Q:I know I have an enlarged prostate. Is this a sign of cancer?
A. Most men with enlarged prostates don’t develop prostate cancer, but there’s a lot more to this question.
The prostate is a walnut-size organ that surrounds the tube (urethra) that carries urine from the bladder. The urethra also transmits semen, which is a combination of sperm plus a fluid the prostate adds.
Benign prostatic hyperplasia (BPH) is the term used to describe an enlarged prostate, which is common in men 50 and older. An enlarged prostate may squeeze the urethra, making it hard to urinate. It may cause dribbling after you urinate or a frequent urge to urinate, especially at night.
Some men with prostate cancer also have BPH, but that doesn’t mean that the two conditions are always linked. However, because the early symptoms are the same for both conditions, you should see a doctor if you have these signs.
The following are other symptoms of prostate problems: blood in urine or semen, burning urination, difficulty getting an erection, painful ejaculation, frequent pain or stiffness in lower back, hips or upper thighs.
Treatment choices for BPH include:
• Observation: if your symptoms don’t bother you a lot, your doctor may suggest that you delay treatment and come in for regular checkups.
• Alpha-blockers: these are medicines that can relax muscles near the prostate and ease symptoms.
• Finasteride (Proscar): this drug acts on the male hormone (testosterone) to shrink the prostate.
• Surgery: an operation can relieve symptoms, but it can cause complications.
Prostate cancer is one of the most common types of cancer among American men. Treatment for prostate cancer works best when the disease is found early.
In a physical exam, the doctor feels the prostate through the rectal wall. Hard or lumpy areas may mean that cancer is present.
Your doctor also may suggest a blood test to check your prostate specific antigen (PSA) level. PSA levels may be high in men who have an enlarged prostate gland or prostate cancer. PSA tests are used for early cancer diagnosis. But PSA test results alone do not always tell whether or not cancer is present.
When doctors suspect cancer, they also may perform a biopsy. Doctors can take out a small piece of the prostate and look at it under a microscope.
There are many options for treating prostate cancer:
• Observation: if the cancer is growing slowly, you may decide to wait and watch.
• Hormone therapy: this stops cancer cells from growing.
• Surgery: there are several surgical options. These include radical prostatectomy or removal of the entire prostate, cryosurgery that kills the cancer by freezing it, radiation therapy to shrink tumors and implant radiation that places radioactive seeds into the prostate. Surgery can lead to impotence and incontinence. Improvements in surgery now make it possible for some men to keep their sexual function.
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