Prostate Health

Understanding the Prostate

The prostate is a small but vital gland in men that plays a key role in reproductive and urinary functions. As men age, changes in the size and function of the prostate can lead to health concerns, making awareness and timely care essential.

What Does the Prostate Do?

The prostate produces part of the fluid that makes up semen, which nourishes sperm and supports fertility. This fluid contains important elements like zinc, enzymes, and citric acid. The prostate’s muscles also assist in pushing semen through the urethra during orgasm, supporting normal ejaculation.

Anatomy of the Prostate

The prostate is below the bladder and in front of the rectum, with the urethra running through its center. Structurally, it consists of connective and glandular tissues, covered by a layer known as the prostatic fascia. It has five lobes: anterior, posterior, two lateral lobes, and a median lobe.

Size and Weight

In healthy adults, the prostate is about the size of a walnut and weighs around 30 grams (roughly the weight of five U.S. quarters). After the age of 40, it often enlarges, a condition known as benign prostatic hyperplasia (BPH). While this enlargement is not cancerous and doesn’t increase cancer risk, it can cause urinary difficulties and other health issues.

Common Prostate Concerns

Some of the common prostate concerns seen in men include- 

Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia, often referred to as BPH or enlarged prostate, is a common condition that develops as men get older. The prostate gland, located just below the bladder, naturally increases in size with age. In some men, this growth can put pressure on the urethra, leading to urinary difficulties and other complications.

An enlarged prostate doesn’t increase the risk of cancer, but it can affect quality of life by causing discomfort and disrupting daily activities. In more severe cases, it may contribute to bladder, urinary tract, or kidney problems if left untreated.

Symptoms of BPH

Men experiencing BPH may notice one or more of the following:

• Frequent or urgent need to urinate.
• Increased urination at night (nocturia).
• Difficulty starting urination.
• Weak or interrupted urine stream.
• Dribbling at the end of urination.
• Feeling of incomplete bladder emptying.

Prostatitis

Prostatitis is the inflammation of the prostate gland. Since the urethra passes through the prostate, any swelling or irritation in this gland can affect both urinary and sexual functions.

It is the most common urinary tract condition in men under 50 and the third most common in older men.

Types of Prostatitis

There are four main types of prostatitis, each with unique features:

• Acute Bacterial Prostatitis- Caused by a bacterial infection, it develops suddenly and is often accompanied by fever, chills, painful urination, and difficulty passing urine.
• Chronic Bacterial Prostatitis- Also linked to bacterial infection, but symptoms develop gradually and may persist for longer. Unlike the acute type, it does not cause fever or chills but still leads to urinary discomfort.
• Chronic Pelvic Pain Syndrome (CPPS)- The most common type, affecting about 1 in 3 men. It is not caused by infection but results in persistent pain in the pelvis, genitals, and perineum. This condition can last for months or even years.
• Asymptomatic Inflammatory Prostatitis- In this type, inflammation is detected during medical tests. It does not require treatment and is not infectious.

Symptoms of Prostatitis

Symptoms vary depending on the type and cause, but may include:

• Pain in the lower abdomen, pelvis, genitals, or lower back.
• Frequent or urgent need to urinate.
• Painful urination (dysuria).
• Interrupted urine flow.
• Blood in urine (hematuria) or semen (hematospermia).
• Pain during intercourse or ejaculation.
• Erectile dysfunction.
• Flu-like symptoms such as fever, chills, and body aches (specific to acute bacterial prostatitis).

Prostate Cancer

Prostate cancer develops in the prostate gland. This is one of the most common cancers in men. On average, about 13 out of every 100 men will develop prostate cancer in their lifetime.

Types of Prostate Cancer

The majority of prostate cancer cases are adenocarcinomas, which begin in the glandular cells responsible for producing fluid. Less common forms include:

• Small cell carcinomas.
• Transitional cell carcinomas.
• Neuroendocrine tumors.
• Sarcomas.

Symptoms of Prostate Cancer

In its early stages, prostate cancer often has no symptoms. However, some stage 1 prostate cancer symptoms may include-

• frequent urination, especially at night.
• difficulty starting or stopping urination.
• a weak urine stream.

As the disease progresses, men may experience:

• Pain or burning during urination.
• Loss of bladder or bowel control.
• Painful ejaculation or erectile dysfunction.
• Blood in urine or semen.
• Pain in the lower back, hips, or chest.

What Causes Prostate Cancer?

Prostate cancer begins when cells in the gland grow and divide more rapidly than normal. Instead of dying as healthy cells do, these abnormal cells multiply and form a tumor. Over time, cancer cells may break away and spread to other parts of the body (metastasize).

Risk Factors

Certain factors increase the risk of developing prostate cancer:

• Age: Risk rises significantly after 50, with most cases occurring in men over 65.
• Race and Ethnicity: Black men and those of African ancestry are at greater risk, especially for aggressive forms diagnosed at younger ages.
• Family History: Having a close relative with prostate cancer doubles or triples your risk.
• Genetics: Inherited conditions such as Lynch syndrome or BRCA1/BRCA2 mutations also increase risk.

Other possible risk factors include:

• Smoking.
• Prostatitis (inflammation of the prostate).
• Obesity (BMI greater than 30).
• Sexually transmitted infections (STIs).

Diagnosis Of Prostate Conditions

Early and accurate diagnosis is essential for managing prostate health concerns. Because symptoms of different prostate issues can overlap, healthcare providers use a combination of physical exams, lab tests, and imaging to determine the cause.

