PROSTATE HEALTH GUIDE 

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The prostate gland is a part of the male reproductive system. Scientists do not know all the prostate's functions. One of its main roles, though, is to squeeze fluid into the urethra as sperm move through during sexual climax. This fluid, which helps make up semen, energizes the sperm and makes the vaginal canal less acidic. It is quite a small gland, about the size and shape of a walnut. It is located in front of the rectum and just below the bladder, where urine is stored and surrounds the tune that carries urine from the body (the urethra).

Ordinarily, the prostate gland increases in size as men get older and in or around 80% of men over 50 develop an enlarged prostate. There are three main problems associated with the prostate: 

Prostatitis      – Inflammation or Infection

Enlargement – Benign prostatic hyperplasia (BPH)

Cancer 

Prostatitis 

Prostatitis is an inflammation of the prostate gland. This inflammation can be acute or chronic.  In fact, chronic prostatitis (which means it doesn't go away) is the number-one reason men under the age of 50 visit an urologist. In some cases, chronic prostatitis follows an attack of acute prostatitis. Chronic prostatitis may also be related to other urinary tract infections.

Acute Prostatitis - This is when symptoms develop quickly. It usually occurs at the same time as a urine infection so it’s important to get checked out by a doctor. Normally a sample of urine will be taken and tested for bacteria and abundant white blood cells. Symptoms of acute prostatitis include:

1. Pain from your prostate, which can be severe. This mainly occurs around the base of your penis, around your anus, and in your lower back

2. Symptoms of a urine infection. For example: pain when you pass urine, passing urine frequently, an urgent desire to pass urine, and sometimes blood in your urine.

3. Pain when passing a fecal motion.

4. Fever (high temperature) - Flu like symptoms and a general ill feeling.

5. A slight discharge (thick fluid) may come out of your penis from your urethra.

6. Your prostate feels will feel tender if you have a rectal examination.

This is not easy to miss. If you have acute prostatitis you are likely to feel quite ill and diagnosis is normally very easy as there are a lot of  bacterium and white blood the urine, which your doctor will be able to detect.

Chronic Prostatitis - In this case the infection and the symptoms develop at a slower rate. The infection is normally just in your prostate and chronic prostatitis is not associated with bladder infections. Symptoms are not as severe with an acute infection and include:

1. Pain similar to acute infection but usually not as severe.

2. Ejaculation may be painful. The pain may vary in severity from day to day.

3. Mild urinary urgency. You may feel an urgent desire to urinate sometimes or a slight pain when you do. The urine stream can be poor also.

4. Again, a general feeling of being unwell, but not as severe as with acute. Your prostate may feel tender under examination (but not always)

Chronic Nonbacterial Prostatitis - This is also known as chronic pelvic pain syndrome and is the most common form of prostatitis.  Sufferers usually find they have had pain around their genitals and urinary tract on and off for about six months. However, on testing there are no bacteria in the urine. This can often be confused with other conditions, such as interstistal cystitis.

What Causes Prostatitis?

There is some debate in medical science about exactly what causes prostatitis but most doctors believe that the normal bacteria which live in the bowel are responsible.  This bacteria may travel up the urethra and cause urinary tract infections which can affect all parts of the urinary system i.e. the bladder, kidneys, urethra or prostate.

 However, prostate infections do occur without a urinary tract infection being present.  If you suffer from an enlarged prostate or have kidney stones, then urine may collect in pools. This increases the risk of infection as bacteria has the opportunity to grow and survive in the collected urine.

However, there are other causes of prostatitis   although they are less common. Some of these other causes are as follows:

1. Prostate surgery - If you have had prostate surgery than the gland is more prone to infection.

2. Medical Instruments – e.g., if a catheter has been passed into the bladder, bacteria can enter and cause problems.

3. Anal Sex – Can allow bacteria to cause infection.

4. Other Infections – Sometimes the prostate can be infected by blood which has been carried from other infections in the body.

