In some ways, men are lucky when it comes to prostate cancer. Unlike many diseases, information on prostate cancer is plentiful. The problem is that there’s so much information, it’s easy to become confused. Prostate cancer is scary and dangerous, but fortunately it’s not too difficult to give yourself the best shot at beating it; it just takes a little understanding.

The prostate is a walnut-sized gland located directly below the bladder. Running through the middle of the prostate is the urethra, which is the tube that runs from the bladder to the penis. It is located in front of the rectum and feels soft and lumpy to the touch.

The prostate has two functions: It helps control the flow and rate of urination through the urethra; it is also responsible for giving semen its whitish color. A white secretion builds in the prostate and, upon ejaculation, is fed into the urethra. This provides a couple of functions: It lubricates the urethra, provides nourishment to sperm, activates the sperm by telling them to swim, and the acidic pH of the prostatic fluid helps sperm become inured to the acidic environment of the vagina.

It is recommended that high-risk patients, such as African Americans and men with family histories of prostate cancer, to begin prostate check-ups when they turn 40. All other men should begin by the age of 45. The reason to get tested early is to get a base PSA reading. PSA, or prostate specific antigen, is a protein made only by the prostate which helps keep semen in its liquid state.

When testing for problems with the prostate, the PSA number is used to help determine whether the prostate is healthy. A high PSA reading could mean three things that could potentially bode trouble: prostatitis, BPH (benign prostatic hyperplasia), or prostate cancer.

Prostatitis is an inflammation or infection of the prostate. It causes a frequent need to urinate, pain when urinating, and lower back pain. It is usually not very serious and after a few weeks of antibiotics will disappear. 

BPH, which is not cancerous, is a condition where the prostate enlarges. It can enlarge in two ways. The first is when cells multiply around the urethra and squeeze down on it, similar to pinching a straw. The second way the prostate can grow is when cells begin to grow into the urethra and bladder. BPH is caused by aging and nearly all men over 50 have an enlarged prostate. There is no cure for BPH and once it starts growing it continues growing until treatment begins.

The symptoms of BPH are mostly urinary: blood in the urine, leaking after urination, weak streams, and the feeling that the bladder hasn’t emptied after urination. This is diagnosed by testing how quickly the bladder empties, the rate of flow, the pressure of the bladder and how empty the bladder is after urination.

Doctors utilize many techniques in the treatment of BPH. Drugs such as Proscar and Flomax are used to try to reduce the size of the prostate or at least slow its growth. However, drugs are only used when there are minor symptoms. In cases where there are recurring symptoms, such as blood in the urine, recurring urinary infections, or bladder stones, surgery is the preferred method of treatment.

The preferred method of surgery right now is transurethral resection of the prostate or TURP. For this surgery, the patient is placed under anesthesia. A scope is inserted in the urethra until the doctor can see the prostate and bladder. Then sections of the prostate are removed and a catheter tube is placed in the bladder to allow for urination. The patient is then hospitalized for 1-3 days with 4-6 weeks of recovery time. It is common to have blood in the urine for a short time after the operation as well as some burning during urination. This is normal and usually goes away in time. Some complications include sterility and impotence but these are rare.

An alternative to TURP is the holmium laser treatment. It is similar to TURP, except, instead of slicing off sections of the prostate, the laser is used to vaporize obstructing tissue and the area is sealed afterwards. The benefits of using the laser are that there are fewer risks, shorter recovery time, little to no bleeding and the patient can usually leave the hospital without a catheter after a few hours or an overnight stay.

Prostate cancer is the most serious problem that occurs in the prostate. The symptoms include frequent urination, weak flow, pain while urinating, erectile dysfunction, blood in urine or semen, or pain in the lower back, hips and thighs.

Currently, prostate cancer is diagnosed using PSA numbers. This is why doctors want their patients to get tested earlier so they can monitor how much the number changes. However, Dr. Thomas Stamey, a professor of urology at Stanford University, California, says that PSA levels are only good for determining prostate size but not for predicting cancer. Dr. Stamey reasoned prostate cancer is found even in men in their 20s and that what is really needed is a way to determine the amount of cancer in the prostate. He says that in spite of that fact it does remain an excellent marker when treating the prostate.

If test results imply that there is the possibility of prostate cancer, the next step is to have a biopsy. For this test, the doctor inserts a probe into the rectum. Then the doctor will look for anything suspicious and collect a slice of tissue from the prostate for a pathologist to examine for cancer. If cancer is present, the doctors will compare the cancer cells to regular prostate cells to determine the aggressiveness of the cancer. If the cells look extremely different, the cancer is likely more aggressive.

There are many treatments for prostate cancer and sometimes multiple treatments are used. External-beam radiation therapy (EBRT) uses powerful X-rays to kill cancer cells. It is very effective; however, it also scars nearby healthy tissues. Most side effects are mild and disappear once treatment is stopped. Sometimes sexual side effects, such as erectile dysfunction, can occur with younger patients having better odds to retain normal sexual function.

In another form of treatment, radioactive seeds are implanted into the prostate, which deliver a higher dosage of radiation over a much longer period of time. In this surgery, 40-100 rice-sized seeds are placed in the prostate. The radiation only emits a few millimeters from the seed, although doctors recommend that for the first few months patients undergoing treatment stay 6 feet away from pregnant women and children. Urination also becomes slower and more painful.

Hormone therapy uses drugs to stop the body from producing testosterone or surgery to remove the testicles. This is usually used when there is advanced prostate cancer in order to shrink tumors making them easier to remove and destroy. Side effects include breast enlargement, reduced sex drive, impotence, and reduced muscle.

Lastly, radical prostatectomy is used to completely remove the prostate and surrounding lymph nodes while trying to leave the muscles and nerves that control urination and sexual function. The most common way the surgery is done is by making an incision in the lover abdomen about an inch above the penis. It is done there because it is also possible to remove lymph nodes to see if the cancer has spread and it makes it easier to save the nerves that control the bladder and sexual functions. A catheter is placed and will remain for 1-2 weeks and some bladder control problems and impotence can occur. 

The best way to reduce problems with the prostate is to avoid a high fat diet. Soy products, vitamin E, and foods rich in lycopenes are all believed to help prevent cancer. Exercise is also a way to help circulation and strengthen the immune system which helps reduce the risk of BPH. And don’t forget your annual prostate exams!