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About the Prostate

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The prostate gland is a small, walnut-sized organ found only in men. It is both a normal part of the male anatomy and an area where some critical medical conditions and diseases can occur. When the prostate is functioning normally, a man is unaware of its existence, but when it becomes enlarged, infected or diseased, it can affect a man’s urinary flow and his sex life – two functions that greatly impact quality of life.

The development of the prostate begins before birth and continues through to adulthood. Male hormones, known as androgens, cause this development. If not enough male hormone is produced, the prostate gland will not grow to normal size. At the other end of the spectrum, too much male hormone can cause the prostate to become enlarged, causing discomfort and urination problems.

The prostate is located near the bladder and rectum, and the urethra (ie, the tube that carries urine from the bladder to the penis) runs through the prostate. One of the prostate’s functions is to produce some of the substances (eg, minerals and sugar) found in semen, the fluid that nourishes and protects the sperm. Another function is to control urination by pressing on part of the urethra.

The prostate gland is relatively small in younger men, although it grows during normal aging. This enlargement is called benign prostatatic hyperplasia or BPH. BPH is not associated with prostate cancer but may cause similar symptoms, such as impingement of the bladder outlet or the urethra and problems with urination. Other symptoms resulting from BPH are frequent urination, particularly at night, and slowing of the urinary stream.

Another condition that affects the prostate is prostatitis, which is a painful swelling or infection of the prostate gland. Symptoms of prostatitis include excessive urinating during the night, pain or discomfort in the lower back, pain or discomfort during or after ejaculation, pain in the tip of the penis, and a burning sensation during urination. This condition can be caused by bacteria, but sometimes the cause is unknown.

The symptoms common to BPH, prostatitis and even a bladder infection may be similar to those for prostate cancer. Prostate cancer is one of the leading causes of death in American men, which is why men 50 and over (40 and over for those with risk factors) should be sure to include prostate cancer screening tests in their yearly physical examinations. The two most common screening tools are the digital rectal examination (DRE) and the prostate-specific antigen (PSA) blood test.

The DRE takes a minute or less. During the DRE, the patient either kneels on the examination table, bends over the table, or lies on his side. The doctor inserts a gloved, lubricated finger into the rectum and palpates the prostate gland, looking for any abnormalities such as lumps, hard nodules or firmness.

The PSA blood test shows the levels of an antigen that is normally produced by prostate cells. Elevated PSA levels are associated with enlargement or inflammation of the prostate or prostate cancer; however, mild-to-moderate increases in PSA do not always mean cancer. Sometimes a raised PSA level is caused by problems such as BPH or prostatitis (ie, infection or swelling of the prostate). Neither of these conditions is life threatening, nor is there any evidence (up to now) linking these conditions to prostate cancer; however, it is possible for a man to have prostatitis or BPH and develop prostate cancer as well.

The prostate gland is a small but mighty organ and because the health of the prostate is so crucial to a man’s overall sense of well being and quality of life, every man 40 and over should meet with their physician to tailor a prostate care and cancer screening program that is right for them.

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