Men's Health Week 2023

The prostate gland isn't big—about the size of a walnut—but its location virtually guarantees big problems if something goes awry and don't keep tabs on it.

The prostate gland is located just below the bladder and in front of the rectum. It also wraps around the upper part of the urethra, the tube that carries urine from the bladder out of the body. That means prostate problems can affect urination and sexual function.

Busy days make it hard to put prostate health on the front burner. It just feels like you don't have time for habits that keep the tiny organ in top shape.

The prostate is prone to three main conditions:

1)  Prostatitis: 

It is infection or inflammation of the prostate. There are two main types: acute prostatitis and chronic prostatitis.

 Acute prostatitis is caused by an infection, usually by bacteria, and results in the sudden onset of painful urination, a small stream and often fever and chills.

Chronic prostatitis, is a less well defined condition. Its symptoms include persistent or recurrent pelvic discomfort, pain or burning with urination, an increased urge to urinate, difficulty emptying their bladders, and/or painful ejaculation.

Treatment includes long course of antibiotics – because infection is difficult to get rid of.

2) Benign prostatic hyperplasia (BPH): Bigger Isn’t Better! It is aging-related enlargement of the prostate gland.

As the prostate expands in size, it effectively pinches off the urethra, making the muscular walls of the bladder have to work harder and causing problems with urination. Symptoms can include weak urinary stream, night-time urination, dribbling after urination, and a stream that stops and goes. These may seem like more of an annoyance than anything else, but they can bring on more serious issues, including the inability to fully empty your bladder, urinary retention (complete blockage), infections, backup in the kidneys, or bladder stones.

Treatment includes - medications to improve urinary flow, surgical procedures - endoscopic (TURP, Laser based, UroLift etc.,)  and open methods.

3) Prostate cancer:

It is the growth of cancerous cells inside the prostate, which may break out of the gland and affect other parts of the body. It is the second most commonly diagnosed cancer in men, with an estimated 1.4 million diagnoses worldwide in 2020. Prostate cancer is primarily a “disease of aging”. A systematic review of autopsy studies reported a prevalence at age < 30 years of 5% and prevalence of 59%  by age > 79 years. 

Prostate cancer can be life-threatening, If detected early, it is very curable, but early prostate cancer may not have any symptoms. Prostate issues typically affect men over 50. So, it is advisable start regular screening after 50 years age. But men with a family history of it—and African-American men—should start screening at age 40. 

The two most common screening tests performed are - a blood test (serum PSA) and Digital Rectal exam. Serum PSA is not an end-all-be-all screening. It’s a fair test, but nothing is absolute.

The goal is early detection, as the cure rate for prostate cancer that’s found in a lower stage is very high. 

Treatments run the range of what you might expect - Surgery, radiation, hormonal manipulation, chemotherapy, biologic therapy or just monitoring are options, with different treatments appropriate for different types of prostate cancer.

Prevention—Sort Of:

 Eating a mostly plant-based diet and exercising has been suggested to prevent cancers in general. Processed food, smoking, alcohol, and red meat to be avoided.

Here’s one final piece of prostate advice  - frequent ejaculation would be a benefit in preventing prostate cancer.

The article is authored by Dr. Nagareddy.S. Patil, Consultant Urologist, Fortis Hospital, Richmond Road, Bangalore.