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Most people have heard of prostate cancer, which is the second-most common cancer in men in the U.S. and the leading cancer in men over 50 . It is a cancer that is hard to prevent, its not hereditary , it generally comes with age and there are no clear early warning signs.
Warning signsPeople ask me all the time what the early warning signs are for prostate cancer, and I hate to tell you that there are none. Thats the dilemma. In the early curative phases, it is essentially asymptomatic. By the time you have symptoms of prostate cancer, such as pain, difficulty urinating or sexual dysfunction, it has advanced beyond the curative phase, and at that point we are only able to treat the symptoms.
BPA and prostatitisOther fairly common prostate issues are benign prostatic hyperplasia and prostatitis. BPH is a natural enlargement of the prostate that happens in all men as they age. It creates symptoms of bladder outlet obstruction so men will feel hesitancy with urination, slow stream or double voiding. It can be corrected with medication or surgery.
Prostatitis is inflammation or infection of the prostate, which can occur as early as puberty into advanced age. Its not dangerous, but it can be annoying. Symptoms include abdominal or pelvic pain, slow urinary stream, hesitancy and frequency. It is treated with antibiotics and removal of certain foods that can aggravate it, such as caffeine.
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What Is The Prostate Gland
The prostate is a gland about the size of a walnut. It is part of the male reproductive system and wraps around the tube that carries urine out of the bladder. It grows larger as you get older. If your prostate gets too large, it can cause health issues. Having prostate problems does not always mean you have cancer.
Sometimes a doctor may find a problem during a routine checkup or by doing a rectal exam. If you think there is something wrong with your prostate, see your doctor right away.
Generations Of Men Underwent Prostate Cancer Tests During An Aggressive Screening Regimen Then The Screenings Stopped Now Doctors Are Reevaluating Just How Worried Men Should Be About Their Prostate
by Michael J. Mooney
Its tucked deep within the body, nestled between the bladder and penis, an elusive gland roughly the size of a Ping-Pong ball. Many people dont know what, if any, purpose the prostate serves most of what we hear about it revolves around the problems it can cause, especially later in life. But without it, there might not be any life at all.
In some ways, the male prostate gland is equivalent to the female mammary glands. Mammary glands are responsible for nourishing a child in the early stages of life the prostate is responsible for protecting the sperm even earlier. It does this by producing an enzyme called prostate-specific antigen , which liquefies the semen, essentially freeing it from the seminal coagulum. PSA also gets credit for neutralizing the cervixs blocking enzyme, which allows sperm to freely enter the uterus and, hopefully, penetrate the egg.
The prostate gland, small as it is, is like a multifaceted diamond: every time you look at it from a different angle, under a different light, you see a different aspect of it, find a new scientific challenge, unresolved mysteries, says urologist Dr. Claus Roehrborn, who specializes in prostate diseases and has chaired the University of Texas Southwestern Medical Center Department of Urology since 2002. His work is at the forefront of current innovations in treating and diagnosing prostate cancer.
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Latest Men’s Health News
At the start, prostate cancer does not cause symptoms. As the cancer grows, you may have trouble urinating. Some men need to urinate often, especially at night. Others have pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis, and painful ejaculation.
To find out if these symptoms are caused by prostate cancer, your doctor will ask about your past medical problems and your family’s medical history. He or she will perform a physical exam. During the exam, your doctor will put a gloved finger into your rectum to feel your prostate for hard or lumpy areas.
Your doctor may also do a blood test to check the prostate-specific antigen level. PSA levels can be high in men with an enlarged prostate gland or with prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate.
If tests show that you might have cancer, your doctor will want to confirm this with a biopsy. He or she will take out tiny pieces of the prostate to look for cancer cells. Your doctor may want to do a biopsy again to re-check the results.
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate or if it has spread to other parts of the body. It also depends on your age and overall health. Talk with your doctor about the best treatment choice for you. You may want to ask another doctor for a second opinion.
Prostate Size May Help In Predicting Cancer Severity
The size of a mans prostate gland may help predict the severity of cancer, with a smaller prostate being more likely to harbor serious disease.
This finding by a group of Vanderbilt-Ingram Cancer Center researchers was published in the December issue of the Journal of Urology. Fourth-year medical resident Judson Davies, M.D., was first author on the paper.
The investigators reviewed 1,251 cases of prostate cancer among men who had their prostates surgically removed between January 2000 and June 2008. The patients were considered to have low-risk disease because their prostates were producing low levels of prostate specific antigen and they had a Gleason score of six or less. The Gleason score is a measure of the grade or severity of cancer found during initial biopsies.
