Men’s Guide to Prostate Changes, Part 2: Non-Cancerous Changes

 

Based on the “Understanding Prostate Changes: A Health Guide for Men page of the National Cancer Institute website

 

Edited (with Introduction) by Dr. Don Rose, Writer, Life Alert

 

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This article discusses many prostate-related topics, ranging from the basics (what it is) to information about prostate changes that happen with age (common changes, how they are treated, and what one needs to know about testing for prostate changes, including cancer). Since negative changes become more likely the older we get, this information is especially relevant for senior citizens. (The article is broken up into five segments. This is part 2.) --Dr. Don Rose

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Non-Cancerous Prostate Changes

 

Most men experience prostate changes that are not cancer. Let us examine these cases.

What is prostatitis and how is it treated?

Prostatitis (pronounced "PRAH-stuh-TYE-tis") is an inflammation or infection of the prostate gland. It affects at least half of all men at some time in their lives. Having this condition does not increase your risk of any other prostate disease.

Prostatitis Symptoms

·                 Trouble passing urine or pain when passing urine

·                 A burning or stinging feeling when passing urine

·                 Strong, frequent urge to pass urine, even when there is only a small amount

·                 Chills and high fever

·                 Low back pain or body aches

·                 Pain low in the belly, groin, or behind the scrotum

·                 Rectal pressure or pain

·                 Urethral discharge with bowel movements

·                 Genital and rectal throbbing

·                 Sexual problems and loss of sex drive

·                 Blocked urine

·                 Painful ejaculation (sexual climax)

Prostatitis is not contagious. It is not spread through sexual contact. Your partner cannot catch this infection from you.

Several tests, such as DRE (digital rectal exam) and a urine test, can be done to see if you have prostatitis. Getting the right diagnosis of your exact type of prostatitis is the key to getting the best treatment. Even if you have no symptoms, you should follow your doctor's suggestion to complete treatment.

What is enlarged prostate or BPH?

BPH stands for benign prostatic hyperplasia (pronounced "be-NINE prah-STAT-ik HY-per-PLAY-zha"). Benign means "not cancer," and hyperplasia means “too much growth”. The result is that the prostate becomes enlarged. BPH is not linked to cancer and does not raise your chances of getting prostate cancer -- yet the symptoms for BPH and prostate cancer can be similar.

BPH Symptoms

BPH symptoms usually start after the age of 50. They can include:

·                 Trouble starting a urine stream or making more than a dribble

·                 Passing urine often, especially at night

·                 Feeling that the bladder has not fully emptied

·                 A strong or sudden urge to pass urine

·                 Weak or slow urine stream

·                 Stopping and starting again several times while passing urine

·                 Pushing or straining to begin passing urine

At its worst, BPH can lead to:

·                 A weak bladder

·                 Backflow of urine causing bladder or kidney infections

·                 Complete block in the flow of urine

·                 Kidney failure

BPH affects most men as they get older. It can lead to urinary problems like those with prostatitis. By age 60, many men have signs of BPH. By age 70, almost all men have some prostate enlargement.

The prostate starts out about the size of a walnut. By the time a man is 40, it may have grown slightly larger, to the size of an apricot. By age 60, it may be the size of a lemon.

As a normal part of aging, the prostate enlarges and can press against the bladder and the urethra. This can slow down or block urine flow. Some men might find it hard to start a urine stream, even though they feel the need to go. Once the urine stream has started, it may be hard to stop. Other men may feel like they need to pass urine all the time or are awakened during sleep with the sudden need to pass urine.

Early BPH symptoms take many years to turn into bothersome problems. These early symptoms are a cue to see your doctor.

How can BPH be treated?

About half the men with BPH eventually have symptoms that are bothersome enough to need treatment. BPH cannot be cured, but drugs or surgery can often relieve its symptoms. BPH symptoms do not always grow worse.

There are three ways to manage BPH:

·                 Watchful waiting (regular follow-up with your doctor)

·                 Drug therapy

·                 Surgery.

Talk with your doctor about the best choice for you. Your symptoms may change over time, so be sure to tell your doctor about any new changes.

