The Prostate - What is it?

The Prostate is an organ forming part of the male reproductive system. It is located immediately below the bladder and just in front of the bowel. Its main function is to produce fluid which protects and enriches sperm. In younger men the prostate is about the size of a walnut. It is doughnut shaped as it surrounds the beginning of the urethra, the tube that conveys urine from the bladder to the penis. The nerves that control erections surround the prostate.

The Prostate - Diagram

There are four main disorders of the prostate. All can have similar symptoms, which may include one or more of the following:

  • Waking frequently at night to urinate
  • Sudden or urgent need to urinate
  • Difficulty in starting to urinate
  • Slow flow of urine and difficulty in stopping
  • Discomfort when urinating
  • Painful ejaculation
  • Blood in the urine or semen
  • Decrease in libido (sex urge)
  • Reduced ability to get an erection

Most men tend to accept the onset of one or more of these symptoms as being a natural consequence of ageing. However, anyone experiencing any of the above symptoms is advised to consult a doctor without delay. Early expert diagnosis and treatment is important and may avert potentially serious health consequences.

The Prostate Enlarged - Diagram

Prostatitis

Prostatitis is a benign (non life threatening) condition. It is NOT prostate cancer. It is caused by inflammation (swelling) of the prostate. It can cause discomfort deep inside the pelvis – all the time or when passing urine or with ejaculation. It can be painful and can spread to other areas of the pelvis. If caused by an infection it may be treated with antibiotics. Treatment is specific to each case and some types of prostatitis can be harder to treat, especially if symptoms have been ignored for some time.

Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH) or enlargement (BHE) is quite common in older men. It is a benign condition and is NOT prostate cancer. Some enlargement of the prostate is usual in most men from age 50 onwards. If the enlargement is sufficient to squeeze the urethra, which passes through the prostate, difficulties with urination may occur. BHP is quite common – though not life threatening, it may be treated. Treatment of BPH may require antibiotics, or, in more developed cases, an operation to widen the urethral passage. This is known as a trans urethral resection of the prostate (TURP). Under a general anaesthetic, an instrument is passed up the urethra through the penis and some of the prostate is removed to improve urine flow. This procedure usually involves a few days in hospital, with a catheter installed during recovery.

Prostatodynia

This is long standing or chronic prostate disease. There is usually no clear signs of infection or inflammation but there may be pain or discomfort in the pelvic region. Treatments are varied including antibiotics, non –steroid anti-inflammatory agents, muscle relaxants and sometimes medications for chronic pain.

Prostate cancer

Prostate Cancer is the only one of the four disorders is potentially life-threatening. One of the most worrying aspects is that many prostate cancers develop without men experiencing ANY SYMPTOMS.

Every year, around 18,700 Australian men are diagnosed and more than 3,000 die of the disease, making prostate cancer the second largest cause of male cancer deaths, after lung cancer. Almost one man in eleven will develop prostate cancer during his lifetime.

Prostate cancer occurs when some of the cells of the prostate reproduce far more rapidly than in a normal prostate, causing a swelling or tumour. However, unlike BPH, prostate cancer cells eventually break out of the prostate and invade distant parts of the body, particularly the bones and lymph nodes, producing secondary tumours, a process known as metastasis. Once the cancer escapes from the prostate, treatment is possible but “cure” becomes impossible.

Prostate cancer is usually one of the slower growing cancers. In the past, it was most frequently encountered in men over 70, and many of those men died of other causes before their prostate cancer could kill them. This led to the old saying “most men die with, not of, prostate cancer”. However, that is certainly is not true today. Three developments have changed things considerably:

  • Men are living longer, giving the cancer more time to spread beyond the prostate, with potentially fatal consequences.
  • More men in their early sixties, fifties and even forties are being detected with prostate cancer. Earlier on-set, combined with the greater male life expectancy, means those cancers have more time to spread and become life-threatening unless diagnosed and treated.
  • Prostate cancer in younger men often tends to be more aggressive and hence more life-threatening within a shorter time.

Provided appropriate treatment commences while the cancer is still confined to the prostate gland, it is possible to "cure" it. The possibility of cure is the main reason why early diagnosis is critical.

All men should be aware of their risk of the disease and consider being tested for it regularly from age 50 onwards, or from 40 onwards if there is a family history of prostate cancer.


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