Diagnosis of Prostatitis

If you suspect that you have prostatitis then you must get it confirmed by a health care professional. Diagnosis is fairly simple in most cases. A simple urine test will detect bacteria in acute prostatitis. However, in chronic prostatitis a sample of prostate secretions is collected. This involves a doctor gently massaging your prostate via your rectum. Fluid form the prostate is pushed out into the urethra and exits through the penis where it can be collected and tested for bacteria. Sometimes further tests are recommended to rule out any underlying problems with the urinary tract which may have contributed to the infection.

Treating Prostatitis

Traditional medicine will treat prostatitis with both antibiotics and painkillers. The antibiotics will be ‘bacteria specific’ once the bacteria has been identified. Until then you may be prescribed a broad spectrum antibiotic to get you started. Painkillers which contain paracetemol or ibuprofen are used to ease the discomfort and keep any high temperature under control and some doctors recommend laxatives to help keep stools soft and easily passable.

It is important to keep your prostate in good health and diet plays an important part in this. Prostate problems are much more common in the West, and there is some evidence that a diet rich in fruit, vegetables and whole-grain foods is beneficial. Also there is strong evidence to suggest that a diet rich in the antioxidant lycopene (found in cooked tomatoes, ketchup, watermelon) can help protect against prostate cancer whilst minerals and vitamins such as zinc, selenium, vitamins D and E can help with the overall health of the prostate. If you have suffered from a bout of prostatitis and treated it successfully, it is vital to take good care of your prostate to prevent any further infections.  Invest in some high quality prostate health supplements and perhaps in some immune system boosters.

Take a look at your diet and try to include plenty of fresh fruit and vegetables. Opt for whole-wheat alternatives when choosing bread and pasta and go heavy on the ketchup and tomato based sauces! Prevention is always better than cure so put yourself in control and look after your prostate.  
 

 

PROSTATE ENLARGEMENT

As a man get older it is common for the prostate gland to become enlarged. This condition is known as Benign Prostatic Hyperplasia or BPH. (Also sometimes called Benign Prostatic Hypertrophy).  During a man’s lifetime, the prostate goes through two main periods of growth. The first is during puberty when the male body is readying itself for it’s reproductive function. Normally the prostate doubles in size around this time. Then again in the min twenties, the gland starts to grow again and continues to grow. However, it is rare to see BPH in anyone under 40 and although it is common in 60 year old men it  tends to affect men in their 70’s and 80’s most. In fact as many as 90% of men in this age group have some symptoms of BPH.

The actual cause of prostate enlargement is unknown. It is believed that factors linked to aging and the testicles themselves may play a role in the growth of the gland. Men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH.Similarly, if the testicles are removed after a man develops BPH, the prostate begins to shrink in size. However, as the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra.

The bladder wall becomes thick and easily irritated and the bladder itself begins to contract with only tiny amounts of urine in it. This causes frequent urination and eventually the bladder becomes weak and looses the ability to expel urine fully. So, this narrowing of the urethra and insufficient emptying of the bladder cause some of the problems associated with BPH.

Symptoms of BPH

The symptoms of an enlarged prostate are as follows:

1. Increased frequency in urination, including more night time visits to the bathroom.

2. Increased urgency – the need to pass urine quickly.

3. Hesitancy or difficulty at the beginning of urination.

4. A weak urine stream

5. A feeling that you still need to urinate even when you have just finished.

If you feel you are experiencing any or all of these symptoms go and see your doctor promptly. BPH is easier to treat in the earlier stages so speed in diagnosis is very important.

 

Treatment of BPH

Often, if the symptoms of BPH are not very intrusive and quite mild, patients will be advised to adopt a non medical, non surgical method of care called ‘watchful waiting’. In a nutshell, this means that nothing is done but the situation is closely monitored and advice about changes in your lifestyle may be given. If your symptoms become worse then you can move on to active treatment. This can include:

Medication – There are two types of prescription drugs used to treat BPH. They are (a) alpha-blockers and (b) 5-alpha-reductase inhibitors.