Watchful waiting

Men with mild symptoms of BPH who do not find them bothersome often choose this approach. Watchful waiting means getting annual checkups. The checkups can include DREs and other tests (see "Types of Tests"). Treatment is started only if symptoms become too much of a problem.

If you choose to live with symptoms, these simple steps can help:

·                 Limit drinking in the evening, especially drinks with alcohol or caffeine

·                 Empty the bladder all the way when you pass urine

·                 Use the restroom often; don't wait for long periods without passing urine.

Some medications can make BPH symptoms worse, so talk with your doctor or pharmacist about any medicines you are taking, such as:

·                 Over-the-counter cold and cough medicines (especially antihistamines)

·                 Tranquilizers

·                 Antidepressants

·                 Blood pressure medicine.

Drug therapy

Millions of American men with mild-to-moderate BPH symptoms have chosen prescription drugs over surgery since the early 1990s. There are two main types of drugs used. One type relaxes muscles near the prostate while the other type shrinks the prostate gland. There is evidence that shows that taking both drugs together may work best to keep BPH symptoms from getting worse.

Alpha-blockers

These drugs help relax muscles near the prostate to relieve pressure and let urine flow more freely, but they don't shrink the size of the prostate. For many men, the drug can improve urine flow and reduce symptoms within days. Possible side effects include dizziness, headache, and fatigue.

5 alpha-reductase inhibitor

This drug, known as finasteride, shrinks the prostate. It relieves symptoms by blocking an enzyme that acts on the male hormone, testosterone, to boost organ growth. When the enzyme is blocked, growth slows down. This helps shrink the prostate, reduce blockage, and limit the need for surgery.

Taking this drug for at least 6 months to 1 year can increase urine flow and reduce your symptoms. It seems to work best for men with very large prostates. You must continue to take the drug to prevent symptoms from coming back.

This drug is also used to treat baldness in men. It can cause these side effects in a small percentage of men:

·                 Decreased interest in sex

·                 Trouble getting or keeping an erection

·                 Smaller amount of semen with ejaculation.

It's important to note that taking this drug can lower your PSA test levels. There is also evidence that finasteride lowers the risk of getting prostate cancer, but whether it lowers the risk of dying from prostate cancer is still unclear.

BPH Medications

Category

Activity

Generic Name

Brand Name

Alpha-blockers

Relax muscles near prostate

doxazosin
tamsulosin
terazosin
prazosin

Cardura
Flomax
Hytrin
Minipres

5 alphareductase inhibitor

Slows prostate growth, shrinks prostate

finasteride

Proscar or Propecia

BPH surgery

The number of prostate surgeries has gone down over the years, but operations for BPH are still among the most common surgeries for American men. Surgery is used when symptoms are severe or drug therapy has not worked well. Be sure to discuss options with your doctor and ask about the potential short- and long-term benefits and risks with each procedure.

Resources

Cancer Information Service (toll-free)

 

Telephone: 1–800–4–CANCER (1–800–422–6237)

TTY: 1–800–332–8615

 

Online

 

NCI’s Web site:

http://www.cancer.gov   

LiveHelp, NCI’s live online assistance:

https://cissecure.nci.nih.gov/livehelp/welcome.asp  

Medicare

For more information about Medicare benefits, contact:
Toll-free
................1-800-MEDICARE (1-800-633-4227)
Online....................
www.medicare.gov

National Kidney and Urologic Diseases Information Clearinghouse

Toll-free ................1-800-891-5390
Online....................
www.niddk.nih.gov


 

This article is based on the webpage “Understanding Prostate Changes: A Health Guide for Men -- part of the National Cancer Institute website. The information provided here is, to the best of our knowledge, reliable and accurate. However, while Life Alert always strives to provide true, precise and consistent information, we cannot guarantee 100 percent accuracy. Readers are encouraged to review the original article, and use any resource links provided to gather more information before drawing conclusions and making decisions.

Dr. Don Rose writes books, papers and articles on computers, the Internet, AI, science and technology, and issues related to seniors.

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