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
--
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
--
Non-Cancerous Prostate Changes
Most men experience prostate changes that are
not cancer. Let
us examine these cases.
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.
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.
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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