November 1, 2014
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Cancer

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Prostate conditions

The prostate gland is susceptible to 3 common diseases: prostatitis, benign prostatic hyperplasia (BPH), and cancer.

Prostatitis

Prostatitis is an infection of the prostate gland. This can occur at any age and, although it may be acquired through sexual contact, often it develops for no apparent reason. Prostatitis may be acute, meaning that it is sudden, severe, and short term; or, it can be chronic, in other words, slow to develop but persistent, lingering for months and reappearing over years.

Acute prostatitis

Acute prostatitis causes severe, sudden symptoms: a strong and frequent urge to pass urine, a burning sensation while urinating, and difficulty getting the urine to pass. Fortunately, acute prostatitis can be completely cured with treatment that includes antibiotics, anti-inflammatory drugs, bed rest, and plenty of fluids. A single episode of prostatitis is no worse than a case of the flu, but if not treated correctly, may evolve into chronic prostatitis.

Chronic prostatitis

Chronic prostatitis develops more slowly than acute prostatitis and its symptoms are more annoying than dangerous. These include:

  • an ache or pain in the genitals, rectum, lower abdomen, or lower back
  • frequent and strong urges to urinate ("frequency" and "urgency")
  • some slowing of the urinary stream

Treatment of chronic prostatitis includes long-term antibiotics, anti-inflammatory drugs, zinc supplements and frequent ejaculation. In addition, it is important to avoid caffeine, alcohol, spicy foods, and smoking, all of which are known irritants of the urinary tract.

Benign prostatic hyperplasia (BPH)

Most older men eventually develop an enlarged prostate, referred to as benign prostatic hyperplasia (BPH). "Benign" refers to the fact that it is a non-cancerous condition and "hyperplasia" means excess growth. In fact, the incidence is so high that a 50-year-old man has a 50:50 chance of developing symptoms. Although cancer is also characterized by excess growth, it should be emphasized that there is no evidence to suggest that BPH leads to cancer.

In BPH, the enlarged prostate squeezes the urethra tighter than normal, like a clamp around a hose, and begins to obstruct the flow of urine from the bladder. As this occurs, the bladder, which is a muscular sac, compensates by becoming thicker and stronger, and contracts harder in order to push the urine past the obstruction. The urethra may eventually become so narrow that the bladder is unable to empty completely, allowing "residual urine" to remain in the bladder after voiding. At this stage the bladder will fill up again that much sooner, causing more frequent urination. When the full-blown syndrome, which is sometimes called "prostatism" or lower urinary tract symptoms (LUTS), is present, the individual will notice a weak urine stream, a need to strain to maximize emptying, a sense of incomplete emptying of the bladder, and the need to urinate more often.

Occasionally, an enlarged prostate may bleed a little bit into the urine - hematuria. Such bleeding is usually painless. It happens because small, fragile blood vessels on the surface of the prostate stretch and rupture, usually due to pressure of straining to urinate or defecate, or from lifting or crouching. In most cases the amount of blood is so small that it can only be seen under a microscope. It is rare for anyone to lose a significant amount of blood from a small vessel on the prostate gland. However, if blood is noticed in the urine then a visit to the doctor is in order to rule out other possible, and more serious causes of hematuria such as growths on the bladder wall or in the kidney.

Cancer

Unlike BPH, in which the excess growth is confined to the prostate gland, a cancer is characterized by uncontrolled growth of abnormal cells which can replace much of the normal prostate and, in some cases, spread to other parts of the body. Both BPH and cancer are influenced by the presence of the male hormone testosterone and both diseases are common.

 
Excerpt from the Intelligent Patient Guide to Prostate Cancer by S. Larry Goldenberg, MD 
in association with the MediResource Clinical Team 

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