for prostate cancer fromwww.cancer.gov/clinicaltrials.
Diagnosis
* Your doctor will do an exam and ask questions, such as, What symptoms do you have? How much do they bother you? Did your father or brother have prostate problems? Be ready to answer these questions before you see the doctor.
* Your doctor may ask for a sample of your urine. If this shows bacteria, an antibiotic is prescribed. This kills the germ that causes the infection. Some men keep getting this kind of infection. Why? They may have a defect in the prostate gland that allows bacteria to grow. Surgery can correct this problem.
* If no bacteria is found, your doctor looks for other problems that could cause your symptoms. He or she may order tests to screen for other prostate problems.
The tests listed below help the doctor find out if the problem is an enlarged prostate or prostate cancer.
* Digital rectal exam. This is done in the doctor’s office. The doctor puts a glove on and inserts a finger into the rectum. The doctor feels the part of the prostate that sits next to the rectum. This test helps the doctor find out the size of the prostate.
* PSA blood test. A high PSA may be a sign of prostate cancer. It could be a sign of BPH or prostatitis, too. PSA blood tests are not a sure thing to detect prostate cancer.
* Imaging. Certain X-rays or other tests are done to get a picture of the prostate.
* Urine flow study. A special device you urinate into measures how fast your urine flows. A reduced flow could mean that you have BPH.
Your doctor may do other tests, as needed, to check for prostate cancer.
Self-Care
For Prostatitis
* Take antibiotics, as prescribed.
* Rest until fever and pain are gone.
* Take an over-the-counter medicine for pain and swelling, if needed. Take it as directed.
For BPH
* Stay sexually active.
* Don’t take over-the-counter (OTC) medications with antihistamines unless approved by your doctor.
* Discuss the use of the OTC plant extract saw palmetto with your doctor before you take it.
For Both an Enlarged Prostate and Prostatitis
* Don’t smoke.
* Reduce stress.
* Take warm baths.
* Don’t let your bladder get too full. Urinate as soon as you get the urge. Relax when you urinate.
* Drink 8 or more glasses of water every day. Don’t drink liquids before going to bed.
* Avoid alcohol and caffeine, especially after dinner.
Prostate problems are only one health concern for men. Get regular checkups to screen for other problems, too.
Resources
Urology Care Foundation
© American Institute for Preventive Medicine
