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Prostate health


Prostate

The prostate is a gland. It helps make semen, the fluid that contains sperm. It surrounds the urethra, the tube that carries urine from the bladder out through the penis. A young man's prostate is about the size of a walnut. It slowly grows larger with age. If it gets too large, it can cause problems. The older men get, the more likely they are to have prostate problems.

The three most common prostate problems are prostatitis (pross-tuh-TYT-uhss), prostate enlargement, and prostate cancer. Although most prostate problems are not cancer, prostate cancer affects many men. Talking to your doctor about prostate problems and whether screening is the right choice for you will protect your prostate health and overall health.

Prostatitis

Prostatitis is an infection or inflammation of the prostate that often causes pain or discomfort. The pain may be in the penis, around the rectum, or in the pelvic area. It may occur during urination or ejaculation. Prostatitis is the most common prostate problem for men younger than 50. Prostatitis can come on suddenly, or it can keep going away and coming back. There are different types of prostatitis. A sudden infection can give you symptoms such as:

  • Fever, chills, and nausea
  • Pain and burning when urinating and during ejaculation
  • Strong and frequent urge to urinate, but only being able to pass small amounts of urine
  • Lower back or abdominal pain
  • Blood in the urine

See your doctor right away if you have any of these symptoms. An acute infection can be life-threatening, but it can be easy to diagnose and treat.

Chronic prostatitis is the most common but least understood form of prostatitis. It is also called chronic pelvic pain syndrome. It is difficult to diagnose because the symptoms are not the same for every patient, and many of the symptoms — such as painful or burning urination and incomplete emptying of the bladder — could be signs of another disease. Chronic pelvic pain cannot be cured, but treatment helps many men manage their symptoms.

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Prostate enlargement

For men over 50, the most common prostate problem is prostate enlargement, also called benign prostatic hyperplasia (buh-NYN prah-STAT-ihk HEYE-pur-PLAY-zhuh). As the prostate grows, it squeezes the urethra, causing urinary problems. Some of these problems include:

  • A frequent and urgent need to urinate
  • Trouble starting a urine stream, even though you feel you have to rush to get to the bathroom
  • A weak stream of urine
  • A small amount of urine each time you go
  • The feeling that you still have to go, even when you have just finished urinating
  • Waking up to urinate more than once or twice a night
  • Leaking or dribbling urine
  • Small amounts of blood in your urine

It's a good idea to talk to your doctor if you have symptoms of prostate enlargement. Your doctor might suggest that you "wait and see" if your symptoms don't bother you too much. Or, you can discuss treatment options if symptoms are or become so bothersome that you can't enjoy life.

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Prostate cancer

Prostate cancer is one of the leading causes of cancer death among men. Researchers are trying to figure out what things might put a man at risk of prostate cancer. Some possibilities include eating a diet that is high in animal fat and being exposed to certain chemicals like pesticides.

Drugs to prevent prostate cancer

Medications called 5-ARIs (like finasteride) may help reduce the risk of prostate cancer. But 5-ARIs are not right for everyone. If you have regular prostate screenings and have no signs of prostate cancer, ask your doctor about the risks and benefits of 5-ARIs for you.

The following are known risk factors for prostate cancer:

  • Age – Being 50 years of age or older
  • Family history – Having a brother, son, or father who had prostate cancer increases your risk (and a family history of breast or ovarian cancer may also increase your risk)
  • Race – Being African-American
  • Genes – Having certain genes can raise your risk

Finding prostate cancer early may save lives. But experts don't agree about whether all men should get screened regularly for prostate cancer. Experts who don't support regular screening point out that some prostate cancers grow very slowly and are not dangerous. And, they say, if a man gets screened, he could wind up getting treatment for cancer that he doesn't need and that can have side effects.

Every man needs to decide if screening is right for him. Talk to your doctor about the pros and cons of routine screening for you. Some issues to discuss include your age, your overall health, your family medical history, and whether or not you feel comfortable "watching and waiting" if tests find cancer.

If you choose screening, you might have:

  • A digital rectal exam (DRE), in which the doctor or nurse inserts a gloved finger into your rectum to feel your prostate.
  • A prostate specific antigen (PSA) test, which is a blood test. The levels of PSA in the blood can be higher in men who have prostate cancer.

Prostate cancer usually doesn’t cause any symptoms in the beginning. If you have symptoms, they might include blood in the urine, pain or burning while urinating, not being able to urinate, and constant pain in the lower back. These symptoms could be a sign of some other condition, but see your doctor as soon as possible if you have any of them.

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Content last updated: January 10, 2011.

Resources last updated: January 10, 2011.

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