John just found out that his friend Stan has prostate cancer. A lot of men he knows have some kind of problem with their prostate. John is worried about what might happen to him.
It’s true that prostate problems are very common after age 50. The good news is there are things you can do.
The prostate is a gland about the size of a walnut and wraps around the tube that carries urine out of the bladder. It grows larger as you get older. If your prostate gets too large, it can cause health issues. Most prostate problems are not cancer. Having a problem with your prostate does not raise your chance of getting prostate cancer.
You may know when something is wrong with your prostate. See your doctor right away if something doesn’t seem right to you. Sometimes a doctor may find a problem that you don’t know about during a routine checkup or by doing a rectal exam. You may also need to have special x-rays or scans to check your prostate and the area around it.
Here are some examples of non-cancer prostate problems:
Benign prostatic hyperplasia, or BPH, is when the prostate is enlarged, but not cancerous. It is very common in older men. An enlarged prostate may make it hard to urinate or cause dribbling after you urinate. You may feel the need to urinate a lot, often at night. See your doctor for an exam.
Treatments for BPH include:
- Active surveillance or watchful waiting. If your symptoms are not too bad, your doctor may tell you to wait before starting any treatment to see if the problem gets worse. You will need a checkup each year. You can start treatment later on if your symptoms get worse.
- Medications. There are medicines that can relax muscles near your prostate to ease your symptoms or medicines to help shrink the prostate. Talk with your doctor about possible side effects.
- Surgery. If nothing else has worked, your doctor may suggest surgery to help urine flow. There are many types of surgery. Talk with your doctor about the risks. Regular checkups are important after BPH surgery.
- Other treatments. Sometimes radio waves, microwaves, or lasers are used to treat problems caused by BPH.
Acute prostatitis is a bacterial infection. It usually starts all of a sudden. It can cause fever, chills, or pain in the lower back and between the legs. It might hurt when you urinate. See your doctor right away. He or she can prescribe medicine to make you feel better.
Chronic bacterial prostatitis is an infection that comes back again and again. This problem can be hard to treat. Sometimes taking antibiotics for a long time may work. Talk with your doctor about other things you can do to help you feel better.
Chronic abacterial prostatitis, also known as Chronic Pelvic Pain Syndrome (CPPS), is a common prostate problem and occurs mostly in young to middle-aged men. It causes pain in the lower back, between the legs, or at the tip of the penis. Men with this problem often have painful ejaculation and need to urinate frequently. Sometimes antibiotics are helpful. The condition is very hard to treat and may require more than one treatment.
Prostate cancer is common among American men. But, very few men die from prostate cancer. Treatment for prostate cancer works best when the disease is found early and has not spread to other parts of your body.
Your chance of getting prostate cancer may be affected by your:
- Age. Being 50 or older increases your chance of prostate cancer.
- Race. Prostate cancer is most common among African-American men.
- Family history. If your father or brother has had prostate cancer, you are more likely to have it too.
- Diet. Eating high-fat food with few fruits and vegetables may increase your chance of having prostate cancer.
Diagnosing Prostate Cancer
Early prostate cancer often does not cause symptoms. As the cancer grows, you may have trouble urinating. You may need to urinate often, especially at night. Some men have pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis, and painful ejaculation.
To find out if these symptoms are caused by prostate cancer, your doctor will ask about your past medical problems. He or she will perform a physical exam. In the exam, your doctor will put a gloved finger into your rectum to feel your prostate for hard or lumpy areas.
Your doctor may also do a blood test to check the prostate-specific antigen (PSA) level. PSA levels may be high in men who have an enlarged prostate gland or prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate.
If tests show that you might have cancer, your doctor will likely want to confirm this with a biopsy. He or she will take out tiny pieces of the prostate to look for cancer cells. Your doctor may want to do a biopsy again to check results.
Treating Prostate Cancer
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate or if it has spread to other parts of the body. It also depends on your age and overall health. Talk with your doctor about the best treatment choice for you.
For cancer that has not spread from the prostate to other parts of the body, your doctor may suggest:
- Watchful waiting, which is also called “active surveillance.” If the cancer is growing slowly and not causing problems, you may decide not to treat it right away. Instead, your doctor will check regularly for changes in your condition. Older men with other health problems often choose this option.
- Surgery. The most common type of surgery removes the whole prostate and some nearby tissue. As with any surgery, there are risks. Talk to your doctor about keeping your sexual function.
- Radiation therapy. This treatment uses high-energy x-rays to kill cancer cells and shrink tumors. Talk with your doctor about possible side effects.
- Hormone therapy. Men who have radiation therapy may also be treated with hormone blockers. This is done if it seems likely that the cancer will come back. Hormone therapy is also used for prostate cancer that has spread beyond the prostate.
You can get more information on treatment choices for prostate cancer by calling the National Cancer Institute’s Cancer Information Service at 800-422-6237. Or, you can go to the NCI’s website at www.cancer.gov to talk online with a cancer information specialist. Click on “Questions about Cancer?” Then click on “LiveHelp.” You can also find information at www.cancer.gov/prostate.
Yearly PSA Testing
Some doctors think men age 50 and older should have yearly PSA tests; others do not. We know that this test can help detect cancer before it causes symptoms, but we aren’t sure that PSA tests save lives. The PSA test can find small cancers that may not grow or spread. Not all prostate cancers are life-threatening, and treatments can cause side effects. That’s why doctors sometimes prefer “watchful waiting” until there are signs that treatment is needed. Researchers are studying ways to improve the PSA test so that it detects only cancers that need treatment. Medicare will pay for a PSA test every year for men age 50 and older.
Remember that the following can be signs of a prostate problem:
- Frequent urge to urinate
- Need to get up many times during the night to urinate
- Blood in urine or semen
- Painful or burning urination
- Not being able to urinate
- Painful ejaculation
- Frequent pain or stiffness in lower back, hips, pelvic or rectal area, or upper thighs
- Dribbling of urine
If you have any of these symptoms, see your doctor right away.
For More Information
Here are some helpful Federal and non-Federal resources:
National Cancer Institute
Cancer Information Service
National Kidney and Urological Diseases Information Clearinghouse
3 Information Way
Bethesda, MD 20892-3580
Agency for Healthcare Research and Quality Publications Clearinghouse
P.O. Box 8547
Silver Spring, MD 20907-8547
American Cancer Society
1599 Clifton Road, NE
Atlanta, GA 30329
American Urological Association Foundation
1000 Corporate Boulevard
Linthicum, MD 21090
For more information on health and aging, contact:
National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
To sign up for regular email alerts about new publications and other information from the NIA, go to www.nia.nih.gov/HealthInformation.
Visit NIHSeniorHealth (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. Special features make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.
National Institute on Aging
U.S. Department of Health and Human Services
Public Health Service
National Institutes of Health