The vast majority of adult men will experience some discomfort, pain, or clinical diagnoses having to do with the prostate. Conditions and diseases of this gland are very often physically painful and discomfiting as well as deeply psychologically taxing. Prostate issues affect men of any age and consequences like infertility and even death have been known to affect male youth and even boys. However, men over 55 are at a much greater risk of prostate cancer.
Being that the number and severity of prostate problems exist on a wide range, the treatments and considerations are predictably complex. It is important to understand the nature of the prostate before learning about the conditions that spring from it.
The prostate is a semi-muscular gland containing two lateral lobes and a median lobe located next to the bladder and urethra. Around twenty milligrams in weight, the prostate is about the size of a couple of matchboxes and sits enclosed in a fibrous layer of smooth muscle. As a gland, its main job is to secrete certain hormones and the thin alkaline fluid that it produces is released with semen during ejaculation.
Typically thought of as a strictly male matter, the Skene’s gland found on the anterior wall of the vagina by the urethra was renamed the female prostate just eleven years ago (in 2002).
Did you know that the prostate actually does not produce semen? Although there are anywhere from 200-500 million spermatozoa in male ejaculate, that only makes up about 3% of the semen, or seminal fluid, itself. The rest is composed of flavins, enzymes, amino acids, fructose, vitamin C, antigens, zinc, citric acid, and mucus. The alkaline solution produced by the prostate insulates and preserves the spermatozoa for conception, specifically protecting the DNA carried by the individual sperm from break down by vaginal and seminal acids.
The main prostate-related conditions are prostate cancer, benign prostatic hyperplasia, and prostatitis.
Prostate cancer is common and its cause is not known. When the prostate tissue of any group of men over fifty is examined under microscope, cancer cells are found in 50% of men over 70 years of age and almost all men over the age of 90. Gratefully, prostate cancer spreads slowly and most men will not have to deal with symptoms resulting from cancer of the prostate. Fewer than 3% of the men diagnosed end up dying from the disease. Withal, prostate cancer is the second most common kind of cancer in men.
Benign prostatic hyperplasia is a noncancerous or benign growth on the prostate, otherwise known as an enlarged prostate. It is very common in men over fifty years of age and, like cancer, the real cause is still not known. A prostate gland expanded by such a growth will narrow the urethra making it hard to urinate and ejaculate. The flow of liquid through the urethra may end up completely blocked; this expands the muscles of the bladder. In addition, because of the oversized bladder and prostate, urine is often not completely voided from the bladder and is left to stagnate. This causes infection and stones in the bladder. Prolonged issues with a benign growth will result in damaged kidneys.
Prostatitis is the inflammation of the prostate gland. The cause of this is also tough to identify, although very often it is the result of infection or bacteria that spread from the urinary tract to the prostate. Pain in the area between the penis and the anus and the lower back is typical of an inflamed prostate and a man suffering from this may experience chills and fever. There may be blood in the urine and the patient may have to urinate very often. The pain, frequent urination, and bloated scrotum from prostatitis may cause impotence.
Physicians urge men in their fifties to be regularly screened for prostate cancer, or any condition of the prostate. If you have a family history of the disease you are particularly at risk. Testing options include a blood test, digital rectal examination (DRE), or an ultrasound which will be used to examine the shape and health of your prostate non-intrusively.
The medical industry does not suggest mass screening since this often results in many misdiagnoses of otherwise healthy males, but all men, beginning at the age of 45, are asked to get screened. Black males are especially at risk for reasons not entirely clear.
If there is a diagnosis for benign prostatic hyperplasia drugs are administered that relax the musculature around the bladder outlet. Although surgery may be required to remove the benign growth, a drug called finasteride will be used to shrink the size of it. In some extreme cases, a man will need a Foley catheter in order to urinate, the kidney or bladder will be infected, and the pain and discomfort are extreme. In this case, an anesthetic will be given via spinal tap and, without the need for a surgical incision, an endoscope will be used to pass up the urethra and a laser will burn away part or all of the cancerous tissue of the prostate.
