Don't Overlook Prostate Health
In observance of Prostate Health Month in September, Avera McKennan will offer a free prostate screening from 8 a.m. - 11 a.m. Saturday, Sept. 27, at the Avera Cancer Institute, located on the Avera McKennan campus, at 1000 E. 21st Street. To register call 1-877-AT-AVERA.
With Dr. Michael Gillett, urologist with Urology Specialists Chartered in Sioux Falls.
At what age should men start thinking about prostate health?
The mid 40s are when most men start to develop urinary symptoms that suggest prostate enlargement, such as getting up in the night or a slowing of your urine stream. If these things start to happen, it's probably time to check in with your primary care physician.
How common is an enlarged prostate?
Very common - in fact, the majority of men who reach age 60 have symptomatic enlargement of the prostate.
Why does this happen?
That's the million dollar question. Nobody knows for sure why the prostate grows, or why it grows more in some men than others. Hormonal factors may contribute to it, and anatomic reasons might be the reason why prostate growth leads to urinary symptoms.
Is the condition serious?
Most of the time, symptoms like difficulty starting your urine stream, slowing down of the stream or having to go more often are not serious, but can be troubling. If growth is severe enough, men can develop retention of urine, which is a medical emergency. Some men develop bleeding, get urinary tract infections or in rare instances, kidney problems.
Is enlargement linked to cancer?
Enlargement by itself is not, so if a patient is described as having BPH (benign prostatic hyperplasia), it does not imply you have cancer, nor is it a precursor to cancer. Prostate enlargement may cause an elevated PSA (prostate-specific antigen) level. But because a high PSA number can also suggest cancer, cancer must be ruled out.
How is enlargement of the prostate treated?
There are very effective medications designed to help patients empty their bladder better, or shrink the prostate over time. Surgical treatments are most often used only when medications fail. Although not yet a common practice, medications may eventually be used as a preventative measure to stop prostate growth before it becomes a problem.
What about supplements?
Supplements have never been scientifically proven to help with enlarged prostate symptoms. The active ingredient in saw palmetto is believed to be similar to the ingredient in prescription medication that shrinks the prostate, although a major medical study has suggested it's no different than a placebo. However, a lot of patients take it and seem to have significant benefits from it.
Why does my doctor recommend I be screened for prostate cancer?
Annual prostate screenings are recommended beginning at age 50. These screenings should begin sooner if there's a family history or other risk factors. Both the PSA blood test and a digital rectal exam are important. A lot of men don't want to have the rectal exam performed. In some cases, men have a normal PSA test, but an abnormal rectal exam, and the biopsy turns out to be cancer. Some men will wait years between exams, but years can make the difference between localized disease, and spread of disease.
How important is it to catch prostate cancer early?
Before PSA tests came out in 1987, most men with prostate cancer had metastatic disease by the time they saw a urologist, and the number who died was quite high. Today, we are much more commonly finding men with treatable cancer. Lifetime risk today of being diagnosed with prostate cancer is about 16 percent, whereas the lifetime risk of dying is only 3 percent.
Is there anything overall that men can do for prostate health?
The risk factors for enlarged prostate are being a man, having a prostate, getting older and having testosterone. We all have that, so you really can't stop it from happening. If you're concerned about symptoms, talk to your physician. Most importantly, get cancer screenings at the appropriate time. It's a very treatable disease, and with the proper screenings there's little reason that any man should pass away from prostate cancer.
