Prostate Enlargement and Prostate Cancer: Is there a Connection?

Prostate enlargement neither causes nor turns into prostate cancer, and is a completely separate condition. In fact, the risk of prostate cancer is lower in men with an enlarged prostate than in men without the condition. However, the two conditions are linked in various ways. Here are four ways in which BPH and prostate cancer are connected

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Early detection of prostate problems

The prostate is a tiny gland located just beneath the bladder and in front of the rectum. It surrounds the urethra and produces fluid that forms part of the semen. 

Though small in size, the prostate is one of the most talked-about glands in men and which causes a lot of concerns. In fact, all men are at risk of developing prostate problems.

The prostate problems include:

  1. Prostatitis

This is an issue frequently associated with young and middle-aged men. Prostatitis refers to inflammation of the prostate due to a bacterial infection or other cause. Only 5-10 percent of men develop prostatitis in their lifetime.

  1. Benign prostatic hyperplasia (BPH)

Also called an enlarged prostate, BPH is the growth of the prostate gland to a large, unhealthy size.  The risk of having the problem increases with age. 

While just 8-percent of men in the ages 31-40 may develop the condition, up to 50-percent of men aged 51-60 years and more than 80-percent of men aged over 80 years have BPH.

An enlarged prostate is neither prostate cancer nor a cause of the cancer. Also, only 50-percent of men with BPH develop symptoms that are severe enough to warrant treatment.

  1. Prostate cancer

Prostate cancer is one of the most common cancers in men with more than 16 percent of men diagnosed with the cancer in their lifetime.  Nevertheless, it is a slow-growing cancer and only about 2-percent of men end up dying of the cancer. 

Just like BPH, the risk of having prostate cancer increases with age. In fact, 75-percent of men with the cancer are usually aged 65 years and older.

The exact cause of prostate cancer is unknown, but risk factors include family history and race. For instance, if you have a brother or father with prostate cancer your risk of the disease increases by more than double. Also, African-American men are at a greater risk of the cancer than Caucasians. 

That is why African-American men and those with family history of the disease are advised to begin screening at an earlier age than the rest of men.

Symptoms of prostate problems

Because the prostate is located just beneath the bladder and surrounds the urethra, problems with the gland usually result in urinary symptoms. 

For instance, while prostatitis rarely shows symptoms, it may cause:

  1. Pain when urinating or ejaculating
  2. Turbid or cloudy urine
  3. An urge to urinate more often
  4. Pelvic pain
  5. Chills and fever

Like prostatitis, an enlarged prostate may not cause symptoms until it compresses the urethra and makes urination difficult. When it shows symptoms, BPH produces:

  1. Frequent urination, particularly at night
  2. Inability to delay urination
  3. Difficulty starting or stopping urination
  4. Feeling as if you can’t get all urine out
  5. Weak urine stream or interrupted stream
  6. Dribbling at the end of urination
  7. Accidental loss of urine
  8. Pain during urination or after ejaculation
  9. Urine of unusual smell or color

Early-stage prostate cancer does not usually show symptoms and is often only discovered after screening with the prostate-specific antigen (PSA) test or the digital rectal exam (DRE).  But advanced prostate cancer shows symptoms such as:

  1. Trouble urinating
  2. Blood in urine or semen
  3. Reduced force in urine stream
  4. Inability to urinate
  5. Pain or burning sensation during urination
  6. Blood in urine or ejaculate
  7. Bone pain
  8. Back pain
  9. Erectile dysfunction
  10. Loss of weight without trying

Early detection of prostate problems

  1. Prostatitis

With prostatitis, the infection is detected early through symptoms. For example, acute bacterial prostatitis tends to begin suddenly, producing chills, fever, or pain in addition to urinary symptoms. Visiting the doctor right away helps to diagnose and treat the infection.

Chronic bacterial prostatitis is a prostate infection that recurs. It is detected via reappearance of similar symptoms that trigger visits to the doctor. When diagnosed, it is managed with antibiotics, though it is quite hard to treat. 

Equally, chronic prostatitis, also called chronic pelvic pain syndrome, can be detected early through symptoms such as persistent pain in the lower back, groin or tip of the penis.  It is treated with a combination of medicines, surgery and lifestyle changes.