The researchers looked at cases of only low-risk patients who might be candidates for less aggressive treatment, including observation, which is sometimes called active surveillance. These options are considered safe for some patients because prostate cancer often grows so slowly that it may never pose a threat to the patients life.
The VICC investigators found that in 31 percent of the cases, when pathologists examined tissue removed after surgery, the severity of the cancer was upgraded from the pre-surgery analysis, and men with smaller prostates were more likely to have their cancer upgraded after surgery.
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Problems With Enlarged Prostate Gland
Benign enlargement of the prostate gland is more common as men get older. It can cause troublesome symptoms, although it doesnt always.
The urethra passes through the prostate gland, so men may have problems urinating if the enlarged gland restricts the flow of urine. If the flow stops completely, a catheter is required to empty the bladder. It is rare for this form of acute urinary retention to cause kidney damage.
An enlarged prostate doesn’t always cause urinary problems. Studies indicate that the size of a man’s prostate gland has little influence on the type or severity of his urination problems. BPH is just one possible cause of urinary symptoms.
Another cause of urinary symptoms can be changes to the muscular wall of the bladder, which may cause spasms of the bladder or weaken the bladder, causing problems passing urine.
Are Prostate Problems Always A Sign Of Prostate Cancer
Not all growths in the prostate are cancerous, and not all prostate problems indicate cancer. Other conditions that cause similar prostate cancer symptoms include:
- Benign prostatic hyperplasia : At some point, almost every man will develop benign prostatic hyperplasia . This condition enlarges the prostate gland but doesnt increase cancer risk. The swollen gland squeezes the urethra and blocks the flow of semen and urine. Medications, and sometimes surgery, can help.
- Prostatitis: Men younger than 50 are more prone to prostatitis, inflammation and swelling of the prostate gland. Bacterial infections are often the cause. Treatments include antibiotics or other medications.
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What Should My Free Psa Level Be
Free PSA is the form of prostate specific antigen that is produced by benign cells of prostate gland, finding 10% of total PSA as Free is acceptable for healthy men. The lower the riskier.Benign prostate tumors normally show Free PSA percentage higher than 10%.Carcinogen cells reducing free PSA percentage to less than 10% and raise the values of total PSA due to the increasing of complexed PSA by cancer cells, from PSA blood test explainedLow PSA level, what does it mean?The normal PSA level is 0 but it can rise to up 4 with infection or other minor issues.A PSA of 0.6 is good and would not normally need further blood tests.PSA 1.0 is lower than men limit of PSA but is still not a cancer marker.If you have prostate cancer already and have had treatment, then 0.5, 1.0, or 2.0 is still nothing serious to worry about.The same is applied for PSA 2.0 or 3.0: means youre a cancer free or have your treatment course succeeded and lowered the PSA percentage.A problem with prostate production of prostate specific antigen can lead to very low PSA level.Diminished free PSA with normal PSA total is not fully understood.
Inflammation Of The Prostate Gland
Bacteria sometimes cause prostatitis . More commonly, the underlying cause is uncertain. Consult your doctor promptly if you experience:
- pain in the groin
- urgent and frequent urination.
Treatment with antibiotics is essential for acute bacterial prostatitis. Admission to hospital is often necessary and, as with chronic bacterial prostatitis, specific antibacterial drugs are required for a long time.
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The Basics: How An Erection Occurs
At its most basic level, an erection is a matter of hydraulics. Blood fills the penis, causing it to swell and become firm. But getting to that stage requires extraordinary orchestration of body mechanisms. Blood vessels, nerves, hormones, and, of course, the psyche must work together. Problems with any one of these elements can diminish the quality of an erection or prevent it from happening altogether.
Nerves talk to each other by releasing nitric oxide and other chemical messengers. These messengers boost the production of other important chemicals, including cyclic guanosine monophosphate, prostaglandins, and vasoactive intestinal polypeptide. These chemicals initiate the erection by relaxing the smooth muscle cells lining the tiny arteries that lead to the corpora cavernosa, a pair of flexible cylinders that run the length of the penis .
Figure 1: Anatomy of the penis
The penis is made up of three cylindrical bodies, the corpus spongiosum which contains the urethra and includes the glans of the penisand two corpora cavernosa , that extend from within the body out to the end of the penis to support erection. Blood enters the corpora cavernosa through the central arteries.
