Prostate Health: The Men's Only Club

The prostate gland, despite its small size, plays a crucial role in men's health and well-being. Yet many men know surprisingly little about this walnut-sized gland until problems arise. Understanding prostate health, recognizing potential issues, and staying informed about screening recommendations can make a significant difference in maintaining quality of life as men age.

Key Takeaways: Prostate Health

• The prostate gland grows throughout a man's life. This walnut-sized gland, which produces fluid for semen, can lead to common health issues like prostatitis (inflammation) and benign prostatic hyperplasia or BPH (enlargement).
• Regular prostate screenings are vital. Men should get regular screenings, including a Digital Rectal Exam (DRE) and a PSA blood test, to check for early signs of prostate cancer.
• Lifestyle choices support prostate health in men. A healthy diet, regular exercise, and staying hydrated are important for maintaining prostate health.

What Is The Prostate?

The prostate is a part of the male reproductive system, located in front of the rectum and between the bladder and penis. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). Its primary function is to produce fluid that nourishes and protects sperm, making up about 30% of seminal fluid.

The prostate continues to grow throughout a man's life, which can lead to various health concerns over time.

Because of its location, any changes in the prostate can impact urination and sexual health, making awareness of prostate health particularly important as men age. As men grow older, their risk for developing prostate-related conditions increases.

What Are Common Prostate Conditions?

Common prostate conditions include prostatitis, enlarged prostate (benign prostatic hyperplasia) and prostate cancer.

What Is Prostatitis?

Prostatitis, a condition characterized by the inflammation of the prostate gland, is known for its frequent and often debilitating pain. Every year, about 2 million doctor visits result in a diagnosis of prostatitis, a term that means "inflammation of the prostate." Behind that simple definition lies a complicated, mysterious malady.

What causes prostatitis

For some men, prostatitis develops because of a urinary tract infection, others have lesser-known causes. In some cases, there's no known cause for inflammation.

Symptoms of prostatitis

Common symptoms of prostatitis include:

• Pain in the groin, genitals, or lower back
• Pain during urination
• Frequent urination
• Pain during ejaculation
• Loss of interest in sex
• Trouble achieving or maintaining erections
• Fever, especially in cases of acute bacterial prostatitis
• Dysuria (a burning or stinging sensation during urination, making it uncomfortable or painful)
• Reduced urine flow
• Rectal pain or pressure
• Fever and chills
• Lower back or pelvic pain
• Urethral discharge during bowel movements
• Erectile dysfunction or decreased sex drive
• Uncomfortable sensations in the rectal or genital area

The symptoms of prostatitis can mimic those of other medical conditions or issues. Therefore, seeking medical advice from a health care provider for an accurate diagnosis is important.

Prostatitis treatment

For patients without acute infections, prostatitis is not a major health threat. It doesn't raise the risk of cancer or any other serious disease.

Treatment for prostatitis typically involves a combination of approaches to relieve symptoms, eliminate infection (if present), reduce inflammation and improve overall prostate health. These may include:

• Medications, including antibiotics
• Alpha blockers
• Pain relievers
• Physical therapy

What Is An Enlarged Prostate?

The prostate, a small gland that produces fluid for semen, is in an ideal position to cause trouble. The gland wraps snugly around the urethra, the tube that carries urine from the bladder. It's a tight squeeze -- and it only gets tighter as men grow older.

What causes an enlarged prostate

As men age, the prostate inevitably grows, putting more and more pressure on the urethra. For some men, this growth is too slow to ever cause any symptoms. But for most, it's only a matter of time before trouble sets in. According to the National Institutes of Health, more than half of all men in their 60s and 90 percent of men in their 80s have symptoms of an enlarged prostate, also called benign prostatic hyperplasia, benign prostatic hypertrophy, or simply BPH.

For most men, an enlarged prostate is little more than a nuisance. But in severe cases, it can completely block the flow of urine and create a medical emergency. Whether a man's condition is mild or extreme, he has many options for relief.

Symptoms of an enlarged prostate

As the prostate begins to squeeze the urethra, emptying the bladder becomes more and more difficult. Common symptoms of an enlarged prostate include the following:

• Frequent urination, especially at night
• A weak urine stream
• topping and starting during urination
• Leaking, dribbling
• A feeling that the bladder is never completely empty

If you have symptoms of an enlarged prostate, you should see your doctor. Remember, there's a chance that your symptoms may signal something more serious.

Do Enlarged Prostates Mean Prostate Cancer?

Though small, the prostate can develop potentially large problems as men age, including cancer.

“Enlargement of the prostate with age is indeed natural and doesn’t necessarily indicate the presence of cancer,” said Nibal Saad, MD, hematologist and oncologist with Franciscan Physician Network in Indianapolis and Mooresville. “Non-cancerous enlargement is also known as benign prostatic hyperplasia.”

According to the Prostate Cancer Foundation, prostate cancer occurs when a normal prostate cell begins to grow out of control. Not all prostate cancer cells are alike. Prostate cancers that are composed of very abnormal cells are much more likely to both divide quickly and spread, or metastasize, from the prostate to other regions of the body. Often, prostate cancer spreads first to tissues that are near the prostate, including the seminal vesicles and nearby lymph nodes.

