Every man is born with one. And if we chaps lived until we were 120 years old, it would cause every single one of us problems to some extent or other. The prostate gland is what I’m talking about – an important little thing and it pays to know about the signs and symptoms when it can start to cause problems, and also how we go about checking it.
So what is the prostate gland? Well, all men have one, and its job is to help make semen. It’s meant to be about the size of a walnut when it’s healthy. You’ll find it sitting just below the bladder and surrounding the urethra (the tube leading from the bladder to the penis). The diagram below gives you a rough idea of where it is and how big it is:
So how does it cause problems? As we get older, the prostate gradually enlarges, which is unavoidable unfortunately. As you can see from the diagram above, if it gets bigger it starts putting pressure on the urethra – essentially like squeezing halfway along a hosepipe. This commonly manifests with one of a range of symptoms:
- Difficulty to starting to pass urine
- Difficulty to stop passing urine and “dribbling” at the end of the stream
- A feeling that your bladder is not completely empty
- And related to this, going to the toilet more than usual – often getting up in the night to visit the bathroom
Could it be prostate cancer? This gradual growth with age is not harmful, despite the annoying symptoms, and we call it “benign prostatic hypertrophy” or BPH – medical language for a harmless big prostate.
Sometimes though the prostate grows abnormally and can develop into prostate cancer. Awareness about prostate cancer is increasing thanks to fantastic campaigns like MenUnited, and it is so important for us to maintain this momentum. Prostate cancer and BPH can have similar symptoms so if you notice them starting, go and see you doctor. Fortunately most men with these symptoms won't have prostate cancer and actually it commonly doesn't cause any symptoms at all at an early stage. So I'd recommend any man over 50 think about prostate cancer screening, whether or not you have any symptoms. There is some great information about this on the Prostate Cancer UK website.
It is important for me to say that under the age of 50, prostate cancer and BPH are far less common so it may be something else like a bladder or prostate infection. If you see your doctor, you should be able to figure it out together and get some help.
When you see your doctor they will ask some detailed questions about your symptoms before examining you. There are two ways that we examine the prostate gland – a blood test, and by physically examining it. In reality, both need to be done together to give you the most accurate advice. The examination is not a particularly glamorous procedure – it involves the doctor placing a finger inside your back passage to manually feel the consistency of your prostate gland. Modern medicine has made many advances, but sometimes the original methods are still very effective! A lot of chaps can be a bit apprehensive or embarrassed about this – don’t be. It doesn’t take long, and it isn’t painful.
The blood test checks for something that your prostate releases into the blood. Broadly speaking a very high level can indicate a possible cancer. However, the trouble is there are other things that can raise the level as well - this is why the blood test is not currently accurate enough to be used alone without physically examining the prostate. If there is any doubt or concern thrown up by this then your doctor may ask you to see a urologist – the specialty of medicine that deals with the prostate an the urinary tract.
Ultimately, big prostates can cause big problems. But there's no need to suffer in silence: there are lots of effective treatments out there.
When it comes to cancer, on the whole prostate cancer is a slow growing cancer, and it is rightly said that many men in their 80s and 90s die with prostate cancer, not from it. Nevertheless, it is vitally important that we continue to educate men about the signs of prostate problems, and to make sure the message is clear – don’t put it down to getting older, go and see your doctor if you notice any of these symptoms!