The Prostates, They Are A-Changin’

Your prostate is changing, and that is Ok.

shutterstock_246585895In both men and women, reproductive system changes are closely related to changes in the urinary system.  Unlike women, men do not experience a rapid change in fertility as they age.  Instead these changes are more gradual.  One of the changes seen in men is the enlargement of the prostate gland.  The prostate gland is replaced with scare-like tissue with age.  This process or condition is commonly referred to as BPH or Benign Prostatic Hyperplaisa.    Thought the most common, BPH is not the only condition concerning the aging prostate.   Others include acute and or chronic inflammation of the prostate gland called prostatitis and prostate cancer.

As we discus each of these conditions in more detail, it is important to know that one change does not lead to another.  For example, having prostatitis does not increase your risk of prostate cancer or BHP.  It is also important to note that age does not predict male fertility and neither does prostate function.  In fact, a man can father a child even if his prostate gland has been removed.

Due to its position, an enlarged prostate can squeeze the bladder and urethra.  This causes symptoms that effect urine flow as well as urgency and frequency of urination.  Men with enlarged prostate also experience a weak stream and hard time initiating urination.  When the urethra is squeezed, the bladder has to work harder to push urine out.  Over time, the bladder muscles get weak leading to frequent urination, incontinence, urinary urgency, incomplete emptying of the bladder leading to dribbling and urinary urgency.  Beside physical exam, getting routine blood tests to check for kidney function, infection and Prostate-Specific Antigen (PSA) should be checked yearly.  Based on these labs results and symptoms, more advanced testing may be necessary to properly diagnose a prostate pathology.

Prostatitis is another condition that can lead to an enlarged prostate.  Though it can present with similar symptoms, they are two different conditions and warrant different treatments.   While BPH is more common in men over 50 years of age, prostatitis is more common in men younger than 35 years of age.  The definition of prostatitis is inflammation of the prostate tissue.  This can be due to an infection or be related to other health problems.  Over the years, prostatitis has been subdivided into a number of categories, but today commonly accepted variations of the disease include nonbacterial (most common), acute and chronic.  While prostatitis has similar symptoms as BPH, men suffering from prostatitis may also have pain in groin or lower back, low grade fever, loss of sex drive and painful ejaculation.

After skin cancer, prostate cancer is the most common cancer affecting American men.  Prostate cancer tends to grow slowly.  What makes this cancer hard to treat is that it takes 10, 20, or even 30 years before the tumor gets big enough to cause symptoms.  At this stage, the cancer may have already spread (metastasize).  This is why I recommend yearly check up of PSA levels to see if there is any change compared to previous years.   If you have a family history of prostate cancer, you have 2 to 3 times higher risk of prostate cancer than men who do not have a family history.   Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.  Other notable risk factors include diet high in fat and processed foods, race and age.

When detected early, prostate cancer survival rates are better than 98%.  However this rate drops to 26% if it is detected in its late stages.

The month of November is known to a group of men as “Movember”.  It involves the growing of moustaches during the month of November to raise awareness of men’s health issues such as prostate cancer, testicular cancer and men’s suicide.  Movember aims to increase early cancer detection, diagnosis and effective treatment.  Besides annual check-ups, Movember reminds us men to be aware of family history of cancer and to adopt a healthier life style.   There is a Movember organization that encourages people to donate what they would otherwise spend on hair grooming to the American Cancer Society.  Consider donating next November, and remember, its always a good time to think about keeping your prostate healthy!