Alpha blockers relax the muscle fibers that cause the tension in the prostate gland. This in turn can reduce pressure on the urethra and help with increased urine flow. However, the do not cure BPH simply ease the symptoms. Some of the more common side effects of alpha blockers include headaches, light headedness, dizziness and a feeling of weakness.

5-alpha-reductase inhibitors are used to block production of a hormone called dihydrotestosterone (DHT). This can help to reduce the size of the prostate by a third. Because these drugs can decrease the size of the prostate, they may be used to delay the need for surgery. Some associated side affects of 5-alpha-reductase inhibitors are decrease libido, inability to maintain an erection and tender breast tissue. These drugs are present in your semen so if your partner is pregnant or has any chance of becoming pregnant, use a condom. 5-alpha-reductase inhibitors are normally most successful after about 6 months.

Surgery

Usually only considered for med who experience no relief from either drug. There are three or four different procedures available so it is important to discuss all the options with your doctor before going through with surgery. Discuss the likely prognosis with him/her and the likelihood of a recurrence after your operation. As with any surgical procedure there are some risks involved . The most common side effect is retrograde ejaculation. This is when semen passed into the bladder during climax instead of out of the penis. This is ordinarily not a problem although it does reduce fertility. Some other complications can include urinary incontinence and difficulty in passing urine. 

Laser Therapy and Transurethral Microwave Therapy

This is quite a new treatment. A laser probe is used to vaporize the prostate tissue and with transurethral microwave therapy heat is used to remove some of the prostate tissue. Although relatively new treatments they are becoming more common due to their success rate. Consult your health practitioner for more information about these procedures.

Natural Treatments for BPH

Natural Treatments for BPH include using a range of dietary supplements, vitamins and herbs. By managing levels of fluctuating hormones in the body the well documented properties of the saw palmetto plant may come in handy when dealing with prostate problems, this very useful herb may also minimize the ensuing inflammation and can reduce swollen gland during sever or chronic prostatitis in the affected individual. Also zinc, copper and vitamin E have properties which can be beneficial when fighting prostate problems.

Although many men feel uncomfortable going to the doctor about their prostate (or indeed anything else!) it is vital that you do so if you feel you are affected by any of the above. The prostate has an embarrassing reputation  as it is connected with sex and urination and also because sometimes the idea of the physical  rectal examination is very off putting. This is such a common problem that most doctors will see several in a week and think nothing of it. You are not alone, in the year 2000 there were 4.5 million men who visited their doctor with prostate problems and as life expectancy rises so does the risk of suffering from BPH.

If you have been diagnosed with BPH, take a look at your overall diet and exercise regime. Invest in some supplements and vitamins which are known to promote prostate health and eat a diet rich in the antioxidant lycopene, found in cooked tomatoes, ketchup, and watermelon.  If you can keep your urinary tract in good health (including your prostate) and keep urinary tract infections at bay then you will go a long way to preventing prostate problems occurring in the first place.

 

PROSTATE CANCER

Prostate cancer usually affects men over the age of 50 and it is very rare in men below that age.  Prostate cancer is unusual in that it can develop very slowly. Small areas of cancer within the prostate are very common and these may stay dormant for years. In or about 30% of all over 50 males have some cancer cells within their prostate and this figure rises to nearly all men who are over 80. Ordinarily, because these cancers are so slow growing the, they do not cause any problem, particularly in older men. However, in a small number of cases, the prostate cancer can develop more quickly and can spread to other parts of the body, particularly into the bones.

What Causes Prostate Cancer

In the United States approximately 1 in 6 men are diagnosed with prostate cancer each year and this number is increasing. There are several reasons for this including longer life spans and therefore more older men and also better detection and diagnosis by the medical profession.

The cause of prostate cancer is unknown, but some factors do seem to be responsible for increasing a mans risk of getting prostate cancer. This is still under research but risk factors seem to be:

1. Men who have a close blood relative (father,brother,uncle) have a slightly higher risk.

2. Breast cancer – If several women in the family have had early breast cancer (especially under 40) this may indicate a faulty gene present within the family group. This gene may increase the risk of men in the family getting prostate cancer.

