Family Health … Take Charge! Simple Changes May Keep Prostate Working Properly

What you should know

The prostate is a walnut-sized gland found only in men. It is located under the bladder and in front of the rectum. The urethra is the tube that transports urine and sperm out of the body. The urethra passes through the prostate gland.

Sometimes the prostate becomes enlarged. This problem is called BPH (benign prostatic hyperplasia.) BPH is the most common prostate problem. BPH is not cancer. An enlarged prostate can push on the bladder or narrow the passage so that urine cannot pass. This can be a problem for men over age 50 .

Symptoms of an enlarged prostate include:

The urge to urinate frequently, especially at night, interrupting sleep.

Sudden urges to urinate, perhaps without time to safely reach a bathroom.

Inability to start urinating even when the urge is present.

Feeling like the bladder is still full, even after urinating

Discomfort or pain in the lower abdomen or fever if the prostate is inflamed.

Weak urination stream.

Dribbling after urinating.

Many men with BPH can manage their problems without medicine or surgery. Simple lifestyle changes can work . At night, they might avoid drinking liquids, caffeine and alcohol. They can change toilet habits and exercise to retrain their bladder to control symptoms. Some decongestants taken for cold symptoms can make BPH worse.

Some men need surgery or medication for prostate problems.

Medicine that reduces male hormones can help shrink the prostate gland. Other medicines improve urine flow by relaxing the muscles.

There are different surgery methods. The surgeon might use a laser, radio frequency microwaves or cryosurgery to shrink the enlarged gland. The surgeon might cut away tissue or widen the passage for urine with a stent, a tiny metal coil. But, surgery and medication can also result in complications or side effects in some men including loss of erections or leaking of urine.

The prostate is part of the male reproductive system and helps to make semen. The prostate also produces prostate specific antigen (PSA), which is found in the blood.

Prostate cancer is a common cancer among older men. Prostate cancers often grow more slowly than other cancers. Most men live with prostate cancer for a long time. Symptoms of prostate cancer can be the same as the symptoms for BPH. Early prostate cancer may not have any symptoms.

Experts are not in agreement on the need for routine screenings for prostate cancer. The U.S. Preventive Task Force does not recommend for or against prostate cancer screening, but most experts suggest that men consider annual prostate cancer screening from age 50 to 70.

Two tests are often used:

The first test is a blood test to check the level of the PSA and changes from a man’s initial PSA. Men with prostate cancer often have a rise in the PSA. The risk of prostate cancer increases with age and is higher in men with a family history of prostate cancer and African-American men. Some men over 50 often have the PSA test in their annual check-ups.

The second test is a digital rectal examination. A doctor feels the prostate gland with his index finger through the rectum. If he or she finds a lump or hardness on the surface of the gland, he might suggest more tests.

If the doctor thinks cancer is a risk, he or she might recommend other tests. Several tests create images to view the prostate and other areas around the bladder. Tests can include ultrasounds, CAT scans, and MRIs. Another test might be a lymph node or prostate biopsy. A biopsy needle is used to take tissue that will be viewed under a microscope. About 80 percent of prostate biopsies find no tumor. Some people feel so many biopsies are wasteful.

Many older men with prostate cancer delay treatment. Men with other serious health problems, like heart disease, another form of cancer, diabetes or AIDS might decide to avoid radiation treatment or surgery. Many older men die with prostate cancer, but not from prostate cancer.

There are several treatments for prostate cancer. Some men have their prostate removed (prostatectomy). Others have hormone or radiation treatment.

What you should do

Discuss the pros and cons of prostate cancer screening with your doctor or health care provider.

If you are overweight, lose weight to avoid worse problems related to an enlarged prostate. A low-fat diet with five servings of fruits and vegetables a day might help. A study also showed that obese men (who had their cancerous prostate gland removed) were more likely than men of normal weight to have cancer that was at a higher grade. (Source: Urology, March, 2007)

The PSA test is not a perfect predictor of prostate cancer. And roughly half of men who get PSA testing will end up getting needle biopsies of the prostate to check out high PSA results.

But the death rate is 2.5 times higher among blacks than among whites. You might want screenings if you have a family history of cancer. Ask your doctor what is right for you.

Men with prostate cancer should see a good urologist. If you have signs of prostate cancer, it is important to get regular check-ups every three to six months to monitor your condition. This “watchful waiting” is important, as the cancer can spread to other parts outside the prostate. Care might include medication to reduce the effect of male hormones on the growth of prostate cells.

Active care can help determine if cancer is fast growing and which treatment is best. Treatment might include surgery, radiation, or hormone therapy. Young men often benefit from surgery. A skilled urologist can often prevent unpleasant side effects of surgery, such as sexual or urinary problems.

For more information

Go to Healthymemphis.org/links for information on benign prostatic hyperplasia, prostate problems, cancer and screening.

Family Health.Take Charge! is provided by the Healthy Memphis Common Table: healthymemphis.org. This article supports the care and advice of your doctor. Talk to your care provider about any health condition or before starting new treatments.

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Ask the Expert

Do you have questions about prostate health?

We’re conducting an online conversation on the subject this week on our Healthy Memphis blog. Go to commercialappeal-web.com/ health, find the entry titled “Prostate Health” and post your question or comment.

Dr. Ithaar H. Derweesh, a board-certified urologist who cares for patients at UT Medical Group, Chief of Urology at The MED and a teacher at the University of Tennessee Health Science Center, will check the blog periodically and answer them.

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(c) 2007 Commercial Appeal, The. Provided by ProQuest Information and Learning. All rights Reserved.