Although it may be the end of long road trips, it’s not the end of the world. It’s simply a signal that, similar to your eyesight needing help as you age, the prostate needs some attention too.
The prostate is a gland the size of a walnut that sits at the base of the penis. It wraps around the urethra (the urine conducting tube) like a donut. The prostate is essential for male fertility, as it makes a fluid that protects and nourishes sperm. But as men age, there are two problems that can arise. One is benign prostatic hypertrophy (BPH), which is a fancy way of saying that the gland enlarges. For some unknown reason, the prostate continues to grow as a man gets older. This occurs in about half of all men in their sixties. And due to its strategic location around the urethra, it can cause urinary urgency, dribbling, weak stream, and can make men get up at night to urinate.
The other potential problem is prostate cancer. Fortunately, it is far less common than prostate enlargement (one of 9 men will get prostate cancer in their lifetimes) and typically causes no urinary symptoms.
BPH is not preventable, but prostate cancer may be. Following a heart-healthy, low-fat, low carbohydrate diet is key to the prevention strategy, as are exercise, weight management, and stress reduction. Concentrate on eating fruits and vegetables, which are high in antioxidants that protect the cells of your body from becoming cancerous. Soy and green tea may also be prostate-protective. Sugar intake should be limited, as it often ends up stored in your body as fat, and obesity is linked to prostate cancer.
It may surprise you to learn that prostate cancer isn’t always lethal. Cancer is no one’s friend, but prostate cancer is typically not as deadly as lung cancer, colon cancer, or breast cancer. Most men who have prostate cancer do not die of it. It is much more slow-growing than many other cancers, doubling in size every 2-3 years instead of every 4-6 months. Because of this, men are 10 times more likely to die of heart disease than prostate cancer. Even more interesting is that some believe that prostate cancer is really a disease of age in men, as the likelihood of having small amounts of cancer in the prostate increases with age. That means that about 80% of 90-year-old men will have prostate cancer but may never know it. It also means that there are many prostate cancers found in men that are “clinically insignificant,” a rare term in cancer medicine. So, many prostate “cancers” actually don’t act as such. The real challenge is to figure out which are important to treat, and which are not.
Although diseases of the prostate are not usually life-threatening, they can affect your quality of life…and your road trips. Men over 55 should consider having their prostate checked regularly, although most men would rather spend quality time with the dentist’s drill than go in for that exam. Luckily, blood tests for something called PSA can also help detect cancer. The symptoms of prostatic enlargement are treated with pills; if these don’t work, various, safe but indescribable minimally invasive procedures can remove the symptom-causing prostatic tissue. And, some of the FDA-approved pills to treat BPH may also prevent prostate cancer. So, for all kinds of reasons, don’t ignore the prostate. Attend to it before it disrupts the flow in your daily life.
BY PAUL TUREK, MD, FACS