Paul Turek, MD, on September’s prostate-cancer awareness month
As a man ages, he is more likely to look at travel experiences as a series of restroom stops. He might begin navigating his way to the grocery store, the gas station, or a friend’s house based on where the public restrooms are. This may sound like the end of the world, but it is not—although it may be the end of long road trips. Similar to needing reading glasses, it is merely another reminder that things are not what they were when we were younger. Blame it on the prostate: the gland essential for normal fertility (but not for erections), which enlarges rather than shrinks over the years.
The prostate is about the size of a walnut and sits at the base of the penis. It wraps around the urethra (the tube that urine comes through). A fancy term for its enlargement with age is benign prostatic hypertrophy (BPH). For reasons that are still unclear, the prostate continues to grow bigger as a person gets older. This is the cause of the urination issues that occur in half of all men by age 60 and in almost all men by age 80.
Bigger but Not Better
Prostatic enlargement is pretty much inevitable. The urinary symptoms associated with it are treated with alpha-blockers, which enlarge the urethral channel by relaxing the muscle fibers within it. Patients may start with herbal remedies such as saw palmetto, but randomized trials have not shown that herbals do anything to improve urination. Other drugs called 5-alpha-reductase inhibitors actually shrink the gland by one-third of its size and can also help urination. If these pills do not keep you peeing straight and strong, several procedures—some involving lasers—can remove the excess prostatic tissue.
The prostate can also become inflamed and infected, in a condition termed prostatitis, which occurs in about 10 percent of men at least once during their lives. This diagnosis is not subtle, as most people with prostatitis pee firewater several times an hour. Ways to avoid this include good hydration, regular timed voiding, and treatment of BPH when it occurs.
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The “C” in Prostate
The last issue with the prostate is no small one: It harbors the most common solid cancer in men. Fortunately, despite the fact that prostate cancer only rarely causes symptoms, most cases are caught early, and cure rates are extremely high. The other positive note is that prostate cancer is much slower growing than other cancers, doubling in size every two to three years instead of every four to six months. A man is 8 to 10 times more likely to die of heart disease than prostate cancer. The risk of having prostate cancer increases with age, so that many people have it but never know it—which is fine as long as something else gets you first.
Although genetics plays a role in the development of prostate cancer, there are steps you can take to prevent it. Following a heart-healthy, low-animal-fat, low-carbohydrate diet is key to cancer prevention, likely because these foods reduce inflammation. Exercise, weight management, and stress reduction are also important. Fruits and vegetables that are high in antioxidants can protect your body from cancer-causing oxidants. Soy and green tea may be especially good for the prostate for similar reasons. Fish are a good source of omega-3 fatty acids, which are also anti-inflammatory. As obesity has been linked to prostate cancer, you may want to consider limiting sugar intake, too, which may be a contributor to weight gain. Finally, there is reliable data to suggest that the medications used to slow BPH (5-alpha-reductase inhibitors) can prevent the occurrence of low-grade prostate cancer.
So for various reasons, do not ignore your prostate. Attend to it before it disrupts the flow of your daily life. That means taking great care of the body around it. In addition, our national urology society recommends screening for prostate cancer between the ages of 55 and 70. Compared to a root canal, at least, this screening is easy: a quick rectal exam and blood testing for a substance called prostate-specific antigen. Take it from a urologist—a happy prostate equals a much happier life. (www.theturekclinic.com)