By Scott D. Miller, MD, MBA
The prostate is a walnut-sized organ that resides below a man’s bladder. Its sole function is to produce a portion of the fluid that is generated during ejaculation (along with the neighboring seminal vesicles and the testicles). The prostate has no other urinary or sexual functions, but it is surrounded by several delicate structures that do provide these functions. As such, when this “walnut” misbehaves, it can certainly make you a little “nutty.”
The prostate enlarges over a man’s lifetime. As urine exits the bladder, it passes through the prostate. Prostate enlargement can restrict urine flow and cause a more frequent desire to urinate. These symptoms can be particularly bothersome at night, interrupting an otherwise good night’s sleep. A prostate infection can also cause the prostate to swell and lead to similar symptoms. However, with an infection, the symptoms are often more severe and can be associated with pain during urination.
The prostate can also wreak havoc with no warning at all. In fact, prostate cancer is the second leading cause of cancer death in men. Unfortunately, once prostate cancer becomes symptomatic, it has most likely spread beyond the prostate. In addition, the earlier a man is diagnosed, the more likely he will preserve those urinary and sexual functions provided by the delicate structures surrounding the prostate. As such, starting at age 40, all men should learn about their best approach for screening and prevention based on their individual risks and health needs.
Men at particular risk for prostate cancer include those with the following:
• Family history of prostate cancer
• Unknown family history
• African-American race
• Prior history of an abnormal PSA blood test
Most men with prostate cancer are diagnosed because of an abnormal PSA (prostate-specific antigen) blood test, the most common method for prostate cancer screening. However, an abnormal blood test does not mean that you have prostate cancer. Other causes of an elevated PSA include:
• Prostate enlargement
• Urinary tract infection
Recent advancements have allowed doctors to utilize the PSA test in ways to reduce the number of men who require prostate biopsies or prostate cancer treatment. Examples include:
• Blood tests that are more advanced than PSA
• Observing trends in PSA values over time
• MRI scan of the prostate
• Molecular (genomic) testing of prostate tissue samples
PSA testing should begin at age 50, but earlier if other risk factors mentioned above are present. Many urologists recommend a baseline PSA test at age 40 in order to use it for future comparison. When caught early, the cure rate for prostate cancer is 98 percent. When caught late, as many as 30 percent will succumb to this disease.
Want to hear more about men’s health? Read Dr. Miller’s 7 Tips for a happier, healthier life here.
Scott D. Miller, MD, MBA, is the Medical Director of Robotic Surgery at Wellstar North Fulton Hospital. He is a urologist with Wellstar Urology in Roswell and has practiced in Atlanta for over 20 years. Wellstar Health System is a proud sponsor of ProstAware’s Blue Ties Luncheon and run4Dad 5K, both of which happen in September. September is National Prostate Cancer Awareness Month. We encourage all men and their loved ones to learn how to reduce the risk of prostate cancer deaths in our community. Visit ProstAware.org to learn more.