  1. An Enlarged Prostate

Like prostatitis, an enlarged prostate can be detected early through symptoms—though such symptoms do not usually match the severity of the condition. That is why men who start to experience urinary symptoms should consult a urologist as soon as possible. 

An early visit to a urologist when you have symptoms helps to:

  1. Catch BPH in early stages when less invasive procedures are most effective.
  2. Bring the symptoms under control and improve quality of life.
  3. Rule out other potential causes of urinary symptoms, such as prostate cancer.
  1. Prostate Cancer

Since prostate cancer tends to show no early warning signs and only produces symptoms when at an advanced stage, early detection is not achieved through symptoms. Instead, the cancer is detected early by screening tests, usually prostate-specific antigen (PSA) test and digital rectal exam (DRE). 

Screening means testing to find prostate cancer in a man without symptoms. The tests used do not provide a diagnosis, but offer valuable information to help find the disease early. Plus, the tests are quick and safe.

Should you undergo screening for prostate cancer?

Screening for prostate cancer is controversial—while some doctors and organizations recommend regular screenings other organizations don’t. 

According to the American Cancer Society, you should speak with your doctor about the benefits, risks, and limitations of screening before you make the decision to get tested.  The organization asserts that you should not undergo PSA blood testing before this discussion. And that the discussion should begin at age 45 if you’re a man at higher risk and at age 50 if you have average risk of the cancer.

Another organization, the American Urological Association, recommends speaking with your doctor about the risks and benefits of prostate cancer screening when you’re aged 55 to 69 years. But that you should only proceed with testing based on your preferences and personal values.

American Urological Association:

  1. Does not recommend PSA screening if you are below 40 years.
  2. Does not recommend routine PSA screening if you are between the ages 40-54 and at an average risk of the cancer.
  3. Does not recommend PSA screening in men aged over 70 years and those with a life-expectancy of less than 10 years.
  4. Does not recommend annual screening, but instead routine screening at intervals of 2 years or more, which must be preceded by a discussion with your doctor.

The United States Preventive Services Task Force does not recommend routine PSA screening for men in the general population, regardless of age. According to the organization, routine cancer screening can detect slow-growing cancers, which are then managed using therapeutic techniques with serious adverse effects but with no much benefit to the patient.

Prompt effective diagnosis of prostate problems

At Advanced Urology Institute, we are committed to early detection of prostate problems. We believe that it is important for patients to participate in screening programs for patients with the chance to speak with experienced physicians and the opportunity for informed decision-making and timely follow-up care.

We provide our patients with open, compassionate consultations that allow for informed decision-making and proper follow-up care, resulting in access to high-quality, objective diagnosis and treatment decisions. Plus, we guard against screening related problems, such as over-diagnosis and treatment of clinically insignificant conditions. 

For more information on prostate cancer and other urological disorders, visit the site “Advanced Urology Institute.”

2 Effective Treatment Options for Prostate Cancer

Prostate cancer can be treated and managed in a number of ways. While the preference of the patient is given priority, it should be tempered with the advice of a trained urologist. A urologist can offer advice on what method is appropriate depending on the age of the patient, the patient’s family history and the natural progression of the disease. The patient also needs to be fully advised of the side effects of any form of treatment before agreeing to undergo the treatment. For any given case of prostate cancer, there are always at least two treatment options available.

1. Surgery

A patient with prostate cancer can choose to have the prostate surgically removed to clear the cancer from the body. The procedure is known as Radical Prostatectomy. It is most appropriate in cases where the cancer is localized and has not spread beyond the prostate. However, even when the cancer is localized, a urologist will determine the progression of the disease before recommending surgery. Low risk localized prostate cancer is unlikely to progress and a radical prostatectomy is unnecessary. On the other hand, when the cancer is aggressive and is likely to result in death if untreated, surgery is definitely the most appropriate choice.

Radical prostatectomy is recommended for patients under the age of 75 , or those with a life expectancy of at least ten years. This is because they are more likely to preserve their sexual and urinary functions after the surgery and they have a stronger chance of outliving any side effects the surgery might have.

