The prostate gland is a male sex organ, about the size of a walnut, located just below the bladder. It surrounds the urethra, the tube that takes urine from the bladder to the penis. The prostate doubles in size during early puberty, then begins to grow slowly at about age 25.
Function
The prostate provides a portion of the fluid that makes up the semen, which carries the sperm through the vas deferens on ejaculation. These secretions are thin and milky and are made up of many different components designed to support and transport the sperm, Mary Estes writes in "Health Assessment & Physical Examination." Semen provides some protection against urinary tract infections. The prostate cells also convert testosterone into a substance that is largely responsible for benign, or noncancerous, enlargement of the prostate as a man ages.
Features
The prostate is made up of five lobes with a groove between the lateral lobes. It is the right and left lateral lobes that your examiner checks when he does a digital rectal examination. This is the area where cancer is most likely to develop.
Effects
Healthy reproduction depends on a healthy prostate. There are three diseases that affect the prostate: prostatitis, benign prostatic hyperplasia and prostate cancer. Prostatitis is a group of disorders that have related symptoms, the Mayo Clinic reports. Some forms are generally well understood, while others are not and are difficult to diagnose. Enlargement of the prostate is called benign prostatic hyperplasia, or BPH. This develops slowly as men age and may or may not cause a problem. It is not cancer and does not become cancer. Prostate cancer is the second most common cancer in men. The American Cancer Society estimated there would be 192,280 new cases of prostate cancer in 2009, the last year for which figures are available. The society also estimated 27,360 deaths from the disease in that same year.
Time Frame
Prostatitis affects young and middle-aged men. It may be acute or chronic, and it may be caused by bacteria. The prostate may grow slowly during the middle years, but the enlargement rarely causes symptoms before age 40. An enlarged prostate is very common in older men. If a man lives long enough, he will likely have prostate cancer. The American Cancer Society estimates that about 1 in 6 men will be diagnosed during his lifetime. More than 2 million men alive today were diagnosed with prostate cancer at some point.
Symptoms
Acute prostatitis and BPH commonly present with symptoms. Prostatitis often has a sudden painful onset of infection: fever, chills, nausea, vomiting and a general feeling of being sick. A man may have pain or burning on urination and pain in the lower back or groin. Frequent urinary tract infections may signal chronic prostatitis. He may have no symptoms and the prostatitis will be found only when he is tested for other problems.
BPH varies in severity and may cause no problems for some men. Others may experience a weak stream or difficulty starting urination. A man may experience dribbling at the end of urination and frequent urgent needs to urinate with increased frequency at night. He may strain to urinate and he may not be able to empty his bladder, which may lead to urinary tract infections.
Early prostate cancer often does not cause symptoms because of its location. It is usually identified during a routine medical examination. When the cancer presses on the urethra, which passes through the middle of the prostate, there may be symptoms similar to those of prostatitis or BPH. Diagnosing prostate cancer starts with DRE and a blood test to check the levels of prostate-specific antigen, or PSA. If these are elevated, an ultrasound examination and biopsy might be required.
Considerations
Hazardous chemicals or drugs that collect in the prostate may kill the sperm, change the way they swim or attach to the sperm and get carried to the egg. There is considerable discussion about the value of beginning DRE and PSA testing at age 50 to identify prostate cancer in its early stages. The decision to be tested is one a man should make with his family and his doctor. Men should stay tuned to their bodies. If a man has urinary symptoms or "something just doesn't feel right," he should contact a doctor to find out what is happening.
Prevention/Solution
The Mayo Clinic lists risk factors for prostatitis as urinary tract infection, trauma from bicycling or horseback riding, dehydration, using a urinary catheter or HIV infection. Treatment for prostatitis may include antibiotics or other medications, depending on its cause. According to the Mayo Clinic, small clinical trials are studying ways to treat chronic prostatitis/chronic pelvic pain. This includes heat therapy, biofeedback and acupuncture.
According to the National Institutes of Health, scientists have not identified what causes BPH. Several theories include the impact of estrogen; the accumulation of dihydrotestosterone, or DHT, which is derived from testosterone in the prostate; or "instructions" given to the cells early in life. Treatment may be necessary to prevent bladder or kidney damage. Medications are the most common treatment, although surgery may be necessary if symptoms are severe.
Most of the risk factors for prostate cancer are largely out of a person's control: age, race, family history. African-American men or a man whose father or brother has had prostate cancer are at higher risk. For all men with prostate cancer, the relative five-year survival rate is almost 100 percent, according to the American Cancer Society. The 10-year survival rate is 91 percent. A man can help improve his prostate health by maintaining a healthy weight, eating fruits and vegetables and getting enough exercise.
References
- "Health Assessment and Physical Examination"; Mary Ellen Zator Estes, RN, MSN, CCRN; 1997
- National Kidney and Urologic Diseases Information Clearinghouse: Prostate Enlargement
- MayoClinic.com: Prostatitis
- Centers for Disease Control: The Effects of Workplace Hazards on Male Reproductive Health
- MayoClinic.com: Prostate Gland Enlargement
