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Prostate Health: The Big Questions

Prostate Health Awareness Month

If you’re a man, you have a prostate, but you may not know what it does or how to stay on top of your health when it comes to this part of the body. The first step in staying healthy is learning about the prostate’s function, what’s normal and when you should see a physician.


What is a prostate?

The prostate is a small gland, roughly the size of a walnut in a young male, which sits just below the bladder. It surrounds part of the urethra, the tube that carries urine from your bladder and helps make some of the fluid in semen, which carries sperm from your testicles. This gland grows larger as men get older, which is when you could start to see problems.

What’s normal and how do I know if I have a problem?

After the age of 40, the prostate gland begins to grow, but typically symptoms of this do not present until around age 50.  The most common problem is a change in urination patterns.  This is a fairly common issue, with 40-50 percent of men from ages 51 to 60 developing evidence of prostate growth.  This number increases with age and up to 8 out of 10 develop an enlarged prostate by the age of 80 years old.

Some indicators that the prostate might be enlarged include: a weak urinary stream, having to urinate frequently, dribbling after completion of urination, having a strong urge to urinate that comes on suddenly or taking a long time to start urination. “This is a common problem,” says Dr. Ryan Tubre, a urologist practicing at UT Health East Texas Physicians North Campus Tyler. “The majority of men’s prostates get bigger as they get older. You may have issues earlier in life, later or not at all.  There are good options out there for treatment in those whose quality of life is affected by their symptoms. I encourage people to let me know what's going on so, we can determine the best treatment plan.”


What problems can I develop?

The most common problems are bladder outlet obstruction caused by benign prostatic hyperplasia (BPH) and prostate cancer. BPH is a non-cancerous growth that can cause a lot of symptoms outlined above. Treatment for this condition can be as simple as changes to a healthier lifestyle, medication, minimally invasive surgery or a more invasive surgical treatment.  Unfortunately, no studies have shown any specific diet to play a major role in the development of these symptoms.  “There are several medications out there that we use to either shrink the prostate or to open up the channel within the prostate, so that you can get better urine flow and better emptying of the bladder creating a better quality of life,” says Dr. Tubre.

An infection in the prostate, prostatitis, occurs when bacteria from the bladder is not cleared away by urination. That bacteria can get into the prostate and cause an infection. The symptoms can be similar to BPH, but can also include chills, fever and pain in the area between the scrotum and anus.

Prostate cancer typically presents without any symptoms.  Occasionally, men may have some mild urinary symptoms, but the vast majority of prostate cancers are found through screening with a blood test. It’s the most common non-skin cancer in men and can be treated.  All prostate cancers are not created equal.  Some may progress slowly with an option of observation, but others can be more aggressive leading to the spread of the cancer and potentially death.  To see if any of these conditions are affecting you, the first step is setting up a screening.


When should I get screened?

When you should get screened depends largely on three factors, your age, family history and race. The screening for prostate cancer should start at age 55 and be repeated every one to two years. It’s important to get tested because it is one of the most common cancers in men, affecting one in seven. A family history of the condition increases the odds. If your father had prostate cancer, you’re twice as likely to get cancer as the general population. If a brother had/has it, you’re greater than three times as likely to develop prostate cancer.

Another group of the population that is particularly susceptible to developing prostate cancer is African Americans. This population has a 60 percent higher incidence than Caucasians.

Screening for prostate cancer typically stops once your life expectancy is less than 10 years.  At that point in your life, the risk of screening is unlikely to outweigh the benefits of treatment, if a cancer is identified.


What exactly does a screening involve?

Prostate cancer screening usually involves two tests. “A DRE - digital rectal exam allows us feel the back side of the prostate and check for any nodules, mass and the size of the gland,” explains Dr. Tubre. Another test is a blood test that measures prostate-specific antigen (PSA). An elevated PSA can be due to several causes, but most commonly either an enlarged prostate gland or the presence of cancer. If the results from either of these tests suggest an issue, then a biopsy could be recommended.


How can I keep my prostate healthy?

The best thing you can do for your prostate is maintain an all-around healthy lifestyle.  “From a lifestyle standpoint, anything that's going to be heart healthy, including balanced diet and exercise, will be prostate healthy.  I do recommend weight loss for my patients who are overweight or obese as this is linked to more aggressive prostate cancer and high rates of treatment failure.  Unfortunately, several studies have been completed showing no dietary patterns or increased intake of healthy foods lowered the risk of developing prostate cancer.”


What’s the big takeaway from all this information?

Most all men develop prostate issues as they grow older, whether that is BPH, prostatitis or prostate cancer. If you’re experiencing problematic urinary changes, have a family history of prostate cancer, African American, or if you’re over the age of 55, talk to your primary care physician about those issues.  The best lifestyle modifications you can do for yourself are eat a healthy diet, stay active and talk about any issues you have. “I encourage people to talk about it,” says Dr. Tubre. “We can't help you if we don't know. If you’re concerned, make an appointment, and we'll go through your options.”


 Ryan Tubre, MD, is a urologist, who practices at UT Health East Texas Physicians North Campus Tyler. Dr. Tubre is currently accepting new patients. To schedule an appointment call 903-877-7826.