2. Radiation Therapy

Radiation therapy, or radiotherapy is the use of radiation in high doses to kill malignant cancer cells or slow their development. Unlike radical prostatectomy, it can be used to treat localized prostate cancer and even advanced prostate cancer. It may be applied in combination with other treatment options such as hormone therapy. It may even be applied if a patient undergoes a radical prostatectomy but the procedure fails to eliminate the cancer fully or if the cancer recurs.

Radiation therapy can be administered externally or internally. When done externally, it is referred to as external beam radiation and is very much like having an X-ray. When administered internally, it is referred to as brachytherapy or internal radiation therapy. In this procedure, a radiation implant is placed inside the body near the affected organ. After a while, the implant ceases to produce radiation. The implant, however, remains in the body.

Both radical prostatectomy and radiation therapy are suitable treatment options and choosing between them may seem a little daunting. The professional opinion of a urologist can help by pointing out the finer points of each choice. The patient also may research the subject by reading up on the various options. There are many sites that offer reliable material on this subject.

For more information about treatment options for prostate cancer, visit the “Advanced Urology Institute” website.

Radical Prostatectomy vs Radiation Therapy


Introduction

Radical prostatectomy and radiation therapy are both cancer treatment methods. Radical prostatectomy is specific to prostate cancer and involves the surgical removal of the prostate, either alone or with other surrounding tissues such as the seminal vesicles and some lymph nodes. There are currently various ways in which a radical prostatectomy can be carried out, including robot assisted laparoscopic prostatectomy, open prostatectomy and laparoscopic prostatectomy.

On the other hand, radiation therapy, also known as radiotherapy, is used in the treatment of almost all cancers, including prostate cancer. It involves the use of high doses of radiation to kill cancer cells or to slow their development by destroying their DNA. For radiation therapy to work effectively, it needs to be applied consistently over a period of time.

Choosing between Radical Prostatectomy and Radiation Therapy

The main advantage of radical prostatectomy is that it is arguably a one time procedure. It takes just a few hours to completely remove the affected prostate and the patient is likely to recover fully, albeit gradually and with the monitoring of a urologist. The main disadvantage is that it is appropriate only where the cancer has not spread to other organs outside the prostate. If it has spread, then removing the prostate and leaving behind other affected organs will have no effect at all. In cases where the cancer has spread, radiation therapy may be the more reasonable choice.

Other factors that urologists and surgeons consider before suggesting either procedure include:

1. Age of the patient — Radical prostatectomy is offered mostly to men under 70 years of age because they are more likely to live longer and be able to survive any long term effects of the disease.

2. The natural progression of the disease — Slow progression of a non-aggressive tumor does not lend itself to surgery. This is a case that can be managed by what is called watchful waiting where the disease is monitored constantly but treatment is deferred for a while.

3. The possibility of cure — The goal of radical prostatectomy is to cure the patient of prostate cancer. If for whatever reason it appears that it is unlikely that this objective will be achieved, then radiation therapy or other forms of treatment should be preferred.

Conclusion

It is important to choose the treatment option that works for your body. In order to make the right choice, make a point of consulting a qualified urologist. Reading material on the subject should also be helpful, and sites such as the one operated by the Advanced Urology Institute should be a good place to start.
For more information, visit the Advanced Urology Institute website.

Robotic Assisted Laparoscopic Radical Prostatectomy


Robotic-Assisted Laparoscopic Prostatectomy is a viable option for treating prostate cancer. It is a minimally invasive method for accessing both seminal vesicles and prostate glands during treatment of prostate cancer. Robotic prostatectomy is performed by an experienced surgical team with the help of advanced surgical robotic technology.

What is Robotic-Assisted Radical Prostatectomy?

Robotic prostatectomy involves the use of a laparoscopic system and Robotic Surgery System called da Vinci® Surgical System. This is a sophisticated robotic system designed to enable the surgeons to operate with enhanced vision, precision and control.

With the help of the surgical system, it is possible to pass miniaturized robotic instruments through keyhole incisions and remove the prostate and other nearby tissues with greater accuracy. During a robotic-assisted radical prostatectomy, it is able to create an incision that extends from the belly button to the pubic bone.

