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The prostate is basically a male sex gland, about the size of a walnut, located beneath the bladder. (Read about "The Urinary System") It makes some of the fluid that carries sperm. The gland is made of two lobes, or regions, enclosed by an outer layer of tissue. The prostate also surrounds the urethra, the canal through which urine passes out of the body.
Prostate problems are not unusual for men over age 50. As men age, the likelihood of problems increases in fact, according to the National Institute on Aging, as many as 90 percent of American men in their 70's and 80's experience prostate problems.
The American Foundation for Urologic Disease says there are three main types of prostate problems - prostatitis or infections and inflammation, enlargement (also known as benign prostatic hypertrophy or benign prostatic hyperplasia), and cancer. Prostatic Intraepithelial Neoplasia (PIN) is another concern. Below find information on these four prostate concerns.
Prostatitis means that the prostate is inflamed. If you have prostatitis, you may have a burning feeling when you urinate, or you may have to urinate more often. (Read about "The Urinary System") You may also have a fever or just feel tired.
Prostatitis may be responsible for a quarter of all office visits by young and middle-age men for complaints involving the genital and urinary systems, according to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). NKUDIC says prostatitis can fall into one of several different categories:
If you are having suspicious problems, you should consult with your doctor. If you have bacterial prostatitis, your doctor will be able to find bacteria in a sample of your urine. Your doctor can then give you an antibiotic medicine to fight the bacteria. (Read about "Antibiotics") If you keep getting infections, you may have a defect in your prostate that allows bacteria to grow. This defect can usually be corrected by surgery. If no bacteria are found, antibiotics will not help. You may have to work with your doctor to find a treatment that does work. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says changing your diet or taking warm baths may help. Your doctor may also give you medication to relax the muscle tissue in the prostate. Your doctor will also try to rule out other possible causes, if you are having urinary problems, such as a urinary tract infection (Read about "Urinary Tract Infections"), a kidney stone (Read about "Kidney Stones") or cancer (see below).
Benign prostatic hypertrophy or BPH is an enlargement of the prostate. The National Institute on Aging (NIA) says that more then half of men in their 60's have BPH. An enlarged prostate can block the urethra. That can make it hard to urinate and create other issues. (Read about "The Urinary System")
If you have BPH, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says you may have one or more of these problems:
You may barely notice that you have one or two of these symptoms, or you may feel as though urination problems have taken over your life.
BPH is diagnosed usually with a digital rectal exam. The doctor inserts a gloved finger into the rectum and feels the part of the prostate that sits next to it. This exam gives the doctor a general idea of the size and condition of the prostate. X-rays or ultrasound may be used as well. (Read about "X-rays" "Ultrasound Imaging") Another way to see a problem from the inside is with a cystoscope, which is a thin tube with lenses like a microscope. (Read about "Endoscopy") The tube is inserted into the bladder through the urethra while the doctor looks through the cystoscope.
Once confirmed, patients have a number of treatment options, in consultation with their doctors. According to the National Institutes of Health, these include:
Each of these methods involves inserting tools via the tip of the penis into the urethra. Some other surgical techniques also use this method to reach the prostate. They include:
The most invasive form of prostate surgery is called open prostatectomy. With this, the surgeon makes a cut in your lower abdomen to reach the prostate and remove tissue.
There is another condition called prostatic intraepithelial neoplasia or PIN. The National Cancer Institute (NCI) calls it a noncancerous growth of the cells lining the internal and external surfaces of the prostate gland. The American Cancer Society says PIN can be labeled either low or high grade. It is usually discovered after a biopsy. (Read about "Biopsy") Having high-grade PIN may increase the risk of developing prostate cancer. ACS says there is a 30 to 50 percent chance of finding prostate cancer with later biopsies after finding high grade PIN.
The National Cancer Institute (NCI) reports that prostate cancer is the second most common cancer among men in the United States and the number two cancer killer. (Skin cancer is more common and lung cancer is deadlier; read about "Skin Cancer" "Lung Cancer")
Age is the biggest risk when it comes to prostate cancer. The older a man gets, the more likely he might develop it. African Americans males have a higher risk in all age groups. The U.S. Centers for Disease Control and Prevention say that prostate cancer among African Americans is the highest known rate in the world. (Read about "Minority Health") Family history (Read about "Family Health History") also seems to play a part, with a higher then average risk for those whose father, brother or son has had the disease, according to NCI.
Our PROSTATE CANCER RISK ASSESSMENT can help you learn more about your own risk factors, based on guidelines from the National Cancer Institute.
Simply click on the link for the form. Fill it out online to learn more about how specific things affect the risk of developing prostate cancer. When you're done, you may want to print it out and share it with your doctor. Any information you enter will NOT be saved once you close the window. This is to protect your privacy. When you're done, simply close the form window, and continue reading.
Prostate cancer often does not cause symptoms for many years. By the time symptoms occur, the disease may have spread beyond the prostate. When symptoms do occur, NCI says they can affect your urinary system (Read about "The Urinary System") and other areas, and may include:
These can be symptoms of cancer, but more often they are symptoms of noncancerous conditions. It is important to check with a doctor.
Finding the cancer isn't always easy. There is much discussion at this time about screening methods and when they should start. You should discuss with your doctor what would be the best path for you as you age. NCI says there are different tests that can be used to find prostate cancer:
The American Cancer Society recommends men talk with their doctors about the desirability of regular screenings for prostate cancer beginning at age 50, or earlier if there are risk factors present, including African American men and men with a family history of prostate cancer.
Prostate cancer is described by both grade and stage. A doctor needs to know the stage and the grade of the disease to plan treatment. If cancer is found, more tests will be done to find out if the cancer has spread from the prostate to other parts of the body (staging) and what grade it is.
Grading - NCI says grade describes how closely the tumor resembles normal prostate tissue. Grading is done by looking at the microscopic appearance of tumor tissue. Pathologists may describe it as low-, medium- or high-grade cancer. One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. In both systems, the higher the score, the higher the grade of the tumor. High-grade tumors generally grow more quickly and are more likely to spread than low-grade tumors, according to NCI.
Staging - The following stages are used for cancer of the prostate, according to NCI:
In stage I, cancer is found in the prostate only. It is usually found accidentally during surgery for other reasons, such as benign prostatic hyperplasia.
In stage II, cancer is more advanced, but has not spread outside the prostate.
In stage III, cancer has spread beyond the outer layer of the prostate to nearby tissues. Cancer may be found in the seminal vesicles (glands that help produce semen).
In stage IV, cancer has metastasized (spread) to other parts of the body, such as the bladder, rectum, bone, liver, lungs, or to lymph nodes (Read about "The Lymph System") near or far from the prostate. Metastatic prostate cancer often spreads to the bones.
Treatment - Treatment depends on the stage and the grade of the cancer and the age and overall health of the patient. Treatment options include:
The decision on which treatment is best depends on many factors, such as the stage the cancer is at, your age, and your overall health. You and your doctor will need to discuss the advantages and disadvantages of the options that can be used in your case.
More Cancer Information:
For a list of individual types of cancer, see Cancer: What It Is
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