Benign prostatic hyperplasia (BPH) is a condition that affects the prostate gland in men. The prostate is a gland found between the bladder (where urine is stored) and the urethra (the tube urine passes through). As men age, the prostate gland slowly grows bigger (or enlarges). As the prostate gets bigger, it may press on the urethra and cause the flow of urine to be slower and less forceful. "Benign" means the enlargement isn't caused by cancer or infection. "Hyperplasia" means enlargement.
FAQ - Prostate Gland
Most symptoms of BPH start gradually. One symptom is the need to get up more often at night to urinate. Another symptom is the need to empty the bladder often during the day. Other symptoms include difficulty in starting the urine flow and dribbling after urination ends. The size and strength of the urine stream may decrease.
These symptoms can be caused by other things besides BPH. They may be signs of more serious diseases, such as a bladder infection or bladder cancer. Tell your doctor if you have any of these symptoms, so he or she can decide which tests to use to find the possible cause.
After your doctor takes a complete history of your symptoms, a rectal exam is the next step. This exam allows your doctor to actually feel the size of the prostate gland.
It might not be possible for your doctor to be sure that your prostate problem is benign just by taking a history and performing a physical exam. Your doctor might need to look at a sample of your urine for signs of infection. Your doctor may also do a blood test. An ultrasound exam or a biopsy of the prostate may help your doctor make the diagnosis.
Once your doctor is sure that your symptoms are caused by benign growth of the prostate gland, treatment can be recommended. However, your doctor may suggest that you wait to see if your symptoms get better because sometimes mild symptoms get better on their own. If your symptoms get worse, your doctor may suggest another treatment option.
Surgery is considered the most effective treatment and is used in men with strong symptoms. This is also the best way to diagnose and cure early cancer of the prostate. Surgery is usually done through the urethra, leaving no scars. Surgery does have risks, such as bleeding, infection or impotence. These risks are generally small.
FAQ - Prostate CancerWHAT ARE MY CHANCES OF GETTING PROSTATE CANCER?
Prostate cancer is the most common cancer among men and the second leading cause of annual cancer deaths, following lung cancer. One in 10 men will be diagnosed with prostate cancer. More than 70 percent of all prostate cancer cases are diagnosed in men over the age of 65. Black men are in the highest risk group and represent approximately 270 cases per 100,000 men. In addition, prostate cancer has the strongest familial link of all the major cancers.
Often, early stages of prostate cancer do not cause symptoms. But, in some cases, men with prostate cancer may experience any of these problems
A need to urinate frequently, especially at night;
Difficulty starting urination or holding back urine;
Weak or interrupted flow of urine;
Painful or burning urination;
Difficulty in having an erection;
Blood in urine or semen; or
Frequent pain or stiffness in the lower back, hips, or upper thighs.
You should speak with your doctor immediately if you have these symptoms or if you are over 50 and not had a recent prostate cancer screening. If you have a family history of prostate cancer, or are an African-American male, you should consider screening beginning at age 45.
Prostate cancer may be highly curable when detected in its early stages. One in every seven men diagnosed with prostate cancer will die from the disease. In advanced stages of the disease, new data from two large clinical trials suggest chemotherapy extends survival among men who have failed hormone therapy. Your physician can provide you with specific guidance based on the facts and circumstances of your case.
PSA test. Prostate specific antigen (PSA) is an enzyme produced in the prostate that is found in the seminal fluid and the bloodstream. To measure the PSA level, a small vial of blood is drawn and sent to a laboratory for evaluation. An elevated PSA level in the bloodstream does not necessarily indicate prostate cancer, since PSA can also be raised by infection or other prostate conditions. Many men with an elevated PSA do not have prostate cancer.
The digital rectal exam (DRE) should be performed along with the PSA test. The DRE is performed by a physician who will insert a gloved finger into the rectum to feel the peripheral zone of the prostate where most prostate cancers occur. The physician will be checking for hardness of the prostate or for irregular shapes or bumps extending from the prostate - all of which may indicate a problem. The DRE is particularly useful because the PSA test may miss up to 25 percent of cancers, and the DRE may catch some of these.
There are a variety of ways to treat prostate cancer including
Surgery to remove the prostate in its entirety, radiation therapy to kill the cancerous tissue in and around the prostate,
Hormone deprivation therapy to stop the production of hormones that help prostate cancer cells to grow,
Chemotherapy to stop the cancer cells from dividing and multiplying,
"Watchful waiting" which involves no active treatment at that particular time. One or more of these treatment approaches may be used by your doctors at various times and stages of the disease. There are a variety of factors that will be evaluated by your physician to determine the best treatment approach.
By measuring levels of a substance called prostate-specific antigen in the blood, your physician can measure disease progression. If you are receiving treatment for prostate cancer and your PSA numbers keep rising, it may be a sign that your therapy isn't working and you may need to consider a more aggressive treatment.
Most men whose cancer returns after local treatment or are diagnosed with advanced disease are treated with hormone therapy. However, at some point, hormone therapy may stop working and the PSA levels will begin to rise again. At this point it is particularly important to seek the advice of a medical oncologist who can work with the rest of your healthcare team to determine the best treatment for you at this stage of the disease.