In the Robotic-Assisted Laparoscopic Radical-Prostatectomy, an image processing machine and a three-dimensional endoscope are used to achieve a clear and magnified view of structures around the prostate gland. This makes it possible to extract affected parts with optimal preservation of critical body parts such as blood vessels, nerves and muscles.

During the procedure, the surgeon operates the surgical system using a computer console that enables him to control tiny flexible instruments. This makes it possible to achieve higher precision and mobility. The whole process is done without the surgeon’s hand entering the area of the surgery in the patient’s body.

Advantages of Robotic-Assisted Laparoscopic-Radical Prostatectomy:

Robotic prostatectomy has some benefits compared to the traditional open surgical methods. Here are some of the advantages:

  1. Less pain
  2. Less loss of blood during the operation
  3. Shorter stay in the hospital.

Possible risks of Robotic-Assisted Prostatectomy:

The following are possible risks associated with the Robotic Assisted Laparoscopic-Radical Prostatectomy, although they are very unlikely:

  1. Damage to adjacent tissue or organ
  2. Infection of surgical site
  3. Bleeding

Laparoscopic Radical Prostatectomy:

As with all surgical methods, the robotic-assisted radical prostatectomy has a number of potential side effects, which include:

  1. Urinary incontinence or inability to control urine. However, this problem will reduce over time.
  2. Erectile dysfunction or impotence: Depending on the age of the patient, erectile function is likely to be affected.

Advanced Urology Institute is a patient-centered institute that works to minimize the possible side effects of a procedure. They research and partner with the best board-certified urologists, among them Dr. David Burday, to make sure that patients have a good experience during the operation and heal well afterward. For further information, visit the “Advanced Urology Institute” website.

Robotic Technology in Urology: Da Vinci Robotic Prostatectomy

Urology has always been one of the leading medical specialties in the adoption and application of the latest cutting-edge technologies. For many decades urology has been one of the areas of medicine that has often readily embraced new technologies and incorporated them into everyday practice for the benefit of patients. Urology was the first medical field to espouse and use scopes for various procedures. And then with the invention of robotic systems, urologists quickly adopted and integrated the da Vinci system in their practices, using it for prostate surgery and making the da Vinci prostatectomy one of the first mainstream
surgical procedures to be performed using robotic technology.

Influence of robotic surgical systems

The introduction of robotic systems in urology has quickly enabled urologists to overcome the limitations of open prostatectomy (traditional laparoscopy) such as limited instrument movement, difficult suturing, complex reconstruction and two-dimensional vision. Likewise, the introduction and quick assimilation of robotic technology has helped to solve the problem of surgeon fatigue in laparoscopic urology. Robotic systems have enabled urologists to perform complex reconstruction and dissection in less than 2 hours delivering excellent outcomes.

Overcoming limitations of open prostatectomy

Before the emergence of robotic surgical systems, men suffering from prostate cancer had very few treatment options. The principal surgical option available was open radical prostatectomy, a procedure that involved large incisions and serious post-operative side effects. For example, when using open prostatectomy, the removal of the entire cancerous prostate resulted in increased risk of post-operative infections, excessive blood loss, considerable pain and longer hospital stays. Open prostatectomy also may lead to loss of sexual function and bladder control due to cutting of the delicate nerve plexus around the prostate. The da Vinci robotic surgery is a minimally invasive procedure that uses smaller incisions, reduces blood loss and ensures a shorter hospital stay, making things better for the patient.

Utmost precision, great outcomes

The intuitive nature of the movement of robotic instruments results in highly precise, accurate, effective and safe prostatectomy. While laparoscopic surgery’s precision is reduced by the fulcrum effect (movement of the instrument tip in the direction opposite to the surgeon’s hands), the da Vinci robotic system has no fulcrum effect, offers three-dimensional visualization, boosts degrees of freedom, eliminates tremor, reduces fatigue and provides motion scaling and ergonomic positioning. Robotic surgery is a remote controlled process in which the surgeon’s movements are precisely translated through sensitive fibers to the instrument’s tip. When applied in prostatectomy, robotic systems have been found to offer several advantages over traditional laparoscopic surgery, including minimal scarring, diminished risk of complications, clinically superior results and quicker recovery.

