Your Prostate Gland- how much trouble can it give you?-
by Harold Gunatillake
Transcript:
Your prostate gland is about the size of an areconut seed or walnut seed situated at the bottom of your bladder in front of your back passage. The urine outlet from the bladder called the urethra runs through it.
The main function of the gland is to secrete fluid along that nourishes and protects sperm, manufactured in your testicles.
In most people the gland gives no problems, but in some it can get inflamed, like any other gland in your body. This, inflammation caused by bacteria is referred to as acute prostatitis.
As you age the prostate naturally gets bigger and in most people such enlargement gives no problems. It is referred to as ‘Benign Prostatic hypertrophy.
When the lateral lobes of the prostate grow outwards, it causes no problems to the urethral tube that runs in the middle of the gland.
But, if the enlargement occurs inwards, causes obstruction to the urinary passage.
Early symptoms of this situation are that you get up in the nighttime a few times to pass water, or you may be finding it difficult to pass water, or you empty your bladder incompletely.
So, if you have any of the above symptoms in your middle age, please see your doctor.
He will insert a finger in your back passage and feel the gland to check whether it is enlarged. You get a great feeling when the doctor does this per rectal or as we call PR examination.
There is a joke that these days doctors insert two fingers, not one: the second finger is for a second opinion.
Benign enlarged prostate does not cause cancer. This is a fear in most people.
If the prostate gland is enlarged causing urinary tract discomfort as described above, there are natural prostatic remedies that reduce the dihydrotestosterone (DHT) that causes the problem, such as palmetto, betasitosterol, pumpkin seeds and vitamin B6. The drugs Avodart and Proscar also reduce the DHT levels.
In the past we enucleated the prostate gland through a cut in the lower abdomen, called the Millins procedure.
Today it is done through a Laparoscopic procedure.
Laparoscopy for prostate removal is a common procedure. Men who undergo this technique have less blood loss, less need for pain medication, shorter hospital stays, quicker return to regular activities, early removal of urethral catheters (tubes inserted through the penis, to drain urine from the bladder), and a quicker recovery.
Radical prostatectomy is also done today by Robotic-assisted procedure.
Prostatic Cancer
About 1 man in 9 will be diagnosed with prostate cancer during his lifetime.
Prostate cancer is the second most common cancer diagnosed in men in Australia and the third most common cause of cancer death. One in 6 men will be diagnosed with prostate cancer by the age of 85. It is more common in older men, with over 63% of cases diagnosed in men over 65 years of age.
Prostatic cancer grows very slowly and is initially confined to the prostate gland, because the gland is enclosed in a thick fibrous capsule. When the condition is detected early and confined to the prostate gland has a good chance of successful treatment.
The two most common tests to check whether you have cancer of the prostate gland, your doctor will do a digital rectal examination as done for benign prostatic enlargement, and the prostatic specific antigen test called the PSA test.
This antigen a protein, is virtually produced only in the prostate gland. It is produced by the normal gland and in cancer of the prostate gland.
Warnings regarding the testing for PSA.
Before 48 hours your PSA test is done, you should not ride a bike, motorcycle, or tractor.
You should not participate in vigorous exercise that could jostle the prostate area.
You should not have a digital rectal examination for 48 hours by the doctor.
Do not have sex for at least 24 hours prior to the test.
The Test is done on a sample of your blood
This test is useful to diagnose early prostatic cancer and monitoring its treatment
The normal range of the age specific PSA is 0-4 ng/ml
The normal prostate gland secretes this chemical right through one’s life. It gradually increases yearly and could be variable.
For men under 50, healthy PSA levels will usually range between 0.3 and 2.5 nanograms per milliliter. In the presence of cancer PSA levels can rise to up to 160 ng/mL. In men between 50 -60, healthy PSA level will usually range between 0.3 and 4.7 ng/mL
Men over 60-70 the healthy PSA levels will usually range between 0.3 and 8.3 ng/mL
For men over 70, healthy PSA levels will usually range between 0.4 and 17.8 ng/mL with an average of 8.9
The protein antigen can rise dramatically, in the presence of prostate cancer.
PSA levels can rise with benign prostatic hyperplasia and with infections in the gland.
There is a problem with over-weight people. They could have cancer of the prostate gland with low PSA levels.
PSA test is controversial because there are cases with false negatives, and that could affect the management.
When it comes to the management of prostate cancer, the treatment assessment is according to the staging, which communicates how advanced the disease is and to help treatment.
The staging is done according to the American Joint Committee on Cancer TMN staging system.
This staging depends on the size or the extent of the tumor, the number of lymph nodes involved, and whether it has spread to distant sites and organs.
The staging is also referred to as the Gleason score.
In stage one the cancer is restricted to one half of the prostate with no spread, and the PSA level is below 10
Stage 2A the tumour is still restricted to one side of the prostate and the PSA level could be less than 20 ng/mL
Stage 2B the tumour has spread onto the opposite side of the prostate
Stages 3 and 4 the cancer has spread and quite advanced.
In most cases where the PSA level is not too high in prostate cancer are left alone and only observed.
The reason is invasive procedures can harm and the morbidity figures do not show better results than no treatment and just observation.
For this reason, the U.S. Preventive Services Task Force now recommends that men aged 55 to 69 decide for themselves whether to undergo a prostate-specific antigen (PSA) test, after talking it over with their doctor. The task force recommends against screening for men over 70 because the potential benefits do not outweigh the risks.
People who eat lot of tomatoes are less likely to get prostate cancer. Lycopene an antioxidant found in tomatoes seem to decrease cell damage and slow cancer cell production
Broccoli and other crucifers including cauliflower, cabbage, Brussel sprouts and kale contains complex compounds that may help protect against cancer, including prostate cancer.
Green tea seems to reduce the risk of prostate cancer.
Phytoestrogens found in beans, peanuts and lentils seem to reduce the risk of prostate cancer.
Omega 3 fish oils and fish in general, may be beneficial to prevent prostate cancer
Bottomline:
Every male after the age of 50 years should be aware of the risk of having prostate cancer.
Annual PSA test on your blood is recommended, especially for those having a family history.
The management and preventive measures are discussed.
Hope this article was useful.
Thank you for watching this video
Stay safe until we meet again.
Goodbye- for now.
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