The prostate gland, roughly the size of a walnut, surrounds the urethra— the tube running from the bladder to the penis. Its primary function is to produce fluids that contribute to semen. Inflammation of the prostate, known as prostatitis, often requires antibiotics for treatment. Additionally, benign prostatic hypertrophy (BPH), common in men over 50, involves enlargement of the prostate, causing symptoms like frequent urination, urgency, nocturia (nighttime urination), and difficulty initiating or maintaining urine flow.
Diagnosis of BPH typically involves a digital rectal examination (DRE) to assess gland size, along with urine flow tests, blood tests, and possibly other evaluations. Treatment options for BPH include medication to improve urine flow and reduce gland size (e.g., finasteride, dutasteride, alpha blockers) or surgical procedures such as transurethral resection of the prostate (TURP) to remove part or all of the enlarged gland.
Diagnosis of BPH typically involves a digital rectal examination (DRE) to assess gland size, along with urine flow tests, blood tests, and possibly other evaluations. Treatment options for BPH include medication to improve urine flow and reduce gland size (e.g., finasteride, dutasteride, alpha blockers) or surgical procedures such as transurethral resection of the prostate (TURP) to remove part or all of the enlarged gland.
There are a range of treatments for bothersome BPH. However, about one in three sufferers manage their condition with medication and lifestyle changes, such as avoiding fluids for at least three hours before bedtime and emptying the bladder completely when you go. There is no proven way to prevent prostate enlargement. Medical treatment options include drugs that improve the flow of urine – some, such as finasteride and dutasteride help shrink the enlarged gland; other drugs called alpha blockers relax the smooth muscle of the prostate and the neck of the bladder, thereby relieving obstruction. Surgical options include a transurethral resection of the prostate (TURP) where some or all of the gland is removed.
If left untreated, BPH can lead to acute urinary retention, a painful condition requiring immediate relief via urinary catheterisation.
Prostate cancer is the most prevalent cancer among men inIreland, excluding skin cancers. Over 3,000 men are diagnosed annually, with a lifetime risk of one in eight. Risk factors include age, family history, and ethnic background (more common in African-Caribbean descent, less in Asian descent). Screening involves prostate-specific antigen (PSA) blood tests andDREs, although elevated PSA levels can also indicate conditions like BPH or infection, complicating diagnosis.
The causes of prostate cancer are unknown. However, a number of factors can increase your risk of developing the condition.
There is no single test for prostate cancer. All the tests used to help diagnose the condition have benefits and risks. The most commonly used screening tests for prostate cancer are blood tests and a physical examination of your prostate (a DRE).
The PSA blood test may help detect early prostate cancer. Men are not routinely offered PSA tests to screen for prostate cancer as results can be unreliable. This is because the PSA blood test is not specific to prostate cancer. PSA can be raised due to BPH, a urinary tract infection or inflammation of the prostate as well as prostate cancer. Raised PSA levels also cannot tell a doctor whether a man has life-threatening prostate cancer or not. This means that a raised PSA can lead to unnecessary tests and treatment.
A dilemma for doctors is that while it is important to diagnose high-risk cases within the window of curability, many men with low-risk prostate cancer do not need aggressive treatment.
For many men with prostate cancer, treatment is not immediately necessary. If the cancer is at an early stage and not causing symptoms, a policy of “watchful waiting” or “active surveillance” may be adopted. This involves carefully monitoring the condition. Some cases of prostate cancer can be cured if treated in the early stages.
Treatment options for prostate cancer range from active surveillance for low-risk cases to surgery, radiation therapy, or hormone therapy for more advanced stages. Treatment decisions balance the potential benefits against significant risks like erectile dysfunction and urinary incontinence.
Preventive measures include maintaining a healthy diet and staying physically active. For more information, resources such as the Irish Cancer Society and the national cancer helpline (1800 200 700) offer valuable support and guidance.
