Health and prostate diseases

Glenn Ellis

( — Every man (and every woman in their life), who lives long enough will have to deal with prostate issues.

Prostate cancer is one of the most common cancer types in men. The good news is that there are many treatment and management options, even if the cancer is caught at a later stage.

Beginning this topic with a small introduction of the prostate gland; what it is and what it does might be helpful. The prostate (not prostrate) is a small, squishy gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum. It is important for reproduction, because it supplies the seminal fluid, which mixes with sperm from the testes. Seminal fluid helps the sperm to travel and survive.

The prostate undergoes two main growth spurts. The first is fueled by sex hormones made by the testicles during puberty. For reasons that are unclear, the second growth spurt of the prostate gland begins when men are in their 30s. It continues to enlarge with age to an average weight of 40 grams in men in their 70s. Many men experience urinary changes as they age, which may be caused by inflammation or enlargement of the prostate gland.

As men age, their prostates enlarge. By the time men are in their 40s or 50s, many are already experiencing symptoms, such as having to get up at night to urinate. As they reach their 60s and 70s, many men may have to get up two or three times during the night to urinate.

The three most common prostate problems are inflammation (prostatitis), enlarged prostate (BPH), and prostate cancer.

Prostatitis is an inflammation of the prostate gland, often resulting in swelling or pain. Prostatitis can result in four significant symptoms: pain, urination problems, sexual dysfunction, and general health problems, such as feeling tired and depressed. Inflammation of the prostate gland is a common cause of men’s visits to their doctors for genital and urinary problems. Men of any age can develop prostatitis, but older men are more likely to experience it than younger men. If you (or a man in your life) are over age 50 and have an enlarged prostate, there is an increased risk of developing this condition. Half of all men experience prostatitis at some time in their life. The most common symptoms have to do with problems with urination. Problems with urination makes sense, given that urine passes through the prostate as it flows out of the body.

BPH stands for benign prostatic hyperplasia. Benign means ‘not cancer,’ and hyperplasia means abnormal cell growth. The result is that the prostate becomes enlarged. An infection or a tumor can also make the prostate larger. Some men with BPH eventually find their symptoms to be bothersome enough to need treatment. BPH cannot be cured, but drugs or surgery can often relieve its symptoms. Treatment is started only if symptoms become too much of a problem.

Often, men with mild to moderate BPH symptoms choose prescription drugs over surgery. Three main types of drugs are used. Two types relax muscles near the prostate, and the other type shrinks the prostate gland. There is some evidence shows that taking drugs together may work best to keep BPH symptoms from getting worse. Surgery for BPH are still among the most common procedures for American men.

That being said, there are few if any health diagnoses that bring fear, confusion, and misinformation as prostate cancer. There are often no symptoms during the early stages of prostate cancer. Only medical screening can detect changes that can indicate cancer.

For more almost 40 years, the PSA test has been the ‘gold standard’ in prostate cancer screening. This is a simple blood test that measures how much prostate-specific antigen is in your blood. If you have an abnormal PSA score, your doctor may recommend another newer test, prostate health index (PHI) that gives a better sense of your prostate cancer risk. The PHI is a more accurate blood test, and measures your risk for having prostate cancer, as well as resulting in fewer unnecessary biopsies. The FDA approved it for men who have PSA scores between 4 and 10.

As cancers go, even though it is the most common cancer in men, and does kill (30,000 die annually), prostate cancer is slow growing and not generally life threatening. Many more men die with prostate cancer than from prostate cancer.

There’s no sure way to prevent prostate cancer, but if you’re concerned about your risk of prostate cancer, you may be interested in prostate cancer prevention. The Mayo Clinic suggests that men: choose a healthy diet; maintain a healthy weight; exercise most days of the week; and If you think you have a high risk of prostate cancer, discuss it with your doctor. This is good advice in maintaining good prostate health throughout life.

Hopefully, this information will lead you to learn more about the prostate. Remember, I’m not a doctor. I just sound like one. Take good care of yourself and live the best life possible!

(The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, is Research Bioethics Fellow at Harvard Medical School and author of Which Doctor?, and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit <>.)