Helping To Produce Semen
2030% of fluid to the total semen volume. The remainder comes from the seminal vesicles and the testicles .
Prostatic fluid contains components that make semen an ideal substance for sperm cells to live in, including enzymes, zinc, and citric acid. One important enzyme is prostate-specific antigen , which helps make the semen thinner and more fluid.
The fluid in semen helps the sperm travel down the urethra and survive the journey towards an egg, which is essential for reproduction.
Prostatic fluid is slightly acidic, but other components of semen make it alkaline overall. This is to counteract the acidity of the vagina and protect the sperm from damage.
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How Is Prostate Cancer Diagnosed
Prostate cancer is diagnosed with a biopsy of the prostate. A biopsy is usually done if symptoms or a screening raises concern. A prostate cancer screening is a test your doctor uses to look for the disease before you have symptoms. There are two screening tests available: a digital rectal exam and a prostate-specific antigen test. You and your doctor will decide if you need a screening. However, these tests can only tell your doctor whether or not your prostate is healthy. Abnormal test results dont always mean you have cancer. How often you should be screened depends on your age and your personal risk factors.
During a DRE, your doctor will insert his or her gloved, lubricated finger a few inches into your rectum to feel your prostate gland. A normal prostate feels firm. If there are hard spots on the prostate, your doctor may suggest additional testing to check for prostate cancer.
During a PSA test, you will get a blood test. A blood test involves inserting a small needle into a vein in your arm to take a sample of blood. The test measures the level of PSA in your blood. Men who have prostate cancer may have a higher level of PSA in their blood. However, a PSA level can also be high because of less serious causes, such as infection or an enlarged prostate.
If your screening test results are abnormal, your doctor may recommend additional other tests to check for cancer. Those tests may include:
How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren’t noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
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Pde5 Inhibitors: Viagra Levitra And Cialis
Approved by the FDA in 1998, sildenafil revolutionized the way we think about and treat erectile dysfunction, largely because it is so easy to use and effective. Since then the FDA has approved three closely related drugs, vardenafil , avanafil and tadalafil .
All four drugs work in a similar fashion, by affecting the normal physiology of the penis. In particular, they block PDE5, an enzyme that breaks down the erection-producing chemical cyclic guanosine monophosphate. This enables the penis to fill with blood and to stay erect long enough for intercourse. Of course, its important to realize that none of these drugs is an aphrodisiac. Youve got to feel sexually stimulated in order for them to work.
The main differences between the drugs have to do with timing: how quickly they begin to work, and how long their effects last . Levitra may start working slightly faster than Viagra although the FDA says that like Viagra, it should be taken about an hour before sexual activity. Some studies suggest that Levitra may help some men who dont respond to Viagra. And while some doctors are skeptical about this claim, theres no harm in trying Levitra or Cialis if Viagra doesnt work for you.
Cialis has also been approved to treat men with both erectile dysfunction and BPH. The dose is lower, usually 5 milligrams per day.
What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. When cancer comes back it is called a recurrence. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed.
Be sure to go to all follow-up visits. Your doctors will ask about your symptoms, examine you, and might order blood tests and maybe other tests to see if the cancer has come back.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life, making healthy choices and feeling as good as you can.
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Example Posed: Ci On Standard Deviation Of Prostate Volumes
Using the 10 prostate volumes from Table DB1.1, what is a 95% confidence interval on the population standard deviation ? We have calculated s=15.92 ml which has n1=9 df. We know the probability distribution of s2 but not of s, so we shall find the interval on the population variance, 2, and take square roots. s2=15.922=253.4464. How do we express a confidence interval?
Prostate Volume And Bph Prevalence: Comparison To Industrial Populations
Compared to TRUS from multiple industrial populations including 1,240 Caucasian German men , 3,924 Caucasian Dutch men , 472 Caucasian Scottish men , and 631 Caucasian U.S. men , the Tsimane have significantly smaller prostate volumes controlling for age and height, and a shallower rate of change with age controlling for height .
The overall age standardized prevalence of BPH among men age 40 80 was 28.4% compared to 60.8% of U.S. men of the same age . For Tsimane men aged 60 80, an age standardized 31.7% presented with BPH, compared with 76.0% of U.S. men aged 60 80 . Only 0.56% of this sample achieved prostate volumes greater than 40 cc compared to approximately 20% of U.S. males .
Tsimane Prevalence of BPH by Age and U.S. Prevalence of Histologic BPH from Berry et al.
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