It’s about the size of a walnut, just below the bladder and surrounding the urethra. Most men don’t even realize it’s there during their first few decades of life. But the prostate gland becomes more important to men as they age, and it could cause major trouble if it’s left unchecked.
'“Men often have few to no symptoms in the early stages of a prostate issue, even with a serious disease like prostate cancer,” says Robert Caruso, MD, a urologist with Clara Maass Medical Center and a member of RWJBarnabas Health Medical Group. “That’s why routine prostate screening is so important.”
What does the prostate do?
Located at the base of the bladder, the prostate gland produces fluid that nourishes and protects a man’s sperm. Also, the muscles inside the prostate gland function as a valve. Those muscles close the bladder and keep urine in.
How can I keep my prostate gland healthy?
Being in overall good health will help your prostate gland stay in tip-top shape. Follow a heart-healthy diet. “Broccoli, brussels sprouts and cauliflower have proven anticancer properties,” Dr. Caruso says. “A diet with a variety of vegetables is best.” Limit the amount of foods associated with a high risk of prostate cancer, such as red meat and saturated fats. Also, exercise regularly to improve your circulation.
How can I tell if my prostate isn’t healthy?
“Symptoms of prostate issues include having a weak urine stream, urinary frequency, burning on urination, pelvic pressure sensation, waking up more than two times a night to urinate, feeling the need to strain or push when urinating, or having blood in the urine,” Dr. Caruso says.
What changes to the prostate occur over time?
It grows bigger, which is a natural part of aging. “Most men’s prostate glands grow between 1 to 3 percent per year during their adulthood and inflammation may accelerate this growth,” Dr. Caruso says.
However, about 50 percent of men at age 50 will develop an enlarged prostate (also called benign prostatic hyperplasia, or BPH), which can cause discomfort and difficulty with urinating. By age 80, up to 90 percent of men have BPH. BPH is the most common prostate-related health concern. Other prostate problems include prostatitis, an inflammation of the prostate most often caused by infection, and prostate cancer.
How is BPH treated?
Treatment may include behavioral changes, such as minimizing caffeine and evening fluids, or medication to relax muscles in and around the prostate and make urination easier. If these measures aren’t effective, next steps may include:
- Transurethral resection of the prostate (TURP). This procedure trims away excess tissue blocking urine flow.
- Simple prostatectomy, a removal of only the inner part of the prostate,“rarely necessary these days,” says Dr. Caruso.
- UroLift. In this brief, minimally invasive procedure, tiny implants lift the enlarged prostate out of the way to help improve urine stream and reduce urination frequency.
- Rezūm. Done under mild anesthesia, this water vapor therapy infuses steam into the urethra, which relaxes the gland and opens the urethra. Like UroLift, it only takes a few minutes and can be done in the office.
When should men begin screening for prostate cancer?
Most men should start talking with a doctor about routine prostate cancer screening between the ages of 40 and 45. “A shared decision-making process is used to determine the appropriate time and frequency of screening, depending on personal risk factors,” says Dr. Caruso. “If after initial evaluation men fall into a low-risk category, they may safely resume screening around age 50 to 55. African-American men and men with a family history of prostate, breast or ovarian cancer are encouraged to start the discussion at age 40.” Screening includes two tests—a physical exam of the prostate, also called a digital rectal exam, and a blood test that checks for the level of prostate-specific antigen (PSA), a protein made by cells in the prostate gland. Your doctor will determine follow-up screenings based on the results.
What do PSA tests reveal?
Doctors evaluate two factors. One is PSA velocity, a measure of PSA levels over time. “If the velocity is more than 0.75 per year, that’s considered significant and may indicate cancer,” Dr. Caruso says.
The other is PSA density, which compares the PSA to the size or volume of the prostate. If your PSA results indicate possible prostate cancer, your doctor will ask you to get a biopsy of the prostate, which will determine whether or not you have cancer. Some newer blood tests, such as 4Kscore and other genetic and genomic tests, can also help assess the risk of aggressive prostate cancer after an abnormal PSA or digital rectal exam.
Treatments for Prostate Cancer
After skin cancer, prostate cancer is the most common cancer in men. One in eight men will be diagnosed with prostate cancer during their lifetime, according to the American Cancer Society. However, survival rates are very high, especially when the cancer is caught early. Because prostate cancer can be slow-growing, not every man will need to be treated right away. However, depending on the stage of the cancer, leading treatments include:
- Radiation therapy, utilizing a state-of-the-art linear accelerator that delivers external beam radiation with precision, or brachytherapy, in which radioactive material is sealed in a seed and placed inside the body.
- Cryotherapy, which uses extreme cold to freeze and kill prostate cancer cells.
- Radical prostatectomy, which removes the entire prostate gland, sometimes with nearby tissue, such as lymph nodes. Surgeons at CMMC use the da Vinci Robotic Surgical System, with tiny incisions for greater precision (the end of the instruments can bend like a human wrist) and up to 10 times magnification. This helps quicken recovery and reduce side effects or complications.
RWJBarnabas Health and Clara Maass Medical Center, together with Rutgers Cancer Institute of New Jersey—the state’s only NCI-Designated Comprehensive Cancer Center—provide close-to-home access to the latest treatment options. For more information, call 844.CANCERNJ or visit our Cancer Services page.
To find a urologist at Clara Maass Medical Center, call 888-724-7123.