If growths are found in the screenings are suspected to be cancerous, a biopsy is performed to remove and test the prostate tissue in a lab. This is done to confirm the presence of cancer and is often followed by MRI scans, x-ray computed tomography scan, and bone scans to see if the cancer has spread. If confirmed, the cancer cells are then categorized in stages and grades. The cancer stage is numbered 1 through 4, with the highest number being most critical and severe. The cells themselves are also categorized on a scale of 2 to 10, the lower numbers being more similar to normal cells while the higher number indicates cells that are abnormal, or cancerous.
In terms of cancer of the prostate, there are two things that help doctors determine the best treatment for the patient. These are: how far the cancer has spread, and how malignant the cells are. The above ratings for cell type and spread are still used today. Often, if the cancer cells are low on the malignancy scale and generally confined to a small part of the prostate gland, and especially if the patient is an older male, the doctor will ask if the patient is prepared to dramatically alter his lifestyle and quality of life. In the end, a specialist may recommend no treatment whatever and the doctor and patient will begin a regime of “watch and wait.”
But if treatment is undertaken it will usually include radiation therapy and pharmaceutical drugs. These cause impotence and incontinence and for a young male this can be devastatingly difficult to deal with. Also when the patient is young, the operation selected could be a potency-sparing radical prostatectomy which removes the cancer in the prostate—and therefore part of prostate itself—while sparing much of the important nerves and tissue. This operation preserves sexual potency in about 75% of men.
When the cancer is advanced, there is no surgery or cure to be had. There are many ways to treat the symptoms, however. For instance, a testosterone-blocker can be used to halt the spread of the cancer (tumor growth depends on a supply of testosterone) with drugs such as leuprolide. Leuprolide has many side effects, including hair loss, breast enlargement, and reduced libido. Other procedures and drugs that reduce testosterone, such as mestranol and bilateral orchiectomy (removal of both testicles), introduce psychological and emotional difficulties the likes of which many men are simply unwilling to accept.
The Diet Solution
Perhaps surprisingly, it has been shown in repeated medical studies that an improved diet, and even the consumption of certain vegetables, greatly reduce the risk of prostate cancer or hyperplasia and even have a great effect once there has already been a diagnosis. It is a rarity, many doctors would say, that diet has such a direct influence over such an endemic and difficult condition.
In a Physicians’ Health Study in 1999, the antioxidant carotenoid lycopene was found positively strongly associated with a reduced risk of prostate cancer. Tomatoes are rich in the antioxidant and men who ate a regular pasta meal, rich with fresh tomatoes and tomato paste, had decreased oxidative genomic damage to prostate cells. A tomato diet is then recommended for anyone over the age of 55 and especially if there is a history of prostate problems in the family.
Cruciferous vegetables were also shown to help the prostate. These are vegetables that come from the mustard plant, and they generally include such traditionally disdained plate items like: cauliflower, cabbage, water cress, bok choy, kale, broccoli, and an assortment of other green leafy vegetables. These foods contain sulfurophane which was positively associated with a reduced risk of cancer in a controlled study.
Lastly, there has been suggestions that selenium and vitamin E have a great effect on cancer. In 2001, a twelve-year study called the Selenium and Vitamin E Cancer Prevention Trial (SELECT) was initiated and the results, which are set to be released this year (2013), are eagerly awaited by medical science and cancer patients. They are presumed to be in favor of a selenium and vitamin E diet for prostate patients.
But it is not too soon to start eating selenium- and vitamin E-rich foods right away. These include wheat, bell peppers, spinach, tropical fruits, wheat for vitamin E, and red meat, fish, shellfish, eggs, nuts, onions, mushrooms, and poultry for selenium.
Prostate cancer is one of those rare conditions that allow the sufferer some control over whether it happens and, when it is diagnosed, how dramatic the symptoms are. If you are under 55, start today by eating more vitamin E-, selenium-, and vitamin C-rich foods (vitamin C was also shown to be good for the prostate). This means you add years of good diet to the cancer battle and it may even mean you ultimately avoid a cancer diagnosis. Most physicians also suggest that men drink less than two glasses of alcohol a day (preferably none), avoid a high-fat diet, and stay fit and active by exercising each day, or at least weekly, all of which is strongly associated with a lowered risk of prostate cancer.