Benign Prostatic Hyperplasia Diagnosis 

If your provider suspects an enlarged prostate, the first step is usually a medical history review and physical exam. Common diagnostic tools include-

• Digital Rectal Exam (DRE): To check if the prostate feels enlarged.
• Urine and Blood Tests: To rule out infections or kidney issues.
• Prostate-Specific Antigen (PSA) Test: Measures PSA protein levels, which may rise with BPH, prostate cancer, or other conditions.
• Urinary Flow and Residual Volume Tests: Measure how well you empty your bladder.
• 24-Hour Voiding Diary: Tracks urination patterns, especially if nighttime urination is frequent.

Prostatitis Diagnosis 

Since prostatitis can have multiple causes, diagnosis often involves both physical exams and lab tests. Your provider may recommend-

• Digital Rectal Exam (DRE): To check for tenderness or swelling in the prostate.
• Urine or Prostate Fluid Tests: To look for bacteria or signs of infection.
• Imaging and Specialized Tests: Such as transrectal ultrasound, cystoscopy (exam of the urinary tract), or urine flow studies to detect blockages.

Diagnosis For Prostate Cancer

Common diagnostic methods include-

• Digital Rectal Exam (DRE): To detect changes in size, shape, or texture of the prostate.
• Prostate-Specific Antigen (PSA) Test: Monitors PSA levels in the blood. Elevated levels may suggest cancer, but can also be due to other conditions.
• MRI or Ultrasound: Provides detailed imaging of the prostate, often used before a biopsy.
• Biopsy: A small tissue sample is taken for microscopic analysis to confirm cancer and determine its aggressiveness.

Treatment Options

Prostate health issues vary in severity, and so do the treatment approaches. Some of the effective treatment options based on the condition are listed below. 

BPH Treatment Options 

The treatment options for BPH include surgery, medicines, and procedures that involve smaller or no cuts. The right treatment choice depends on- 

• The age.
• The size of the prostate.
• Overall health condition. 
• How serious the symptoms are. 

Some of the effective medicines for managing BPH include-

• Tadalafil- This medicine is often used to treat erectile dysfunction. However, some studies suggest that the use of Tadalafil can treat an enlarged prostate. Some Tadalafil options recommended by doctors are Vidalista 10mg,  Tadalista 10 Mg, or Vidalista Professional 20 Mg. 
• Combination Therapy- Your doctor may prescribe taking an alpha blocker and a 5-alpha reductase inhibitor at the same time.
• Alpha blockers- They work by relaxing the smooth muscle of the bladder neck and prostate. This makes urinating easy. Some alpha blockers recommended by your doctor include alfuzosin (Uroxatral), doxazosin (Cardura), and tamsulosin (Flomax). 

Prostatitis Treatment Option

The recommended treatment option for managing prostatitis includes- 

• Antibiotics- They are used to kill any bacterial infection. 
• Anti-inflammatory Agents- These are non-steroidal medications that help in reducing pain from inflammation in the prostate. 
• Pelvic Floor physical therapy- It helps in relaxing certain muscles in the pelvis. It is done with an expert to help you lessen the tension in the pelvic floor muscle. 
• Home care- Taking hot baths, heating pads, or using donut-shaped pillows can help. 
• Lifestyle Changes- Following lifestyle changes, such as weight loss and diet changes, can help ease the symptoms. 

Prostate Cancer Treatment Option

Treatment for prostate cancer depends on your overall health, how aggressive the cancer is, and whether it has spread. Many early-stage cases can be cured, while advanced cases often focus on control and symptom relief.

Main Treatment Options

• Surveillance: Active surveillance involves regular PSA tests, scans, and biopsies, with treatment only if the cancer progresses. Watchful waiting is used for older patients or those with other health issues, focusing on symptom relief rather than cure.
• Surgery: A radical prostatectomy removes the prostate gland, often effective if the cancer is contained. Techniques include open or robotic-assisted surgery.
• Radiation Therapy: 
  • Brachytherapy places radioactive seeds in the prostate.
  • External beam radiation (EBRT) directs radiation at the tumor from outside the body.
• Systemic Treatments: For cancers that spread beyond the prostate.
  • Hormone therapy lowers testosterone to slow cancer growth.
  • Chemotherapy kills rapidly dividing cancer cells.
  • Immunotherapy and targeted therapy help the body attack cancer or focus on genetic changes in tumor cells.

How To Keep Prostate Healthy- Preventive Care

Taking care of your prostate health goes hand in hand with maintaining your overall wellness. While certain prostate conditions may not always be preventable, healthy habits and proactive choices can reduce risk and support better outcomes.

Maintain a Balanced Diet

Include fruits, vegetables, whole grains, and foods rich in antioxidants.

Limit red meat, processed foods, and high-fat dairy products.

Tomatoes, berries, nuts, and green tea are especially known for supporting prostate health.

Stay Physically Active

• Regular exercise helps improve blood circulation, balance hormone levels, and support urinary health.
• Aim for at least 30 minutes of moderate activity most days of the week.

Maintain a Healthy Weight

• Obesity has been linked to higher risks of prostate problems.
• Combining a healthy diet with regular exercise can help manage weight effectively.

Limit Alcohol and Quit Smoking

Excessive alcohol intake and smoking may worsen urinary symptoms and affect overall prostate function.

Stay Hydrated 

Drink enough water to stay hydrated, but avoid drinking large amounts before bedtime to reduce nighttime urination.

Regular Screenings

Men over 40 should discuss prostate health with their healthcare provider.