Transforming Lives Through Health

Prostate issues (BPH & Cancer)

BPH: Benign Prostatic Hypertrophy: The prostate is an organ that surrounds the urethra of a biologic man. The prostate sits right below the bladder. The prostate is about the size of a walnut. The urethra is a tube that carries urine and sperm out of the body. As men age the prostate will enlarge and interfere with urination of ejaculation. It can prevent urine and sperm from passing through your urethra. By the age of 60, 50% of men will have signs of BPH. By the time men are in their 85s, 90% of men have BPH. BPH does not increase your risk for prostate cancer.

Prostate Cancer: Prostate cancer has similar symptoms to BPH. Everyone between the ages of 55-69 should have their prostate screened for possible cancer. African Americans and people who have a family with a history of prostate cancer are at increased risk for prostate cancer. If you are at an increased risk of prostate cancer, then you should start getting screened at age 40. A PSA is a blood test that checks the level of prostate-specific antigen. This is a protein produced by prostate cells. When a man has prostate cancer, the prostate cells will increase the production of the PSA. The higher the level, the more likely you have prostate cancer. If you have elevated levels of PSA then your PCP should be referring, you to an urologist. Prostate cancer can be treated, and men can live a full healthy life. Not all treatments require radiation or surgical removal.

Signs of BPH

· Incomplete emptying of bladder

· Increased frequency of urinating

· Urgency

· Intermittency (stopping and starting urinating)

· Weak stream

· Straining to urinate

· Nocturia (getting up to urinate at night)

· Pain after ejaculating or while urinating

· Urine changes colors or smells.

Untreated BPH can cause the following problems:

· Further blockage of the urethra causing symptoms to worsen

· Urinary tract infections

· Bladder stones

· Hematuria: blood in urine

· Kidney damage due to urine backing up from bladder up to the kidney. This can create a urine backflow that increases pressure on the kidney.

Testing for BPH:

There are many tests for BPH which includes a digital rectal exam. Since the prostate sits below the bladder but in front of the rectum, a gloved digit into the rectum can feel the edges and the surface of the prostate to estimate the size of the prostate. Any hard areas of the prostate could be cancer. Most men avoid this test. A lot of providers will just subscribe medication for BPH if you have symptoms of BPH.

Treatment and Management of BPH:

There is no cure for BPH. Treatment will vary depending on your symptoms. A International Prostate Symptom Score (I-PPS) is a screening tool used to determine the severity of your symptoms and how to manage the BPH. Most of the time BPH is managed with medication.

Medications:

· Tamsulosin (Flowmax)

· Terazosin (Hytrin)

· Doxazosin (Cardura)

· Alfuzosin (Uroxatral)

· Silodosin (Rapaflo)

Medications that decrease the production of DHT to slow the growth of prostate

· Finasteride (Proscar)

· Dutasteride (Avodart)

Some men may need a combination of medications to improve the symptoms and improve urine flow. Dutasteride and tamsulosin (Jalyn) is a common combination.

Surgery:

If your prostate tissue blocks the urethra then you may need to have surgery. There are several different types of surgery.

· Transurethral resection of the prostate (TURP)

· Transurethral incision of the prostate (TUIP)

· Transurethral electrovaporization

· GreenLight laser treatment

· Aquablation

Minimally invasive treatments: Newer alternative treatments instead of surgery. These are procedures that are done as outpatient procedures. They are cheaper and have less side effects and allow for a faster recovery. Since these procedures are new, there is not a lot of studies on the long-term effects or complications.

· Prostatic urethral lift

· Rezum therapy

Diet that can benefit a healthy prostate

· Mediterranean diet

· Berries

· Broccoli

· Citrus

· Nuts

· Tomatoes

· Turmeric

Poor diet may make symptoms worse

· Processed foods

· Large amount of sugars and carbohydrates

· Alcohol

· Caffeine

· Dairy

· Red meat

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Compassionate Health Care for All Ages

Transforming Lives Through Health

Prostate issues (BPH & Cancer)

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