Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
The prostate is a small, rubbery gland that is situated just below the bladder. It’s roughly the size and shape of a walnut, and sits around the urethra, the tube that carries urine from the bladder through the penis. From the side, the prostate sits between the front of the rectum and the base of the penis. Prostate occurs only in males.
Men could live without the prostate (it is not essential for life), but it plays a key part in fertility and reproduction, and grows during adolescence under the influence of the male hormone testosterone and its by-products.
The prostate produces some of the fluids contained in the semen, the liquid that transports sperm. About 70 to 80 percent of the fluid in semen comes from the seminal vesicles, two small structures that sit on top of the prostate like rabbit’s ears. The muscles in the prostate also help push semen through the urethra when ejaculating.
KEEPING THE PROSTATE HEALTHY
• Living a healthy lifestyle is the best way to keep the body well, and to protect against cancer.
• Maintaining a healthy body weight, not smoking, exercising regularly, and having a healthy diet can all play important roles in preventing disease, including prostate cancer.
• A review of research suggests that eating red foods such as tomatoes and watermelons may reduce the progression and growth of prostate cancer cells. Red foods contain a powerful antioxidant called lycopene.
• Eating fruits, especially citrus fruits such as oranges, lemons, grapefruits, limes, and mandarins, may also slightly lower the risk of prostate cancer, according to some studies.
• Coffee and green tea may also lower cancer risk, but more studies are needed to confirm this.
• A review of research done in 2014 indicated there may be a link between saturated fats and animal fats and prostate cancer risk, so it may pay to reduce intake of these types of fats.
• Too frequent masturbation can cause prostate cancer. It’s been studied, and, so far, there has been no link found between masturbating or having sex too often and prostate cancer. If anything, the effect may be the opposite, but more research is needed to know how and why.
WHAT CAN GO WRONG?
• Enlarged prostate (benign prostatic hyperplasia-BPH)
It’s common for the prostate to get bigger as men age. Around half of the men aged over 50 experience benign prostatic hyperplasia, which means swelling or enlargement of the prostate. This can mean the prostate expands from the size of a walnut to the size of an apricot, or even a lemon.
For some men, an enlarged prostate doesn’t cause any symptoms or bother. Others will find that an enlarged prostate causes symptoms, including:
• Difficulty peeing, including getting started or getting a strong or steady ‘flow’
• Frequent urination
• Needing to urinate suddenly, without the normal build-up
• Waking up at night to go to the toilet
• Pain or burning when urinating
• Pain when ejaculating.
Sometimes an enlarged prostate can be treated with lifestyle changes, like drinking less before going to bed. Some men would be prescribed medicines to help with the condition, and surgery can also be an option, though this is less common because of the risk of side effects.
Prostatitis is inflammation of the prostate. It’s different from an enlarged prostate, though some of the symptoms are similar. Prostatitis can cause the prostate to become swollen, tender, or inflamed. Symptoms of prostatitis can include:
• urinating urgently, often in the middle of the night
• Pain when urinating, or after you ejaculate
• Blood in the urine
• Lower back pain
• Pain in the rectum
• Feeling of heaviness behind the scrotum
• Urinary blockage
There are different types of prostatitis. Bacterial prostatitis is caused by a bacterial infection, and can be treated with antibiotics. Then there’s chronic prostatitis, or chronic pelvic pain syndrome.
• Prostate cancer
Prostate cancer is the most commonly diagnosed cancer in men. The risk of developing prostate cancer increases with age. For men under 75 years, the chance of developing it is 1 in 7. By age 85, this increases to 1 in 5. Other factors that might increase the risk of developing prostate cancer include:
• Family history: a father or brother who has had prostate cancer
• Hereditary genetic mutations in the BRCA1 or BRCA 2 genes
• Having the genetic condition Lynch syndrome.
Symptoms of prostate cancer
In its early stages, prostate cancer doesn’t necessarily cause symptoms. Men with prostate cancer might experience some of the following symptoms:
• urinating frequently or suddenly
• Difficulty urinating, including trouble getting started or maintaining a strong or steady flow
• Feeling of haven’t completely emptied the bladder after going to the toilet
• Pain, burning, or discomfort when peeing
• Blood in urine or semen
• pain in the lower back, upper thighs, hips, or chest
• Feelings of weakness or numbness in the legs or feet
• unexplained weight loss
• Feeling tired, short of breath, or dizzy
• Rapid heartbeat
• Pale skin.
There isn’t one simple test that can be used to diagnose prostate cancer. Below are the types of tests that might be recommended to check prostate health.
• Digital rectal exam (DRE)
This test can’t diagnose prostate cancer. It can only give the doctor an indication of prostate health, and may help them feel any abnormalities or changes in the prostate.
• Prostate-Specific Antigen (PSA) testing
Prostate-Specific Antigen (PSA) is a protein made by the cells in the prostate. A PSA test isn’t a test for cancer. Higher levels of PSA might indicate prostate cancer, but a high reading could also be caused by other conditions. It is also possible to have low-level readings and prostate cancer.
• Prostate biopsy
A prostate biopsy is used to diagnose prostate cancer. If there are signs of cancer or prostate abnormalities, it will be done to either diagnose or rule out cancer.
It’s a good idea to check in with the healthcare provider about prostate issues.