Managing Your Prostate Health

While your prostate is the normally the size of a walnut, this small gland can cause trouble as you grow older, including the possibility of developing prostate cancer. The good news is that there are effective strategies for dealing with prostate problems. In this article, we’ll pass along some tips for taking care of the prostate and preventing prostate cancer.

What Is the Prostate?

People who are assigned the male gender at birth usually have a prostate. It’s located below the bladder, in front of the rectum. It surrounds the urethra – the tube that carries urine from the bladder. The prostate’s job is to make fluid that is part of semen. 

When the prostate is normal, it does its work in the background and doesn’t demand much attention. However, as a person with a prostate gets older, it usually increases in size and this is where problems begin. Enlarged prostate starts to affect people over age 40, and its incidence increases with age, to the point that more than 90 percent of men over age 80 have the condition.

Because it is wrapped around the urethra, as the prostate enlarges it puts a choke hold on the urethra, decreasing or interrupting urine flow. The symptoms of an enlarged prostate include:

• Slowed or delayed start of urination
• Weak urine stream
• Incomplete bladder emptying
• Needing to urinate frequently
• Getting up to urinate several times at night
• Dribbling at the end of urination
• Incontinence (leaking urine)

Treatment for an Enlarged Prostate

If you are experiencing any of the above symptoms, your first move should be to make an appointment with a urologist (a specialist physician who treats conditions affecting the urinary tract).

At your first appointment, the urologist will talk with you to understand what symptoms you are having, their severity, and how they are affecting your daily activities. The urologist may do several tests, such as checking your urine for blood or infection and determining how much urine remains in your bladder after you urinate.  

The urologist can prescribe medication to help shrink the size of the prostate and relieve the symptoms you’ve been experiencing. For example, finasteride is used to treat prostate enlargement, as it blocks the hormone which causes the prostate to get bigger.

The urologist can order a prostate-specific antigen (PSA) blood test to check for signs of prostate cancer. The physician can also do a digital rectal exam to feel how enlarged the prostate is and whether there are any bumps on it that might indicate prostate cancer.

Tip: Be sure to see your urologist for follow-up visits. Prostate issues can be controlled, but they don’t go away entirely. Annual checkups (or more frequently, if recommended by your physician) are important to keep things flowing smoothly and to look for signs of cancer.

Tip: Continue to take your medication as prescribed. If your doctor prescribes a medication such as finasteride to shrink the size of the prostate, you should continue taking it and don’t miss any doses. You will probably feel better after taking the medication for several months and may think you no longer need it. However, your prostate can start growing again once you are off the medication and your symptoms may return.     

PSA Testing

Having an enlarged prostate doesn’t necessarily mean you will get prostate cancer. While the majority of people with a prostate will experience enlargement by the time they are in their 60s, only about 13 percent will be diagnosed with prostate cancer in their lifetimes. Still, prostate cancer is a significant risk – it’s the second most common cancer in men, after skin cancer -- and screening should be considered when appropriate.    

The lab test for PSA is the most common way of monitoring the prostate for signs of cancer (in conjunction with a digital rectal exam by a physician). The test measures the level of PSA in the blood, which usually goes up when cancer is developing in the prostate.

The guidelines for when PSA testing should begin have changed over time. It used to be that annual PSA testing was recommended beginning at age 50. However, more has since been learned about the drawbacks of PSA screening, including false positive test results. That’s when a person has an elevated PSA number but doesn’t have prostate cancer. False positives may lead to unnecessary prostate biopsies.

The U.S. Preventive Services Task Force now recommends that people between the ages of 55 and 69 should make an individual decision about whether to have PSA testing done, after talking with their doctor. PSA testing is not recommended for people 70 years old or older.

The American Cancer Society (ACS) has a somewhat different view, recommending that PSA testing should be considered beginning at age 50, if the person’s risk of prostate cancer is average and they expect to live at least 10 more years. The ACS recommends that younger people should have a discussion with their doctor about PSA screening, if they are at high risk for developing prostate cancer: 

• At age 45 for African Americans and people with a first-degree relative (such as a father or brother) who had prostate cancer at an early age (younger than 65).
• At age 40 for people with more than one first-degree relative who had prostate cancer at an early age.

If you decide to undertake PSA testing, you’ll want to have it done at least once a year and keep track of your PSA number so you can see how it has changed over time. Looking at your PSA test results in a hospital or physician practice patient portal is a handy way to do this, as you can see results from multiple tests and compare them.  

Tip: Retest if your PSA number suddenly spikes. A PSA test number can increase sharply for reasons other than prostate cancer. For example, a groin injury or activity like riding a bike before the blood draw can produce higher PSA test results. If a PSA test result is significantly higher than usual, you may want to have a follow-up PSA test done in a few weeks to see if the number remains elevated or has returned to normal.

Prostate Health

Unfortunately, prostate issues are a fact of life for many people. While there are no specific preventive measures, studies have found that people who are more physically active are less likely to have enlarged prostate symptoms. Even walking regularly at a moderate pace helps, the study found.

Along with exercise, a healthy diet can also help lower prostate cancer risk. This includes:

• Fruits that have the antioxidant lycopene, such as tomatoes and watermelon. Redder, ripened tomatoes are best and cooking them increases lycopene absorption.
• Citrus fruits like oranges, lemons, and limes.
• Foods containing isoflavones, such as tofu and other soy products, chickpeas, lentils, alfalfa sprouts, and peanuts.
• Green tea, which has cancer-fighting compounds. 

We hope that you’ve found this information helpful and that you’ll seek help for any prostate issues that you are having. You can be assured that effective treatments are available which will provide you with relief and keep you comfortable for years to come.