Prostate Primer | by Andrea Juarez

What women need to know about prostate health

Posted on Thu, Jan 29, 2015

Knowing signs of trouble with male gland can help women encourage prevention

Prostate diagramAlthough prostate cancer ranks No. 2 as a cancer killer in American men, it’s also highly treatable when detected early. But for that to happen, men need to see their doctors and pay attention to their health. Since some men tend to need a gentle nudge in this area, often from a woman in their life, we asked the experts what women should know about the sometimes troublesome gland.

“Women should check with their husbands, fathers, and brothers to see what they are doing,” says Dr. Stephen Ruyle, urologist with The Urology Center of Colorado. “Don’t assume they are taking care of their prostate health.”

What is the prostate?

The prostate is a gland in the male pelvis, below the bladder and in front of the rectum. Its primary purpose is related to reproduction, since it makes about 50 percent of the fluid in ejaculation. It also affects urination and muscle fibers related to bladder control, Ruyle says.

Why does being proactive matter?

As men age, they have an increased likelihood they will experience some sort of prostate health problems. The most common include:

Dr. Nancy Huff, Advanced Urology

Dr. Nancy Huff, Advanced Urology

Prostatitis – It is an infection of the prostate gland that occurs in men of all ages and generally is linked to a urinary tract infection. It can manifest with or without symptoms, such as pelvic and genital pain, pain with urination, and prostate gland inflammation. If left untreated, it can become septic. Antibiotics are generally a successful treatment, says urologist Dr. Nancy Huff with Advanced Urology.

Enlarged Prostate – For men older than 50, prostate enlargement is the most common problem. Technically called “benign prostatic hyperplasia,” or “BPH,” it affects more than half of men by age 60 and by age 85, 90 percent have it, according to the American Urological Association.

An enlarged prostate is the result of growths, but most are benign. Men should see a doctor if they have problems with urination such as a weak stream, difficulty starting/stopping, increased frequency, not emptying, or blood in the urine. Severity of BPH varies and usually worsens over time, Huff says.

Prostate Cancer – The AUA reports one in seven men will be diagnosed with prostate cancer and black men and those with a family history are more at-risk. Symptoms are sometimes absent and sometimes similar to an enlarged prostate; they might also include painful ejaculation, low back pain and leg swelling.

To stay atop of prostate health, men should have regular prostate screenings and be expedient about consulting with their general physician or urologist when problems occur. “If experiencing symptoms, your doctor will likely perform a PSA (prostate-specific antigen), DRE (digital rectal exam) and a urine specimen to examine white blood cells, infections and to rule out other problems,” Huff says. “Sleeping and urination issues can also be symptoms of other medical conditions such as diabetes and sleep apnea.”

What are prostate screenings?

Digital Rectal Exam has been a mainstay for evaluating prostate health because the doctor physically feels the gland, particularly the backside of it – where cancerous nodule growths are more prevalent, Huff says.

The PSA Blood Test measures the prostate gland’s protein level, also called “prostate-specific antigen.” Levels run from 0 to 4, but the numbers are generally lower for younger men and increase with age. Ruyle says it is important to know the baseline level and monitor it over time, in order to measure how quickly it increases (its velocity). The PSA test is important because some men exhibit no symptoms but still have cancer.

The 2013 AUA guidelines recommend low-risk men start PSA tests at 55 years old and continue to 69. “That’s too late to start and 69 is certainly too early to stop,” Ruyle says. “There’s no harm in the blood test. Most of the controversy relates to course of treatments. The important thing is to have the baselines early and follow-ups so we know what we’re dealing with.”

Many medical professionals like Ruyle and Huff encourage early PSA testing, starting early to mid-40s and certainly at least by 40 years old for black men and those who are symptomatic or with a family history (a father, brother, or son diagnosed with prostate cancer). If all is normal, follow-ups may be every couple of years.

What happens if his PSA levels are high?

Elevated PSA levels can be attributed to cancer but also to an infection or an enlarged prostate. A biopsy might subsequently be performed, depending on the PSA level/velocity, if nodules were found during the DRE, and as deemed necessary. “It may be appropriate for a doctor to closely monitor someone diagnosed with prostate cancer instead of recommending additional treatment,” Huff says. “Treatment may include medications to minimally invasive surgeries like laser therapy.”


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