What is the Prostate
The prostate is a gland in the male reproductive system. It produces fluid ejaculated during sexual acts. Although there are several diseases of the prostate that can develop, these three different problems are the most common:
- Prostate Enlargement (BPH)
- Prostatitis, an Inflammation of the Gland
- Prostate Cancer
What is BPH (Benign Prostatic Hyperplasia)
Benign Prostatic Hyperplasia (BPH) or enlarged prostate is often responsible for blocking the flow of urine out of the urinary bladder and is common in men over the age of 50. Prostate enlargement is a benign condition. BPH is not cancer and does not turn into cancer.
- At about age 45, the prostate often starts growing. In some cases, it can continue to enlarge for the rest of a man’s life. It’s generally accepted that this growth is influenced by hormonal changes.
- By itself, prostate enlargement isn’t a problem. But the prostate gland surrounds the first section of the urethra, the tube that carries urine from the bladder out through the penis.
- In some men, the growth of the prostate is inward causeing blockage of urine flow. The increase in size pinches on the urinary channel, or urethra. The enlargement can interfere with the normal flow of urine and cause uncomfortable symptoms such as frequency, urgency or getting up from sleep at night to void many times..
Symptoms Associated with BPH (Enlarged Prostate)
- Frequent urination, especially at night.
- A sudden, almost uncontrollable urge to urinate
- A weak, interrupted urine stream
- A sense of incomplete bladder emptying
- Leakage of urine
- Difficulty in starting urination
- An enlarged prostate can even result in total blockage, a very serious condition.
- Recurrent bladder infections
- Hormone or Androgen Suppression:
- Medication that relaxes the muscles that surround the prostate channel.
Surgical and Laser Procedures to Treat BPH
- Transurethral Resection of the Prostate (TURP): Transurethral resection of the prostate (TURP) has been the primary choice of treatment for BPH that is causing obstruction of the bladder outlet.
- Transurethral Incision of the Prostate (TUIP): A transurethral incision of the prostate (TUIP) is the alternative to TURP that comes closest to matching its results in both terms of symptom relief and improvement in flow rates.
- Open Prostatectomy: Open prostatectomy refers to a major surgical procedure to remove the obstructing portion of the prostate.
- EVOLVE LASER THERAPY: The Evolve Laser Therapy uses advanced laser technology to evaporate obstructive prostate tissue often in less than 20 minutes in an office setting under local anesthesia.
- Transurethral Needle Ablation of the Prostate (TUNA): Transurethral needle ablation (TUNA) of the prostate is similar to laser ablation of the prostate.
- Frequent urge to urinate, yet difficulty in doing so
- Chills and fever, in acute infections
- Pain or burning during urination.
- Symptoms may come and go in the chronic type of prostatitis
- Warm baths
- Massage to release the glands fluid
- If the cancer is growing slowly and not producing symptoms, the doctor may suggest watchful waiting with regular checkups.
- Surgery to remove the prostate and surrounding tissue.
- Radiation therapy to kill the cancer cells and decrease the size of the tumor using high-energy waves.
- Brachytherapy (Radioactive Seed Implantation): Tiny pellets containing radioactive medication are permanently implanted directly in the middle of the prostate where they give off low-level radiation continuously for up to one year. Using transrectal ultrasound, or TRUS guidance, these seeds can be positioned so that radiation is distributed throughout the entire prostate gland.
- Hormone Therapy, which slows or stops prostate cancer growth
Inflammation or infection of the prostate gland is called prostatitis. There are different types of prostatitis. Some are caused by bacterial infection, but in most cases, no cause is found for the inflammation. Prostatitis can occur in men of all ages.
Symptoms Associated with Prostatitis
Treatments for Prostatitis
Prostate Cancer: Screening & Treatment
Prostate cancer is now the most common type of cancer in males. The cancer can grow without symptoms for years, even decades. Prostate cancer is rare before the age of 40 but the risk increases with age. Its cause is unknown.
If not treated early and effectively, prostate tumors can grow and spread into other tissues, such as lymph nodes and bone. Although only a small proportion of prostate cancers progress to this severe stage, the ones that do can spread relatively quickly and are not easily treated or cured.
Prostate cancer may not cause urinary symptoms during its early stages. In its advanced stages, when cure is most difficult, prostate cancer may produce symptoms that are similar to an enlarged prostate. The routine use of PSA testing, along with digital rectal examination (DRE) of the prostate, has dramatically improved our ability to find prostate cancer earlier, and possibly at a more curable stage, than ever before.
It is for this reason that it is necessary for males over the age of 40 to be seen routinely by the Urologist.
Prostate Specific Antigen (PSA) Test
PSA is NOT a cancer measurement and threfore, elevated PSA does not mean you have cancer.
PSA stands for Prostate Specific Antigen, a protein that is only found in the prostate. A blood test for PSA is used as a screening tool for prostate cancer.
Why PSA is Measured
PSA is present in all normal prostate tissue. The prostate cell holds onto most of the PSA and lets very little leak into the blood stream. The small amount that leaks out is the PSA that is measured by the blood test.
Prostate cancer cells actually have less PSA in each cell, but the cancer cell tends to leak more PSA into the bloodstream, hence the reason for measuring the PSA levels. Knowing this, researchers have come up with a normal range of PSA that should be expected in patients who do not have prostate cancer. The catch is the word ‘normal’. Almost any condition that affects the prostate can make the PSA rise. In addition, not all patients with prostate cancer have an elevated PSA. Twenty percent of diagnosed prostate cancer occur in men with normal PSA levels.
Non-cancerous Causes of High PSA Levels
The most common non-cancerous cause of elevated PSA levels is Benign Prostate Hyperplasia (BPH) – Enlarged Prostate. As men age, particularly after age 50, the prostate normally gets bigger. The most common symptom with BPH is difficulty urinating. About 80 percent of men will develop some aspect of BPH in their lifetime. BPH is NOT cancer, nor will it lead to cancer, but it may cause a false elevation of PSA values.
Another common cause of false elevation of PSA value is Prostatitis, an inflammation of the prostate. Prostatitis is very common and usually causes symptoms similar to a bladder infection, such as burning, frequency and urgency to urinate. However, many men with prostatitis have no symptoms. The inflammation from prostatitis causes PSA to leak into the bloodstream and causes the PSA level to be higher than normal.
Ejaculation has been shown to cause an increase in the PSA level in some men for about 48 hours. If possible, the patient should not ejaculate for 48 hours before a PSA test. If ejaculation has occurred and the PSA is elevated, a repeat test is necessary.
Even a simple rectal exam can cause the PSA to rise somewhat.
What this means is that PSA is NOT a cancer measurement, and that an elevated PSA does not mean you have cancer. The only test that will determine the presence of cancer with certainty is a biopsy of the prostate.
Treatment for Prostate Cancer
There are many treatment options for prostate cancer, depending on whether it has spread.
When caught early, prostate cancer has an encouragingly high cure rate. Early treatment may save your life as well as your lifestyle. In many cases, treatment for prostate cancer will not affect your sex life or your ability to control urination.
Prostate disease does not necessarily have to interfere with your life or your lifestyle. Call us to schedule an appointment for a complete evaluation to determine the cause and treatment for your prostate problems.