It can also cause serious health problems if not treated
African American men have had the highest prostate cancer rate of any group in the world. African American men have an almost 70 percent higher rate of prostate cancer than in Caucasians and almost double the rate of prostate cancer in Asians. Before discussing prostate cancer, this week we will first discuss general prostate health. Next week we will discuss prostate cancer.
What is the prostate?
The prostate is considered part of the male reproductive system. It is a small gland, normally about the size of a walnut. It is located between the bladder and rectum. The tube that carries urine from the bladder out of the body passes through the prostate. The prostate makes the fluid “semen,” which nourishes and carries sperm when the man ejaculates. Scientists are still unclear on all the functions of the prostate.
What is an enlarged prostate?
Over time, the prostate can enlarge. The prostate can begin enlarging in a man’s 30s. When a man reaches the age of 40, the prostate gland might have increased 1.5 to two times its original size. By the time a man reaches the age of
60, it might be two to three times its original size.
Because the prostate surrounds the urethra, the tube that carries urine out of the bladder, an enlarged prostate gland can put pressure on and squeeze the urethra, interfering with the passage of urine. These types of urination problems usually don’t occur until after age 50, but, rarely, they can occur earlier.
The enlargement of the prostate is a common occurrence. It is called benign prostatic hypertrophy (BPH). BPH is a non-cancerous condition. In fact, 90 percent of men over the age of 80 have an enlarged prostate, and about one-third have troublesome symptoms. BPH can’t be prevented, and those with a positive family history and at increased age are at higher risk for developing BPH.
What are symptoms of BPH?
• Difficulty beginning urination
• Urinating frequently
• Frequent urination at night
• Suddenly having an urge to urinate
• Stopping and starting repeatedly while urinating
• Having to strain/put pressure on to urinate
Importance of exams
To maintain good prostate health, it is important for men (and women, for other reasons) to have regular general medical examinations. An enlarged prostate is easily detected by a rectal examination.
The rule of thumb is to have two general medical examinations in your 20s, three general medical examinations in your 30s, a general medical examination every two years in your 40s, and yearly after age 50. Of course, this schedule is just a general recommendation. Your physician will discuss with you the best timing of general medical examinations based on your personal medical history.
BPH is a progressive medical disease. Left untreated, BPH can cause serious health problems such as kidney and/or bladder damage, kidney infections, and prostate infections. It can also be an extreme inconvenience with the above-mentioned urination problems, including multiple visits to the bathroom during normal sleeping hours.
BPH is not a precursor to prostate cancer.
BPH is a treatable condition. If you have BPH, there are several treatment options:
Observation. Patients with early/mild BPH and who are not suffering any significant symptoms may be advised by their doctor to simply schedule an annual medical examination, which might include a variety of tests relating to BPH.
Behavioral changes. These may include limiting fluid intake in the evening and/or before bed. Particularly important is limiting drinks containing alcohol or caffeine. Maintaining a healthy weight is also very important for a healthy prostate.
Medication. These include medications called alpha-blockers and 5 alpha-reductase inhibitors. They can be taken together. They help to ease symptoms and can cause a decrease in the size of the prostate.
The FDA is currently examining these medications to see if they could possibly have any effect on increasing the risk for developing prostate cancer. The medications can be very helpful, but talk with your doctor about the risks and benefits if you are considering these medications.
Surgery. This is reserved for patients with severe symptom when all other measures are not providing the desired relief.
Next week we will discuss a different prostate condition: prostate cancer.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.