The prostate is a walnut-sized gland which forms part of the male genitourinary system. It is located in the lower abdomen, right below the urinary bladder and in front of the rectum. It “hugs" or surrounds the male urethra where urine and semen pass. As a gland, it secretes part of the seminal fluid that flows during ejaculation through the urethra.
Disorders of the Prostate
Most disorders of the prostate occur with aging. The three main causes of prostatic disorders are:
1. Inflammation, which is due to prostatitis
2. Benign prostatic hypertrophy, or enlargement of the prostate related to aging
3. Prostatic cancer
It is important to remember that although the prostate may become enlarged in all of these conditions and cause different symptoms, most cases are benign, or non-cancerous.
Inflammation of the prostate is usually brought about by bacterial infection and can lead to enlargement of the prostate. Prominent symptoms include pain on urination, fever and chills, difficulty in urination, sexual dysfunction, rectal pressure or pain and low back pain, among others. This condition can be treated by antibiotics. It does not cause or lead to cancer.
Benign prostatic hypertrophy (BPH) is enlargement of the prostate due to an abnormal growth or proliferation of cells related to the aging process. This is a very common condition among men and becomes symptomatic beginning at the age of 60 and more so during their 70s to 80s. Although it may be troublesome because of the difficulty encountered in urination, BPH does not lead to cancer. Since it entails growth of the gland just like a tumor and can reach a size more than double its original, BPH can cause urinary tract infection that can lead to kidney failure. It can also completely block passage of urine which can be very distressing and may become an emergency.
BPH may be treated medically with drugs which can help relax the bladder and shrink the enlarged prostate. However, depending on the size of the tumor, surgery may eventually be needed to trim the prostate so that complete urination can be achieved.
Prostate cancer or cancer of the prostate is the second most common cancer in American men. The tumor grows very slowly, and may take more than ten years to develop symptoms. Precancerous cells may be developing in men at the age of 50, and by the age of 80 most men (more than 50 percent) have cancer cells in the prostate. However, these may not be a serious threat to health, and in most, the diagnosis is made at late stages when the cancer cells have already spread to other organs or have metastasized. Although malignant prostate tumors are common, the risk of dying from it is very low.
Symptoms of prostatic cancer are similar to those of BPH, especially with regards to the difficulty in passing urine. As the cancer spreads to other organs like the bones and lymph nodes, other symptoms may be experienced, such as back pain.
Risk factors in developing cancer of the prostate are family history of the cancer, age above 50, genetic predisposition, race (African American are the most prone, while Asian are least likely to have it) and a high fat diet. BPH and a history of prostatitis are not necessarily causes related to this type of cancer.
Although it is possible to perform a screening for early detection of prostate cancer by doing physical and laboratory examinations, doctors are not sure if these can decrease the risk of dying related to the malignancy. Many studies have yet to be done in this regard.
Treatment of prostate cancer includes watchful waiting (in slow growing tumors), radical resection and radiotherapy. Hormonal ablation and removal of the testicles may be done in metastatic cases to decrease the production of testosterone (a male hormone).
National Institute of Cancer, “Understanding Prostate Changes: A Health Guide for Men" accessed 12/01/10 https://www.cancer.gov/cancertopics/screening/understanding-prostate-changes
NIDDK, “Prostatitis: Disorders of the Prostate" accessed 12/01/10 https://kidney.niddk.nih.gov/kudiseases/pubs/prostatitis/