3. Africian-Carribean and African-American men seem to have a higher risk of developing prostate cancer. Asian men appear to be at a lower risk.

4. Diet can have an effect of cancer and this includes prostate cancer. A high fat (animal fat including dairy products) and  a diet high in calcium may increase the prostate cancer risk.

Symptoms of Prostate Cancer

Often, men with prostate cancer do not even realize they have it as there are no symptoms in the early stages. The symptoms only occur when the growth is large enough to put pressure on the urethra and can sometimes be mistaken for benign prostatic hyperplasia or BPH (see prostate enlargement section).

The symptoms for both cancer and BPH are similar and it is vital that you discuss exactly how you are feeling with your doctor and allow him/her to perform all the necessary tests in order to be sure of an accurate diagnosis. Symptoms of prostate cancer (and BPH) include:

1. Hesitation or difficulty when urinating.

2. Frequent urination, especially during the night

3. Pain when urinating

4. Although very uncommon there can be blood in the urine.

If you have any of the above symptoms do go and get checked out by your doctor. Remember, that most of the time enlargements of the prostate are not cancerous and can be easily controlled and treated.

As we said earlier, prostate cancer is usually slow growing cancer and you may not feel any of the above symptoms for many years. Sometimes the first sign of prostate cancer is pain, usually around the back or pelvic area. This can mean that the prostate cancer has gone undetected and spread to the bones.

Diagnosis of Prostate Cancer

When you visit your doctor with prostate or suspected prostate trouble he/she will take a medical history and discuss your symptoms thoroughly with you. In order to find out what exactly is causing the problems your doctor will need to carry out some tests.

The tests usually consist of:

1. A urine test to rule out infection followed by a blood test to measure the PSA or Prostate Specific Antigen levels.

2. A digital rectal examination.

You may be referred to the hospital for further tests. These may include:

1. A Trans-Rectal Ultra Sound guided biopsy (TRUS)

2. CT Scan

3. MRI Scan

4. Bone Scan

Your doctor will explain all these tests to you in detail should he/she decide to send you for them. Remember, if accurate diagnosis is confirmed you will probably not have to have all these tests done.

Treatment of Prostate Cancer

Prostate cancer can be localized which means it only affects the prostate or it may be locally advanced or advanced. This means it has moved to other organs in the body as well.

The kind of treatment you will receive depends on the level of cancer you have. If the cancer just affects the prostate gland your doctor may discuss some of these treatments with you:

1. Active Monitoring or Watchful Waiting – you will be place under close observation and treated only or if necessary.

2. External Beam Radiotherapy – radiation is used to kill cancer cells.

3. Surgery – the prostate is removed.

4.Brachytherapy – radioactive seeds are implanted in the prostate.

5. High Dose Brachytherapy – temporary sources of radiation are targeted directly at the diseased prostate gland.

Also sometimes if the cancer is advanced or locally advanced your doctor may feel hormone therapy will be effective either as a stand alone treatment or alongside something else. Less commonly available treatments are Cryotherapy which involves freezing the prostate and High Intensity Focused Ultrasound.

It is vital that you discuss all aspects of your treatment with your doctor including the side effect and the likely prognosis after the treatment is finished. This will give you confidence and help you understand exactly what is involves so that you know what to expect and can stay in some sort of control.

Whilst undergoing any treatment like this, it is important to look after yourself well. Eat well, including plenty of fruit and fresh vegetables in your diet. Drink plenty of water and cut down on caffeinated drinks and alcohol. Studies show that tomatoes and tomato based products such as ketchup and some pasta sauces may help protect against prostate cancer. This is because they are high in the anti-oxidant lycopene which helps the body fight the growth of prostate cancer cells. It is worth while investing in a good immune boosting tonic whilst on these treatments and taking supplements which promote healthy prostate function.

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