State-of-the-art prostatectomy at Advanced Urology Institute

Want to be treated by a highly trained and experienced team of surgeons, technicians and nurses? At Advanced Urology Institute, we have urologists who are specialists in robot-assisted surgery for prostate cancer and other urological conditions. We perform dozens of surgical procedures every month using the da Vinci robotic system. This minimally invasive, high-precision robotic technology delivers great results with complex and delicate surgeries such as prostatectomies, where the target site is surrounded and confined by the nerves regulating erectile function and urinary flow. At AUI, we use the robotic system as an exacting tool to avoid damaging these nerves, shorten recovery time and ensure quick return to normal activities.

For more information on exceptional, world-class treatment using robotic technology, visit the “Advanced Urology Institute” site.

Treating Prostate Cancer

Prostate cancer is one of the most common cancers among American men. In fact, it is the most frequently diagnosed non-skin cancer in men, with over 2 million American men currently living with the cancer. Statistically, a new case arises every 3 minutes, one in six American men has prostate cancer, while an American man dies of it every 19 minutes.

Making treatment decisions

At Advanced Urology Institute, we make every effort to deliver world-class treatment and care for patients with prostate cancer. After a diagnosis, our physicians review various treatment options before picking any treatment for the patient. We also conduct further studies, such as biomarker testing and imaging studies, to ensure that we have correctly established the stage or extent of the disease. We use this information to make the right decisions and give prostate cancer patients the most effective treatments. We choose treatment options depending on the cancer itself (high-risk, intermediate risk or low-risk) and patient factors (personal preferences, age and other health issues).

Prostate cancer treatment options

Advanced Urology Institute offers a wide range of innovative and effective diagnostic and treatment procedures for patients with prostate cancer. At the institute, newly diagnosed patients get the opportunity to meet and discuss their condition with renowned and experienced specialists on the same day.

Our treatment options include:

  1. Active surveillance: For a low-risk prostate cancer that may not harm a patient over the course of his lifetime, urologists at AUI usually recommend close observation. It often comes with secondary chemoprevention.
  2. Prostatectomy: Prostatectomy is a surgical procedure to remove the prostate. For localized prostate cancer, radical prostatectomy may be employed. However, at Advanced Urology Institute, we commonly apply the robot-assisted technique, which is a minimally-invasive, laparoscopic procedure.
  3. Radiation: An external beam of radiation is directed at the prostate in order to kill cancerous cells.
  4. Cryotherapy: Probes are inserted into the prostate gland to allow for the introduction of liquid nitrogen into the gland. Once administered, liquid nitrogen produces an ice ball inside the prostate which destroys cancerous cells.
  5. Brachytherapy: A radioactive seed is implanted in the prostate. The procedure involves inserting and removing the needles that are used to place radioactive seeds inside the prostate.
  6. Hormone therapy: Various medications can be administered to reduce or inhibit the secretion of testosterone hormone. Diminished quantities of testosterone means reduced or no growth of the cancer.
  7. Chemotherapy: Certain drugs may be used to boost the effectiveness of the other treatments, both for metastatic and localized disease.

Multi-disciplinary treatment and care

At Advanced Urology Institute, our goal is to cure prostate cancer while also maximizing the quality of life of our patients. We carefully weigh the benefits of every treatment option against the side effects and develop the most practical individualized treatment programs for all patients. We also believe that effective management of prostate cancer needs extensive collaboration. We have implemented a multidisciplinary approach to treatment that allows our various specialists, such as urologists, radiation oncologists, medical oncologists, radiologists, pathologists and clinical trial nurses to deliberate and get diverse, specialized perspectives before making treatment decisions for any patient. During AUI conferences, detailed discussions among experts help to clarify the benefits and risks of various diagnostic tests and treatment options, resulting in better treatment outcomes for our patients.

Advanced Urology Institute uses image-guided targeting, MRI, ultrasound and fusing 3-D guidance to boost the accuracy and usefulness of prostate biopsies. We also apply minimally-invasive, outpatient procedures in most cases. So, with our comprehensive consultation service and multidisciplinary approach that incorporates the latest technologies, research developments and expertise, all our patients can be sure of the best possible prostate cancer treatment. Want help with prostate cancer? Get more information from our “Advanced Urology Institute” site.

What is Da Vinci Robotic Prostatectomy?

