Prostate Disease

Illustration of  the anatomy of the male reproductive tract
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Facts about the prostate gland:

The prostate is a sex gland in men. It is about the size of a walnut, and surrounds the neck of the bladder and urethra - the tube that carries urine from the bladder. It is partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It is made up of three lobes: a center lobe with one lobe on each side.

The prostate gland secretes a slightly alkaline fluid that forms part of the seminal fluid, a fluid that carries sperm.

Types of non-cancerous prostate problems:

Most clinical conditions of the prostate are benign (non-cancerous), including the following:

  • benign prostatic hyperplasia (BPH)  - an age-related condition of the prostate that is not malignant. BPH is the most common non-cancerous prostate problem, occurring in most men by the time they reach their 60s. Symptoms are slow, interrupted, or weak urinary stream; urgency with leaking or dribbling; and frequent urination, especially at night. Although it is not cancer, BPH symptoms are often similar to those of prostate cancer.
  • prostatism - the symptom of decreased urinary force due to obstruction of flow through the prostate gland. The most common cause of prostatism is BPH. 
  • prostatitis - inflammation or infection of the prostate gland characterized by discomfort, pain, frequent or infrequent urination, and sometimes fever.
  • prostatalgia  - pain in the prostate gland, also called prostatodynia. It is frequently a  symptom of prostatitis. 

These problems are quite common and may happen to men of all ages. Prostatitis is mainly a problem of men younger than age 50, and BPH primarily affects men older than age 50.

Procedures used to evaluate prostate problems:

In addition to an annual physical examination that includes blood, urine, and possibly other laboratory tests, the National Cancer Institute and the American Cancer Society suggest consulting your physician about these recommendations for the evaluation of the prostate gland:

  • DRE (digital rectal examinations)
    As recommended by your physician, DREs are usually conducted annually for men over the age of 50. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should consult their physicians about being tested at a younger age.
  • PSA (prostate-specific antigen)
    As recommended by your physician, a PSA test is usually conducted annually for men over the age of 50. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should consult their physicians about being tested at a younger age.

What are some other prostate cancer evaluation procedures?

If the DRE or PSA are unusual, your physician may repeat the tests or request an ultrasound and other procedures. These evaluation tools may include:

  • transrectal ultrasound (TRUS) - a test using sound wave echoes to create an image of the prostate gland to visually inspect for abnormal conditions such as gland enlargement, nodules, penetration of tumor through capsule of the gland, and/or invasion of seminal vesicles; may also be used for guidance of needle biopsies of the prostate gland and/or guiding the nitrogen probes in cryosurgery.
  • computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  • magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  • radionuclide bone scan - a nuclear imaging method that helps to show whether the cancer has spread from the prostate gland to the bones. The procedure involves an injection of radioactive material that helps to locate diseased bone cells throughout the entire body, suggesting possible metastatic cancer.
  • lymph node and/or prostate biopsy - a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present.

The diagnosis of cancer is confirmed only by a biopsy.

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