Problems with the prostate - ever heard of "benign prostatic hyperplasia"?

While prostate cancer is well known and much revered by most of us, chances are that you are one of the millions of people who have never heard of Benign Prostatic Hyperplasia or (BPH).

Yet BPH affects at least 50% of men over 50, rising to 80% of men over 80!

From the age of 40 onwards, it is advisable to have a health check-up at least once a year, and each check-up should include certain specifics such as a prostate check. 

According to the Cancer Association of South Africa (CANSA) prostate cancer is one of the leading cancers in males worldwide and the most prevalent cancer in South African among males. 
 The lifetime risk for men developing prostate cancer in South Africa is one in twenty-four. In terms of men's health issues the prostate is the leading cause for concern in the older man. It is also the leading cancer among men in North America and the second most common malignancy in males worldwide, after lung cancer.  It is estimated that 38,7 million men in North America, Europe and Japan have prostate cancer. However, if caught early, cancer of the prostate gland is eminently treatable.  

• More about the prostate and its function

The prostate gland is an acorn shaped gland that lies below the bladder and surrounds part of the urethra, through which urine passes from the bladder en route outside.

It is an unusual gland in that it goes through several growth phases during a man's lifetime, the last taking place around the age of 50. The prostate is one of three glands that play a role in reproduction. It produces about 15 percent of the total volume of the semen, although we don't yet know the exact function of the fluid produced by the prostate - it may enhance the survival of sperm cells by reducing acidity in the vagina.

• Screening for prostate cancer - how is it done?

The most generally used method is the digital rectum examination that is an examination of the rectum. As part of the examination the healthcare practitioner inserts a lubricated, gloved finger into the lower part of the rectum in order to feel the prostate for lumps or anything else that seems unusual.

Prostate-specific antigen (PSA) test is a specific test that measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. The level of PSA may also be high in men who have an infection or inflammation of the prostate or benign prostatic hyperplasia.

• Prostate cancer - warning signs

According to CANSA prostate cancer develops in the tissues of the prostate gland and usually grows slow in comparison with other cancers. 
Early warning signs are difficulty in passing urine, slow stream or inability to stop or start the flow, frequent need to urinate especially at night. 
The symptoms may be related to other factors such as inflammation of the prostate called prostatitis or enlargement of the prostate gland (benign prostate hyperplasia) or benign prostatic hypertrophy which is non - cancerous.

Late warning signs are inability to urinate, lower back pain, blood in the urine or semen, painful ejaculation, erectile dysfunction and weight loss.

• Treatment for prostate cancer

Treatment includes surgery, external radiation therapy, internal radiation therapy and hormonal treatment.  In an advanced stage chemotherapy may also be given in advanced stage prostate cancer not responding to hormone therapy.  If the cancer is at a very early stage or not expected to progress a more careful "watch and wait" approach may well be followed.

• Benign prostatic hyperplasia and its symptoms

A lining known as "the capsule" surrounds the prostate gland.  When the gland starts to enlarge in BPH, the capsule prevents expansion outwards, with the result that the extra cells end up squeezing the urethra, thus causing problems with urine flow.

BPH is a non-cancerous enlargement of the prostate gland, which is why it's called benign which affects at least 50% of men over 50, rising to 80% of men over 80. While it does not cause cancer it causes "lifestyle issues" as the enlarged gland makes it more difficult to urinate - and can even in some cases lead to serious medical complications.

Most men will consult their doctor when the difficulties with urination start causing them some discomfort. If "BPH" is confirmed, they will be told that they can adopt one of three approaches: watchful waiting in order to see if the condition improves by itself, as can occasionally happen; medication; or surgery. Symptoms of BPH that demand immediate surgery are: acute retention of urine; stones in the bladder; recurrent urinary tract infections and bleeding from the prostate.

• Treatment options

Surgery or "GreenLight" Laser treatment is most often used. The "GreenLight" Laser is used to perform Photo Selective Vaporisation of the Prostate (PVP). What this means is that the laser destroys the excess tissue by vaporising it, leaving a cavity within the gland, in a procedure, which is minimally invasive.

Where conventional BPH surgery demands a hospital stay of three to four nights, with the laser treatment you will be out in 24 hours.  In fact, some patients will not even require an overnight stay - they can be in and out in one day. For men in demanding jobs, this is very good news as they can be back at work within roughly two days and they will be back to normal activity - sport, sexual activity, even manual labour - in ten days to two weeks, as opposed to three to four weeks."

[Sources: The National Cancer Institute  -  http://www.cancer.gov/cancertopics/pdq/screening/prostate/Patient/
Health 24
http://www.health24.com/medical/Condition_centres/777-792-821-1834,18188.asp
CANSA
https://www.givengain.com/cgi-bin/giga.cgi?cmd=cause_dir_news_item&cause_id=1056&news_id]