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Although small, the prostate can cause big trouble as men age

As we leave the month of October, which is synonymous with breast cancer awareness, we head into November, which is becoming more widely known for bringing awareness to cancer of the prostate.

Most people have heard of prostate cancer, which is the second-most common cancer in men and the leading cancer in men over 50. It is a cancer that is hard to prevent, it’s not hereditary (although family history is important), it generally comes with age, and there are no clear early warning signs.

Warning Signs
People ask me all the time what the early warning signs are for prostate cancer and I hate to tell you that there are none.

That’s the dilemma. In the early, curative phases, it is essentially asymptomatic. By the time you have symptoms of prostate cancer, such as pain, difficulty urinating or sexual dysfunction, it has advanced beyond the curative phase and at that point we are only able to treat the symptoms.

BPA and Prostatitis
Other fairly common prostate issues are benign prostatic hyperplasia (BPH) or prostatitis. BPH is a natural enlargement of the prostate that happens in all men as they age. It creates symptoms of bladder outlet obstruction so men will feel hesitancy with urination, slow stream or double voiding. It can be corrected with medication or surgery.

Prostatitis is inflammation or infection of the prostate which can occur as early as puberty into advanced age. It’s not dangerous, but it can be annoying. Symptoms include abdominal or pelvic pain, slow urinary stream, hesitancy and frequency. It is treated with antibiotics and removal of certain foods that can aggravate it such as caffeine.

Neither BPH or Prostatitis are precursors to cancer, nor does having one of them increase your risk of getting prostate cancer.

Detection Methods
Just because there aren’t obvious warning signs doesn’t mean that we can’t be proactive in early detection. The PSA test, or prostate-specific antigen test, is a blood test. If you have an elevated PSA, it doesn’t mean you have prostate cancer, it just means we need to closely monitor your PSA levels. If those levels are consistently high, we would do a transrectal ultrasound and biopsy, which gives us more information.

Few men under age 40 need to have the PSA test. A man between the ages of 40 and 54 with a strong family history, African American men or men with an abnormal prostate exam, should be paying attention. Between the ages of 54 and 75, we recommend every man have an annual PSA test, which can even sometimes be bi-annually if PSA levels are extremely low. During your 50s and 60s is when we begin to become aggressive about it. It’s not something to be ignored. But it’s very unusual to see prostate cancer in men under age 45.

If there are family members either on the mother or the father’s side who have had prostate cancer, it does increase your risk and you will need to be monitored. We call that a familial propensity, but that is different than being genetically passed from generation to generation.

Joel Locke, M.D. is a board-certified urologist with Urology Associates in Franklin and is a credentialed physician at Williamson Medical Center.

Posted on: 11/7/2013


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