The da Vinci system is a revolutionary, minimally-invasive surgical robot for treating prostate cancer. Designed by Intuitive Surgical to help overcome the shortcomings of both the traditional laparoscopic prostatectomy and open prostatectomy, the da Vinci system enables a surgeon to conduct highly precise, nerve-sparing surgery using several dime-shaped incisions. With the da Vinci surgical procedure, entire cancerous tissue or prostate can be removed, cancer completely eradicated and internal repair achieved without interference with sexual function, potency and bladder control.

Also called robotic prostatectomy, the da Vinci uses a finely-controlled robotic apparatus, including micro-surgical instruments and high-resolution cameras, to perform prostate surgery safely, achieving faster patient recovery and better treatment outcomes.

High-Precision Prostatectomy

During da Vinci robotic surgery, urologists use the “motion scaling” feature on the system to convert subtle hand movements made outside the body into extremely precise and accurate movements inside the body. The urologist controls the robotic arms of the da Vinci console by applying natural wrist and hand movements. Through motion scaling, filtration and seamless translation of hand-and-wrist movements, the urologist can achieve greater precision that is normally not achievable during traditional laparoscopic and open surgery procedures. The da Vinci system not only provides urologists with enhanced dexterity, range of motion and flexibility, but also enables surgeons to safely access difficult-to-operate areas of the pelvis, abdomen and closed chest. The robot also filters and eliminates unpredictable hand movements and hand tremors that may occur during the operation.

Computerized 3-D Visualization

The da Vinci system dramatically improves visualization by providing a sharper and brighter view than can be seen during traditional laparoscopic endoscopes and by the eye during open surgery. The robotic system comes with a proprietary camera, enabling the surgeon to zoom in, rotate and even change image visualization. As a result, the 3-D image produced is clearer and brighter, and with no flickers as seen in traditional laparoscopic systems.

Even though the da Vinci robotic prostatectomy is a remote procedure, urologists have the feeling that their hands are fully immersed in the body and are able to complete all the necessary procedures efficiently. With the 3-D visualization and robotic hand simulation, the da Vinci system enables urologists to perform highly complex procedures more effectively than traditional laparoscopic surgery or open surgery.

Getting da Vinci Prostatectomy at Advanced Urology Institute

At Advanced Urology Institute, the da Vinci prostatectomy patients are usually discharged 24 hours after their operation. The system is used at AUI because it has superior benefits to traditional laparoscopic prostatectomy or open prostate surgery. The benefits of the da Vinci prostate surgery include:

  1. Reduced pain and higher nerve-sparing rate.
  2. Shorter hospitalization, with most patients going home the next day.
  3. Minimal blood loss, fewer transfusions and reduced risk of complications (such as impotence and incontinence).
  4. Quicker return to pre-surgery erectile function and urinary continence.
  5. Faster return to routine activities.

Are you looking for a da Vinci urologist near you? You can check out this life-changing technology at Advanced Urology Institute. For more information, visit the “’Advanced Urology Institute” site.

Prostate Cancer: Early Detection and Screening

Prostate cancer screening means conducting tests to find the cancer in people with no symptoms. Screening helps in early detection of the cancer when it is still easier to treat. To detect prostate cancer before symptoms appear, urologists recommend either measuring the amount of prostate-specific antigen (PSA) in blood or doing a digital rectal exam (DRE), when the urologist inserts a gloved, lubricated finger into the rectum. If the results of a PSA or DRE are abnormal, the urologist will request further tests. Finding prostate cancer via a PSA or DRE screening means the disease is probably still at an early stage and will respond well to treatment.

PSA Screening

Prostate Cancer: Early Detection and ScreeningThe prostate-specific antigen (PSA) test measures the amount of the protein (PSA) released in blood by prostate cells. Even though both normal and cancerous (abnormal) prostate cells produce the protein, higher blood levels of PSA indicate the possibility of cancer. The PSA test is one of the best indicators of prostate cancer and is recommended by urologists because it is widely available, relatively inexpensive and is a low-risk blood test for patients.

