By Pete Alfano
By the time men reach the age of 50, they have probably heard their primary care physician utter the dreaded “P” word. That would be the prostate, a small gland described as the size of a ping pong ball or walnut that is part of the male reproductive system. It is also the second leading cause of cancer in men. And it can be responsible for keeping men awake at night as an enlarged prostate often presses on the bladder and urethra, resulting in more frequent urination.
Okay, so that is the bad news. The good news is that while the Harvard Medical School says one of every eight men will get prostate cancer during their lifetime, it is one of the more treatable cancers with early detection. And in most cases, prostate cancer is a slow-growing cancer, which for older men, means they will probably die from something else. In fact, cancer cells in the prostate tissue may take up to 30 years before they manifest as a tumor.
This doesn’t mean men should postpone regular screenings. When prostate exams are ignored, prostate cancer, like any cancer, may metastasize, spreading to other organs, dramatically increasing the risk of more extreme treatment and death. Men over 50, African Americans, and men with a family history of prostate cancer are at the highest risk and are encouraged to have a prostate exam at least once a year. For those with a family history, exams should begin earlier than the target age.
Screening for prostate cancer is also recommended because there often are no symptoms until the cancer has spread. Because it is normal for the prostate gland to become enlarged as men get older, other medical non-cancerous conditions are associated with the prostate. One is BPH, which stands for benign prostatic hyperplasia. This condition means the prostate cells are growing, resulting in an enlarged prostate, which is normal. This is not considered a pre-cancerous condition. Another is prostatitis, a bacterial infection treated with antibiotics that can become chronic.
So, what symptoms of an enlarged prostate should men not ignore? Among them are trouble passing urine, frequent urinating, blood in the urine, which may be microscopic, feeling that the bladder has not fully emptied, and even lower back and pelvis pain. A primary care physician can perform two tests to help identify a prostate problem. The first is a prostate-specific antigen (PSA) test, which indicates the amount of PSA in the blood. A test result above 4.0 nanograms may be a red flag indicating either an enlarged prostate, infection, or cancer. A digital rectal examination is uncomfortable, but a doctor can feel the prostate to determine whether it is enlarged or if there are abnormalities, such as a prostate nodule or a hard growth on the prostate.
Depending on dramatic changes in the PSA screening and the digital exam year to year, a physician may refer the patient to a urologist for additional screening, which could include a biopsy. There are also lifestyle changes men can make to help avoid prostate cancer. And yes, they are the usual suspects — exercise regularly, manage stress, which can weaken the immune system, stay hydrated, eat vegetables, cut down on red meat, and maintain a healthy weight. Your prostate will still become enlarged with age, but regular screenings can help detect an issue before it becomes more serious.