What Is Prostate Cancer?

Prostate cancer is the second most common cancer in men, with risk increasing significantly with age. According to the American Cancer Society, about 1 in 7 men will be diagnosed with prostate cancer during his lifetime.

Most prostate cancers grow slowly and may not cause symptoms for many years. There are aggressive variants, however, that can rapidly spread to other parts of the body.

What causes prostate cancer

Unfortunately, the exact cause of prostate cancer remains a mystery, but men should be aware of some key risk factors. These tend to fall within the categories of age, family history (including genetics), and race. 

The Prostate Cancer Foundation cites these risk factors:

• Tall height
• Lack of exercise and a sedentary lifestyle
• Very high calcium intake
• Black race
• Family history
• Agent Orange exposure

Symptoms of prostate cancer

Different people have different symptoms for prostate cancer. Some men do not have symptoms at all. Sometimes, you just need to listen to what your flesh and bones are telling you.

The CDC suggests that if you have any of the following symptoms, be sure to see your doctor right away, as these are possible signs of prostate cancer.

• Difficulty starting urination
• Weak or interrupted flow of urine
• Frequent urination, especially at night
• Difficulty emptying the bladder completely
• Pain or burning during urination
• Blood in the urine or semen
• Pain in the back, hips, or pelvis that doesn’t go away
• Painful ejaculation

Keep in mind that these symptoms may be caused by conditions other than prostate cancer.

How Do You Check For Prostate Cancer?

Prostate cancer is the second most common cancer in men worldwide and the second-leading cause of cancer death among men in the United States. But there is good news: prostate cancer screenings have been associated with decreased death rates.

Timely detection of prostate cancer, when it is still confined to the prostate gland, offers the greatest opportunity for effective treatment. Regular screenings and early detection are key in identifying the disease before it progresses to an advanced stage, improving the chances of successful management and survival.

Digital Rectal Exams

A digital rectal exam is a simple, potentially life-saving screening for men to check for prostate cancer. It's also something that most people would rather avoid. If your doctor recommends a digital rectal exam, try to put your squeamishness aside and look at the big picture. A few moments of discomfort could be the key to a healthy future.

The digital rectal exam, which can reveal prostate size and provide clues to a clearer diagnosis, is very straightforward: Your doctor will slide a gloved, well-lubricated finger into your rectum to feel for anything out of the ordinary, such as lumps or hardness that may indicate a hidden condition. It lasts less than a minute and usually doesn't cause any pain, although there might be some slight soreness after the test.

Your doctor can use the digital rectal exam to check your prostate gland for unusual swelling, lumps, or areas of hardness, all potential red flags for cancer. If your prostate is larger than normal, you may have benign prostatic hyperplasia, a very common, noncancerous condition that can make it difficult for you to urinate. If your prostate is tender when it's touched, the gland may be infected, a condition called prostatitis.

PSA Test

Sometimes tumors on the prostate gland can lie just out of reach. According to the American Urological Association, most prostate cancers are detected with a prostate specific antigen (PSA) blood test.

Prostate-specific antigen is a protein produced by the prostate regardless of whether cancer is present. However, an elevated value should raise concerns and, thus, is used and studied extensively. It is crucial to take PSA measurements in context of age, size of the gland and other factors such as an enlarged prostate, prostatitis and certain medications a patient may take.

How Is Prostate Cancer Treated?

Radiation therapy for prostate cancer usually consists of a sealed radiation source placed inside or next to the area requiring treatment. Another common treatment is prostate cancer is cryotherapy – a procedure that uses very cold temperatures to freeze and kill cancer cells.

Chemotherapy is sometimes used if the cancer has spread outside the prostate gland and hormone therapy isn’t working. However, chemotherapy is not considered a standard treatment for early stages of the disease, according to the American Cancer Society.

But when it comes to prostate health, men should take heart.

“We live in a remarkable day and age in which medical care is being increasingly individualized,” Dr. Saad said. “For example, two friends diagnosed with prostate cancer may have entirely different experiences. That’s why it is important for you to work with your healthcare providers to seek the care that is best for you – not what is right for just anyone with prostate cancer.”

Maintaining Prostate Health

While some risk factors like age and genetics cannot be changed, several lifestyle factors may support prostate health:

Diet and Nutrition

• Eat a diet rich in fruits and vegetables
• Include foods high in lycopene (tomatoes, watermelon, pink grapefruit)
• Consider omega-3 fatty acids from fish or supplements
• Limit red meat and high-fat dairy products
• Maintain a healthy weight

Physical Activity

Regular exercise may help reduce the risk of BPH and prostate cancer. Aim for at least 150 minutes of moderate-intensity exercise per week.

Stay Hydrated, But Time It Right

Drink plenty of fluids during the day, but consider limiting intake before bedtime to reduce nighttime urination, especially if experiencing BPH symptoms.

When to See a Healthcare Provider

Men should consult with their healthcare provider if they experience:

• Changes in urination patterns
• Blood in urine or semen
• Persistent pelvic pain
• Painful ejaculation
• New or worsening urinary symptoms

Additionally, all men should have regular discussions with their healthcare providers about prostate health, particularly as they approach middle age.