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WHY EVERY MAN OVER 50 SHOULD HAVE A PROSTATE CHECK UP
Estimates suggest that by the age of 50, around three out of ten men suffer from an enlarged prostate.
This figure rises to five out of ten by age 70 and may reach eight out of ten by 80 years.
Every man who experiences prostate problems must seek medical advice. In fact, every man over the age of 50 should have his prostate checked annually.
WHAT IS THE PROSTATE?
The prostate is a small, male gland (about the size of a walnut in normal adults) which wraps around the outlet of the bladder, like a collar.
Through it passes the urethra, the urine channel from the bladder, which is joined inside the prostate by the vas, the channel carrying sperm from the testicles.
WHAT DOES IT DO?
The function of the prostate is to produce a fluid which nourishes sperm cells. These come from the testes, are stored with semen in the seminal vesicles and are enriched by the fluid from the prostate as they pass into the urethra during ejaculation.
However, the prostatic fluid does form a significant part of the semen, so if the prostate has to be removed later in life, the volume of semen will be reduced.
WHAT IS PROSTATE TROUBLE?
There are three main types of prostate problems:
· Enlargement of the prostate, called Benign Prostatic Hypertrophy (BPH),
· Inflammation of the prostate (or prostatitis)
· Cancer of the prostate.
A man may have any one, or a combination of these conditions.
WHY DOES THE PROSTATE ENLARGE?
We do not know what makes the prostate enlarge, but such enlargement happens commonly as men grow older.
However, simple enlargement of the prostate is of little significance; more important is the effect of the enlarging prostate compressing the urethra and interfering with urination.
WHAT ARE THE SYMPTOMS OF AN ENLARGED PROSTATE?
Early symptoms are: being woken at night by the need to urinate, urinating frequently, a reduction in the flow of urine, delay in starting the flow of urine and dribbling of urine afterwards.
The poorly emptying bladder is more prone to infections; this may cause symptoms of greater frequency of urination, burning pain on urination and sometimes, blood in the urine. (Note - blood in the urine must always be investigated fully as it may warn of cancer developing.)
Loss of urinary control may become embarrassing and also retention (inability to pass urine) may occur.
WHAT SHOULD BE DONE ABOUT AN ENLARGED PROSTATE?
If the symptoms are severe enough, treatment will usually be recommended.
The options are:
*Surgery which usually involves the insertion of an instrument through the urethra to make an incision which relaxes the bladder neck.
*Medications, including those which affect hormone levels or relax the prostate.
*Other treatments - for example laser, microwave and heat: these treatments are still relatively new and need further long-term evaluation.
Your urologist and general practitioner will give advice about which, if any, of these approaches is the most suitable.
WHAT WILL BE THE EFFECTS OF TREATMENT?
An enlarged, obstructing prostate can make your older years miserable and properly timed surgery can alleviate this misery.
With appropriate treatment (either surgery or medication) you will be relieved of most of your symptoms of difficult urination.
The sex drive and the ability to achieve an erection are usually unaltered.
WHAT IS PROSTATITIS?
Prostatitis is inflammation of the prostate. Its symptoms may be similar to an enlarged prostate or cancer of the prostate. Pain on urination is more common than in Benign Prostatic Hypertrophy and the prostate is often infected.
These symptoms will need to be checked by your doctor.
WHAT ABOUT CANCER OF THE PROSTATE?
Enlargement of the prostate and cancer may have similar symptoms, but an enlargement does not necessarily mean cancer is present. The difference is often detected on rectal examination, when the prostate is easily felt. Every man over the age of 50 who experiences prostate symptoms should seek medical advice.
Prostate cancer is more common in older men and in men with a family history of the condition.
If prostate cancer is detected early, for example during an annual check-up, it can usually be treated successfully.
HOW LIKELY AM I TO BE AFFECTED BY PROSTATE TROUBLE?
We know that many older men have small amounts of prostate cancer in their gland, but lead a normal life without it causing them any problem. Studies suggest that one quarter of men in their 50s, rising to over 40% of men over the age of 60 years may be in this category.
The lifetime risk of being diagnosed with prostate cancer is about 1 in 10 men. The life time probability of dying of prostate cancer is about 1 in 68 men.
High risk groups
Men who are at high risk of developing prostate cancer are those whose father or brother have had prostate cancer at an early age. The risk is higher if more than one relative has been diagnosed with it. For example one study reported that a man whose father or brother had prostate cancer was twice as likely to get it. If two first degree relatives were affected they were almost 5 times as likely to get it.
Low risk groups
Men less than 40 years of age, without a family history of prostate cancer are at low risk of developing it. Men older than 75 years who develop prostate cancer in most cases will not be threatened by it. Men 50 - 75 years are at moderate risk of both developing prostate cancer and being threatened by it.
Lions Australian Prostate Cancer Website
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