Men aren’t known for being very conversational, especially about their health, and much less about their problems. So it isn’t unusual to not talk much about a man’s prostate. But men – and the women who love them – it is important to learn about the prostate and what you can do to take care of it and to treat it when a problem occurs.
So without getting too technical or medical, what is the prostate and why is it important? The prostate is a rubbery, walnut-size gland that is part of a man’s reproductive system. It is located between the rectum and the bladder and it surrounds the urethra. The urethra is about an eight-inch tube that empties the urine from the bladder.
As part of the reproductive system of a man, the prostate serves primarily as a transport system for the sperm that is produced in the Seminal Vesicles. The prostate adds a fluid that nourishes and transports the sperm. During stimulation, the muscles in the prostate contract and send the mixture into the urethra and out onto its journey. So far, so good.
As long as the prostate maintains its normal size and has no incursion from cancerous cells, it will normally function late into a man’s life. There are three primary ‘diseases’ of the prostate that a man should be aware of and be ready to treat with his doctor’s advice, direction, and expertise. These are:
- Prostatitis – an inflammation or swelling of the prostate.
- Benign Prostatic Hyperplasia (BPH) – This is an enlarged prostate not caused by cancer.
- Prostate Cancer – When cancer cells form in the prostate.
If you are taking care of yourself and have had annual physical’s with your primary doctor, you are on the right track in caring for your prostate. At about age fifty your doctor will begin examining your prostate. If before age fifty you have been having trouble urinating then your doctor will already have begun examining your prostate. The exam is simple, but uncomfortable. It is called a DRE.
The DRE stands for digital rectal exam. That’s right – the dreaded snap of the glove and the, “Drop your pants and bend over the table,” from the doctor. He coats his finger with a lubricant and then goes in your rectum. The prostate sits right below it so it is easy for him to access. He is feeling the surface to make sure it is still rubbery and smooth. A hardening surface might indicate a swelling that could be prostatitis or BPH. A blood test will usually follow if the doctor sees – or feels – any signs of enlargement.
As men age, it is very common for their prostate to get bigger. A bigger prostate usually means some trouble urinating as the prostate surrounds the urethra and that swelling could tighten around the urethra tube and restrict the flow of urine. Trouble urinating is a man’s unscientific first sign of an enlarged prostate – BPH.
BPH is not a life-threatening condition but it can cause urination problems. If a blood test has been done, and there are no signs of disease – i.e., cancer – then BPH can be treated with medications, some minimally invasive treatments, or several options for surgery. Treating BPH should be done with the advice, direction and monitoring of a doctor, normally a urologist.
Diagnosing and treating prostate cancer is a situation that requires your complete attention. In terms of diagnosing, your primary doctor is probably doing annual bloodwork on you. One of the markers he looks for is your PSA. This stands for Prostate Specific Antigen. If he sees your PSA rising from year to year, or he finds a lump or hardness during the DRE, he will send you to a urologist. This is a doctor who specializes in diagnosing and treating diseases of the urinary tract.
The urologist will do a biopsy of your prostate to see if there are cancer cells present. If so, then he will discuss your options for treatment. You should also discuss these options with y our spouse, family, and your primary doctor. There are many factors to consider when treating the prostate which we will discuss later. But first, a word of caution about PSA numbers.
According to the American Cancer Society (ACS), there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer. A lump or hardening of the prostate and increasing PSA numbers are indicators of a potential problem. Again, according the ACS men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer. If it is more than 10, the chance of having prostate cancer is over 50%. That means there is a 50% chance that you don’t have prostate cancer. But don’t gamble with the odds. These number are not exact indicators, so it is imperative that you have a biopsy to determine if cancer cells are in your prostate.
If it is determined that you have cancer in your prostate you will normally have several options for treatment. They vary from ‘watchful waiting’ to removal. All of the options have pluses and minuses so you must discuss the options with family and your doctors. Not just your primary but get opinions from other urologists. The aggressiveness of treatment varies dramatically from doctor to doctor BUT, the bottom line is your health and longevity. Fearing the removal of your prostate for any reason doesn’t mean you should avoid the issue. Learn all you can. Read every article you can, talk to cancer survivors, family, spouse, and other doctors.
Some of the treatments are irreversible so you want to make the best decision for your long-term health and well-being.
Once you have educated yourself, and you, your spouse and your doctors have made a decision, you can go forward with confidence.
There are a number of good websites that can give advice and direction regarding the prostate. They are:
But always, always, see your doctor regularly and follow their advice and direction in treating symptoms or problems. Normally, if a prostate problem goes beyond mild swelling, your doctor will refer you to a urologist. Also be proactive. Pay attention to your prostate by monitoring your urination. Learn all you can about the prostate and the potential problems with it. The more prepared you are in dealing with the prostate and its issues, the better you will physically, mentally, and emotionally manage any problems that arise.
