Prostate issues

Cancer of the prostate is the second most common cancer in American men, according to the American Cancer Society, and the third leading cause of cancer death in men. The recommendation is to begin screening at the age of 40. Screening involves a prostate-specific antigen, or PSA, blood test and a digital rectal exam.

PSA Test

A PSA is a blood test used to help detect prostate cancer. An elevated level of the antigen in your blood might indicate you have cancer.  

In most cases of elevated PSA levels, other tests will be conducted to determine the appropriate cause of the concerning test results. And, just because your first PSA test is elevated, does not mean you have cancer. Depending on your levels, your physician will repeat your PSA every six months to determine if the test is a false positive or a true upward trend.

Who should have a PSA test?

• Men between the ages of 50 and 70 are most recommended to get a PSA test.
• Men of African-American and Caribbean descent are more likely to develop prostate cancer.
• Those who have family members with prostate cancer are more likely to develop it themselves. 

Most men will develop benign prostatic hyperplasia (BPH) if they live long enough.

BPH is a noncancerous enlargement of the prostate gland. It almost never makes its appearance before age 40, but it becomes increasingly common with age. BPH affects about half of all men between the ages of 51 and 60 and up to 90 percent of men older than 80, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reports.

Given its prevalence, it's good to know that BPH is treatable. And some men will never experience symptoms even if the prostate gland is enlarged.

A prostate profile

The prostate gland is a part of the male reproductive system. One of its main roles is to produce semen, the fluid that carries sperm out of the penis during ejaculation.

Weighing in at about an ounce, the prostate is the approximate size and shape of a walnut. The gland wraps around the urethra, which carries urine from the bladder out of the body.

Because of its location, this small gland can have a powerful effect on a man's ability to urinate normally. BPH can cause the prostate to become large enough to squeeze the urethra and block the passage of urine.

Scientists don't yet know what causes the gland to become enlarged. But some research suggests that it may occur because cell growth in the gland increases with hormonal changes in the aging body.

BPH does not occur in men whose testicles were removed before puberty, according to the NIDDK.

What to watch for

According to the Urology Care Foundation, BPH can cause one or more of the following symptoms:

• A weak urine stream.
• Difficulty starting and interrupting urination.
• Difficulty postponing urination.
• Leaking or dribbling urine.
• Frequent urination, especially at night.

You need to see a doctor if you have pain or burning when you urinate, see blood in your urine or can't urinate. These could be signs of BPH, or they could be caused by another problem, such as cancer.

Diagnosis and treatment

You may notice symptoms of BPH yourself, or a doctor may find that your prostate is enlarged during a checkup. The doctor may refer you to a urologist for testing to confirm that you have BPH.

Treatment for BPH could be as simple as taking medicine to relieve symptoms, or you may need surgery to remove obstructing prostate tissue.

But since symptoms of BPH sometimes go away on their own, your doctor may suggest that you wait before starting treatment. In that case, regular checkups are recommended to make sure the condition doesn't get worse.

Prostatitis is an inflammation of the prostate gland. It can affect any man, and it's a common cause of doctor visits for men of all ages, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

The symptoms

According to the American Academy of Family Physicians (AAFP), prostatitis can cause symptoms such as:

• The need to urinate often.
• Pain during urination.
• Body aches.
• Fever.
• Lower back or groin pain.
• Loss of interest in sex.
• Erectile dysfunction.

The causes

Possible causes of prostatitis include:

• Infection of the urinary tract.
• Trouble with the muscles in the pelvis or bladder.
• A defect in the prostate.

Some cases of prostatitis have no known cause. Rarely, a prostatitis infection can be caused by a sexually transmitted disease such as chlamydia.

Types of prostatitis

According to the NIDDK, there are several types of prostatitis:

Acute bacterial prostatitis is the least common but easiest form to find and treat. It's caused by an infection.

Chronic bacterial prostatitis is caused by both an infection and a problem with the prostate.

Chronic prostatitis/chronic pelvic pain syndrome is the most common form of the disease. Unfortunately, it's also the form that researchers know the least about. Symptoms may come and go without warning. Often it has no clear cause.

Asymptomatic inflammatory prostatitis often causes no symptoms, and is found during tests for infertility or prostate cancer.

Treating prostatitis

See a doctor if you have symptoms of prostatitis. The symptoms are similar to the symptoms of other diseases, such as cancer, so your doctor will want to rule these out.

Your doctor will check for prostatitis by checking the prostate with a gloved finger. The doctor may also test your urine to look for an infection.

Most cases of prostatitis are treated with antibiotics. According to the AAFP, other possible ways to ease symptoms include nonsteroidal anti-inflammatory medications such as ibuprofen, hot baths, and medicines that help the bladder and prostate work better.