As you age, it is important to be aware of prostate health issues. It is recommended that men over 40 have an annual prostate exam and, at age 50, annual screening for prostate cancer using a prostate specific antigen (PSA) blood test.
What Is The Prostate?
The prostate is a gland about the size of a walnut that is located at the base of the bladder. I often liken the anatomy of the prostate to a doughnut; the urine flowing through its center. Because of its location, diseases of the prostate effect urination. The primary function of the prostate is to manufacture fluid which is the major component of the ejaculate. This is the fluid in which sperm cells, which are manufactured by the testicles, are carried.
Prostatitis is an inflammation or infection of the prostate which can produce inflammatory symptoms including urinary frequency, urgency, and urinary burning. It is common in young men but can occur in men over 80 as well. Most prostatitis is easily treated with antibiotics and/or anti-inflammatory medication.
Prostate cancer is the commonest cancer in men in the United States. Prostate cancer can often behave in a very benign fashion and most patients do not die from this disease. Most prostate cancers diagnosed today produce no symptoms since they are usually microscopic or very small in size. For prostate cancer to produce urinary symptoms, the cancer usually is present for a long time and occupies a significant portion of the prostate tissue. Most cancers of the prostate today are discovered by prostate biopsy occasioned by an elevation of the prostate specific antigen blood test. The microscopic cancers discovered this way are rarely symptomatic.
Benign Prostatic Hypertrophy (BPH)
Benign prostatic hypertrophy or enlargement of the prostate occurs in almost every man over 50. It can produce no symptoms but often causes difficulty urinating, straining to urinate, urinary hesitancy or waiting, waking up at night to urinate, interrupted urinary stream, and urinary retention. Blood in the urine is also a common symptom of benign prostatic hypertophy.
The prostate can be examined by a trained physician using a rectal approach. Since the prostate is just outside the rectum, its posterior or rear surface can be examined and evaluated by this rectal examination. This is a painless and simple examination and should be done annually in men over 50.
The risk of prostate cancer climbs with age. As a matter of fact, approximately 75% of men over 80 will have prostate cancer if their prostates are removed and examined microscopically. This prostate cancer in the elderly seems to have little biological aggressiveness and rarely produces symptoms. There is a higher incidence of prostate cancer in black Americans than in Caucasians. If there is a family history of prostate cancer (grandfather, father, brothers), then prostate cancer seems to be a bit more likely.
Benign prostatic enlargement and prostate cancer are both readily treatable. Often no surgical treatment is necessary. There are many new technologles available to treat both of these problems. If you have any questions about your prostate or prostate cancer, please do not hesitate to contact the office.
Treatment of Enlarged Prostate
There are medications and several minimally invasive methods to treat prostate enlargement. These can be discussed with Dr. Schrager at your visit.