MEDICAL SURFARI: PROSTATE PROBLEMS CAN BE PREVENTED

What is the most mispronounced gland of the human body? It is the prostate (not prostrate, which means to lay flat). The prostate is one of the male sex glands and it is located just below the bladder between the rectum and the scrotum. It is about the size of a walnut and it surrounds the urethra, the tube that drains the bladder of urine to the outside of the body. A normal functioning prostrate contributes fluid to the sperm during ejaculation.

As men age, the prostate may change and enlarge, causing some constriction of the urethra, and this may result in slow and less forceful urine flow as well as sexual dysfunction. Enlargement of the prostate may be due to a benign (non-cancerous) condition where there is an increase in the number of cells within the prostate. This condition is referred to as benign prostatic hyperplasia (BPH). The prostate gland may also enlarge due to a malignant (cancerous) growth within the gland.

Prostate cancer is second to lung cancer as the leading killer of American men. Although this is one of the leading causes of cancer death among men, it is one of the most treatable cancers when detected early. Approximately one of every ten men in the United States develops cancer of the prostate by the age of 85. This risk is two to three times greater for African-American men. The risk for prostate cancer increases with age, and it usually occurs after age 50. Many prostate tumors take three or four years to double in size. This allows time for early detection before the cancer spreads beyond the prostate.

Early detection is the key to reducing the toll of cancer. Nearly 70 percent of newly diagnosed prostate tumors are localized within the gland. This may be detected early by a simple, but admittedly not so pleasant, annual digital rectal examination in which the doctor inserts a lubricated gloved finger into the rectum, and gently feels the prostate for signs of cancer. All men over 40 should have this as part of their annual physical examination. Most health insurance plans include prostate exams in their coverage, and many clinics and health groups will provide low cost or free prostate exams.

Often there are no symptoms when a prostate tumor is small and contained within the prostate. As it grows, it may press on the urethra and cause a need for frequent urination, (especially at night) trouble starting or stopping urination, weak urinary stream requiring straining to urinate, pain or burning while urinating, blood in the urine, and/or pain in the back, pelvis or hips. If you experience any of these symptoms, you should see your physician immediately.

The American Cancer Society recommends that all men over age 50 also have a blood test (serum prostatic surface antigen, "PSA") checked every year, particularly if they are at high risk for prostate cancer, or if they have a strong family history for such.

Be certain to talk with your doctor about your need for regular prostate screening examinations.

World Wide Web Resources

OncoLink

cancer.med.upenn.edu/pdq_html/2/engl/201229.html

Oncolink is a web site provided by the University of Pennsylvania Cancer Center that provides a link to the National Cancer Institute.

Cancer and Treatment Information

www.mskcc.org/document/WICPROST.htm

This web site form the Memorial Sloan-Kettering Cancer Center provides a wealth of information on all aspects of prostate cancer, including prevention, diagnosis and treatment options.

Cancer Research Foundation of American

www.preventcancer.org/crfa.html

The Cancer Research Foundation of America provides information of various types of cancer, including prostate cancer.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.