Perplexing Prostate Problems

What are your chances of having them?

By Barbara Pierce

All men are at risk for prostate problems. That’s because all men have a prostate.

For such a little gland, the prostate causes a lot of concern. Like a troubled, war-torn country, it’s in the news all the time and something always seems to be going wrong there, but you don’t really know where it is or why it’s important.

The prostate is a walnut-sized gland found only in men. It sits just below the bladder and surrounds the urethra, the tube that carries urine through the penis. The prostate’s job is to make fluid for semen.

Naeem Samad, a specialist in urology with the Slocum-Dickson Medical Group in New Hartford, offers information to help you improve your chances of avoiding prostate trouble.

Prostate cancer is the most common cancer in men (besides skin cancer). About one man in six will be diagnosed with prostate cancer in his lifetime. Keep that number in perspective, though. Because prostate cancer is usually slow growing, only about one in 35 men will die of prostate cancer.

The risk for prostate cancer increases with age. About two out of every three men with prostate cancer are over age 65.

The cause of prostate cancer isn’t known. Risk factors include having a father or brother with prostate cancer — family history more than doubles your risk. African-American men are more likely to get prostate cancer than Caucasians.

According to the American Cancer Society, most cases of prostate cancer can’t be prevented. This is because the causes of prostate cancer are still unknown.

“There are no symptoms of prostate cancer in its early stages,” said Samad. “The only way it can be detected is through an abnormal exam or an elevated PSA.”

PSA testing may be necessary

Prostate-specific antigen tests measure a protein in your blood. Prostate cancer causes elevated PSA levels, but a high PSA level is not always a sign of prostate cancer. Readings may be elevated because of some other reason.

“As there are no symptoms of prostate cancer in its early stages, it is important to start getting routine exams at age 50,” urges Samad. “If you have a family history of prostate cancer, start at age 40. As a part of your routine exam, your family doctor can feel your prostate gland. If it feels abnormal, he can order a PSA. If that’s abnormal, he might refer you to an urologist.”

“In its early stages, it’s very treatable,” added Samad. “There are many ways to treat.” Options for treatment depend on several things, such as how fast it is growing, how much it has spread, and your overall health. For men diagnosed with low-risk prostate cancer, treatment may not be necessary right away. Some men may never need treatment — just careful watching.

The prostate grows naturally with age, usually without problems. An enlarged prostate is an age-related thing. In men under 40, only one in 12 have an enlarged prostate; men who are aged 50-60 about one in two; for men over 80, the number goes up to eight out of 10 with an enlarged prostate.

An enlarged prostate does not lead to prostate cancer and most men don’t need any treatment for it. For some men, it can cause bladder and kidney problems. The enlarged prostate compresses the urethra, making urination difficult. Urinating frequently, especially at night, difficulty getting a urine stream going, or feeling as if you are unable to get all the urine out can result from an enlarged prostate.

These symptoms do respond well to medication or other treatment options.

A common disease is prostatitis, is an inflammation of the prostate. Often caused by bacteria, it’s a type of men’s urinary tract infection. Prostate infection is rarely serious, but if you have symptoms of prostatitis, see your doctor.

Symptoms include pain when urinating or ejaculating; needing to urinate more often; cloudy urine; fever and chills, and pain in the pelvis area.

Samad identified other problems that mean you should see your doctor.

— Frequent urination during the night: “As we age, we have more problems urinating.” he explained. “If you’re in your 50s and you get up during the night to urinate, this is not a concern. But if it’s more than once, have it evaluated. It could be something that can be treated.”

— Blood in the urine: “Blood in the urine is worrisome,” he added. Waiting to see if the blood will go away is not a good idea. Blood even one time is enough to see an urologist.