Digital Rectal Exam (DRE)

To perform a digital rectal exam, the urologist inserts a gloved and lubricated finger into the rectum in order to feel the state of the prostate gland. Since prostate cancer often begins in the back of the prostate, DRE helps to assess the texture of this area and checks for hard areas and bumps (nodules) which might indicate cancer. DRE is also effective in detecting whether the cancer has spread to nearby tissues or has reoccurred after treatment.

Confirming Prostate Cancer

After a digital rectal exam (DRE) or PSA blood test, the urologist may request a biopsy to confirm the cancer. But before the doctor can decide whether biopsy is necessary, a number of supplementary tests and considerations must be made, including family history, ethnicity, prior biopsy findings and different forms of PSA. A biopsy means the doctor takes out a small portion of the prostate tissue to be examined under a microscope for cancerous cells. Since cancerous cells appear different from normal prostate cells, a close exam of biopsy cells will help to confirm the cancer.

When to Start Screening

The age of beginning or stopping prostate cancer screening depends on individual risk. Men with a higher risk of having prostate cancer should start screening at age 40. This includes African American men and all men with first and second degree relatives with a history of prostate cancer. Men with average risk should start screening at 50, but only after discussing it with their doctors to reduce the rate of unnecessary biopsies. Men age 75 and older or those with limited life expectancy (less than 10 years) should be discouraged from early detection testing for prostate cancer because they may not benefit much from screening. Nevertheless, a decision to go for prostate cancer screening must be made with the help of a urologist or GP and should depend on a man’s lifestyle, family history, overall health and life expectancy. For more information on screening, diagnosis and treatment of prostate cancer, visit the site, Advanced Urology Institute.

Symptoms of Enlarged Prostate

An enlarged prostate, also called benign prostatic hyperplasia (BPH), is an increase in the size of the prostate. While most men have prostate growth throughout their life, not all men get bothersome symptoms. As the prostate grows it presses on the outside of the urethra and can slow down or even stop the flow of urine. BPH is common in men in their 50’s, with about 1 in 3 men above 50 years of age having urinary symptoms.

It is not clear what causes prostate enlargement. However, the following risk factors are involved:

Age – While prostate gland enlargement hardly causes symptoms in men below age 40, about a third of men in their 60’s and about half of men in their 80’s have BPH symptoms.

Hormone Levels – The balance of hormones in the body changes as men grows older, causing the prostate to grow.

Family History – Those with a blood relative, especially a father or brother, with prostate problems are more
likely to have BPH.

Ethnic Background – BPH symptoms are more common in white and black men than Asian men. Black men tend to experience BPH symptoms at a younger age than white men.

Lifestyle – Regular exercise lowers the risk of BPH while obesity increases the risk.

Diabetes and Heart Disease – The risk of BPH increases in men with diabetes, heart disease and those on beta blockers.

What are the symptoms of an enlarged prostate?

The severity of symptoms in people with BPH varies, but tends to worsen over time. Common symptoms include:

  • urgent or frequent need to urinate
  • nocturia (increased frequency to urinate at night)
  • difficulty starting urination
  • inability to completely empty the bladder
  • weak urine stream or a urine stream that stops and starts
  • straining while urinating
  • dribbling at the end of urination

The less common symptoms of BPH are:

  • inability to urinate
  • urinary tract infection
  • blood in the urine

You may never get all of these symptoms. In fact, some men with an enlarged prostate do not get any symptoms at all. In some men, the symptoms eventually stabilize and may even improve over time, while in others they may get worse. Some of these symptoms may be caused by other conditions, like anxiety, cold weather, lifestyle factors, certain medicines and other health problems. Therefore, if you have any of the above symptoms, visit your physician to find out what could be causing them.

How can a urologist help?

A urologist will take your medical history and conduct a physical exam. Depending on the severity of the symptoms, the urologist will order tests such as digital rectal exam, urine test, blood test for kidney problems, prostate-specific antigen (PSA) blood test or a neurological exam. The doctor may also request additional tests such as urinary flow test, post-void residual volume test, and 24-hour voiding diary. If the problem is more complex, the urologist may recommend a transrectal ultrasound, prostate biopsy, cystoscopy, urodynamic and pressure flow studies, intravenous pyelogram or CT urogram. If an enlarged prostate is diagnosed, the urologist has various treatment options to offer including lifestyle modifications and medicines. In severe cases, the urologist will opt for surgery. For more information and help with BPH, visit Advanced Urology Institute.

