Prostate Problems

Prostate Problems

Growths in the prostate can be benign (not cancer) or malignant (cancer). Prostate cancer is cancer of the prostate gland. It is the second-leading cause of cancer death for men. About 1 in 7 men will be diagnosed with it in their lifetime. About 1 in 35 men will die from it. Benign prostatic growth (benign prostatic hyperplasia, a.k.a. BPH) is even more common.

To understand prostate disorders, it helps to know how the prostate normally works.

The prostate is part of the male reproductive system. It is about the size of a walnut and weighs about an ounce. The prostate is below the bladder and in front of the rectum. The prostate goes all the way around a tube called the urethra. The urethra carries urine from the bladder out through the penis. The main job of the prostate is to make fluid for semen. During ejaculation, sperm made in the testicles moves to the urethra. At the same time, fluid from the prostate and the seminal vesicles also moves into the urethra. This mixture—semen—goes through the urethra and out of the penis.

Source: Urology Care Foundation

Symptoms

Typical urinary symptoms from prostate disorders include nocturia (getting up at night to void), frequency, urgency, poor stream, double voiding, and needing to wait for the stream to start (hesitancy). The majority of patients with early stage prostate cancer will not experience any symptoms from the tumour itself. Some will notice a worsening of their urinary symptoms (frequency, urgency, poor stream), and others may notice blood in the semen or urine.

The symptoms of benign and malignant prostate growth cannot be distinguished without further investigations, including a thorough examination and a PSA (prostate specific antigen) blood test.

Diagnosis

Prostate cancer is suspected when a PSA blood test is abnormally high and/or the prostate feels suspicious on examination. The next investigation is typically an MRI scan. If that test raises concerns, then a biopsy may be recommended. 

If prostate cancer is not suspected or tests are reassuringly negative, then further tests might be suggested to assess any urinary symptoms. These include a flow rate test, ultrasound scan, urodynamics, or cystoscopy. 

Treatment of benign prostatic hyperplasia (BPH)

Many men with symptoms related to an enlarged, benign prostate have learned to live as they are. Treatment is typically reserved for those men who are bothered by their symptoms, or if the enlargement is causing problems with kidney function.

Treatment falls broadly into medical and surgical options. Tablets may be suggested to try to improve urinary symptoms gradually. There are several effective surgical treatments available and, if needed, Mr Keeley will advise you of the most appropriate ones for you.

Treatment of prostate cancer

Mr Keeley will advise you regarding the treatment options, which in broad terms include surgery to remove the prostate gland, radiotherapy, hormonal therapy, and chemotherapy.

Prostate cancer cells can spread by breaking away from a prostate tumour. They can travel through blood vessels or lymph vessels to reach other parts of the body. After spreading, cancer cells may attach to other tissues and grow to form new tumours that may damage those tissues. When prostate cancer spreads from its original place to another part of the body, the new tumour has the same kind of abnormal cells and the same name as the primary (original) tumour. For example, if prostate cancer spreads to the bones, the cancer cells in the bones are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. For that reason, it’s treated as prostate cancer, not bone cancer.