Our bones stop growing once we reach maturity, but some tissues, like cartilage, keep growing throughout our lives. This is why our ears and noses continue to grow. In men, the prostate gland also grows as they age.
What is the Prostate?
The prostate is a reproductive gland located below the bladder, surrounding the urethra. It helps produce semen.
As the gland continues to grow, so do your chances of developing a problem with your prostate. The two most common prostate conditions that can develop as men age are benign prostatic hyperplasia (BPH) and prostate cancer.
Benign Prostatic Hyperplasia (BPH)
BPH is non-cancerous and occurs when the prostate grows too large.
In early adulthood, the normal prostate gland is about the size of a walnut. “As men age, the prostate naturally enlarges. In those with BPH, this enlargement can block the urethra and cause issues with urination and sexual function,” explains Mehrad Adibi, MD, Carilion Clinic Urology. This common condition starts in many men in their 20s and continues throughout their lifetime.
Symptoms develop slowly and can take years to become a problem. They include:
- Trouble starting urination or having to strain
- Frequent urination, especially at night
- Passing only a small amount of urine
- Feeling like the bladder is not fully emptied
- Strong or sudden urges to urinate
- Weak or slow urine stream, with multiple starts and stops
It’s important to get checked by your doctor as soon as you notice symptoms. Over time, BPH can weaken the bladder, cause infections, block urine flow and even lead to kidney failure. “Catching bladder deterioration early can make treatments more effective,” notes Dr. Adibi.
There are many treatments available to improve symptoms and maintain a healthy bladder, including:
- Medicines to relax muscles around the bladder neck and ease the passage of urine
- Enzyme inhibitors to shrink the prostate gland
- Surgery to remove some of the tissue in the prostate causing the bladder obstruction
Both surgery and medications have risks and side effects, so it’s important to discuss all options with your physician. For symptoms that don’t interfere with your everyday life, your doctor may recommend "watchful waiting" to monitor changes over time. Limiting evening drinks, especially alcohol or caffeine, can also be helpful.
It’s also important to note that having BPH does not increase your risk of prostate cancer.
Prostate Cancer
Prostate cancer is the most common cancer in men. The CDC estimates that 13 out of every 100 American men will get prostate cancer at some point.
Most men with prostate cancer have no symptoms. If they do have symptoms, they’re usually similar to those of BPH. That’s why it’s important to have routine prostate-specific testing with your primary care physician, especially if you’re over age 50. Prostate Specific Antigen (PSA) screening is a simple blood test that can be done to evaluate your risk of prostate cancer. Checking your PSA is recommended as part of every man’s routine annual health check.
Diagnosis usually involves imaging tests like an MRI or ultrasound and a targeted biopsy. Treatment options available at Carilion include:
- Active surveillance for low-risk prostate cancers
- Robotic surgery to remove the cancerous prostate gland
- Radiation therapy
Early detection and treatment of prostate problems is key. Be sure to keep up with your yearly checkups (including your PSA blood test!) and talk to your primary care doctor about other screening options and referrals to urology.