4 Common Symptoms of Enlarged Prostate

Prostate gland enlargement occurs in men as they age and is quite common in men above the age of 50. Medically referred to as benign prostatic hyperplasia (BPH), the condition can be completely benign or have serious complications such as bladder blockage, urinary retention, bladder infections, kidney stones or kidney damage. Since the prostate gland is located underneath the bladder, its increased size can block the flow of urine through the urethra, a tube that carries urine from the bladder out of the body via the penis. This in turn results in problems with urination and other complications.

Benign prostate enlargement (BPH) is not prostate cancer.

Even though the complications of an enlarged prostate may be serious, BPH is not prostate cancer. Neither does it imply you have a greater risk of getting prostate cancer. Usually, the growth of prostate tissue associated with BPH starts around the inner prostate (a ring of tissue around the urethra) and progresses inward. In contrast to this, prostate cancer often grows from the outer part of the prostate and continues outward. Therefore, having an enlarged prostate does not increase your risk of prostate cancer because the two conditions typically begin in different areas of the prostate. Nevertheless, men can have prostate cancer and enlarged prostate at the same time, so you should speak with your urologist or GP if you have any concerns about prostate cancer. Keep in mind that BPH does not cause erection problems and does not affect a man’s capacity to father children.

What causes BPH?

Generally, an enlarged prostate is considered a normal part of the aging process in men, believed to result from changes in hormone levels and cell growth. And while the actual cause of benign prostate enlargement is still unknown, studies have shown that changes in the cells of the testicles play a role in the growth of the gland. This is confirmed by the fact that men whose testicles are removed at a young age never develop the condition while those whose testicles are removed after developing BPH experience shrinkage in the size of the prostate. Some studies have also revealed that men with obesity or diabetes, as well as men with a father or brother with the condition, are more likely to develop BPH.

What are the 4 common symptoms of an enlarged prostate?

One of the more common symptoms of BPH is a frequent or urgent need to urinate. Men with BPH will have the urge to urinate more often and particularly at night, a condition known as nocturia. By frequent urination, we mean having to pass urine eight or more times a day. The need to urinate will be urgent because the increased pressure placed on the bladder and urethra by the enlarged prostate make holding urine more difficult.

On the other hand, urinating can be made more difficult by BPH because the increased pressure on the urethra may block urine flow from the bladder out through the penis. You may find it hard to start a urine stream or experience an interrupted or weak urine stream. Depending on the severity of your BPH, you may find it difficult to pass urine, a condition resulting in urine retention. When this happens, you must see your doctor immediately so that a catheter can be inserted into your bladder to drain the urine. Your doctor may recommend you see a urologist for surgery to remove a portion of the enlarged prostate tissue or make cuts on the prostate in order to widen the urethra.

Another symptom is pain during urination or ejaculation caused by pressure on the urinary tract or reproductive system due to BPH. In fact, some men even feel the need to push out urine, which may also cause pain. Remember, pain during ejaculation or urination may also be due to infection.

Other problems associated with an enlarged prostate include urinary tract infections, unusual urine color or smell, blood in urine, bladder stones, and bladder or kidney damage. But not all men with BPH show these symptoms. In fact, some men with enlarged prostate do not get any symptoms at all. If you do have symptoms, you should definitely see your doctor.

How is an enlarged prostate treated?

Your urologist will ask you questions about your symptoms and about your past health. A physical exam, a urine test (urinalysis) and a digital rectal examination will also be performed to aid diagnosis. In some cases, your doctor will request the prostate-specific antigen (PSA) test in order to rule out prostate cancer.

If you only have mild to moderate symptoms, your doctor can recommend “watchful waiting” for lifestyle changes and regular check-ups to monitor symptoms. Your doctor may also prescribe medications such as alpha-blockers or 5-alpha-reductase inhibitors to alleviate the symptoms.

If your condition does not improve after trying recommended lifestyle changes and medications, your doctor may opt for surgery. The type of surgery chosen by the urologist will depend on the size of your prostate, any other medical problems you have and the potential risks and benefits of the operation. For more information about treatments for enlarged prostate, visit an Advanced Urology Institute clinic near you.

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