The prostate is a gland that lies underneath the bladder, and it surrounds the tube that comes out of the bladder which is called the Urethra. It's only found in men, and it's about the size and shape of a walnut. Its main job really is to produce fluid, to keep the sperm and semen healthy. There are three main conditions that can affect the prostate. The most common one we see is called an enlarged prostate. It's not cancerous, but it just means it's enlarging, because the man is getting older. It's commonly seen in men from about the age of 50 onwards. The second condition that we see in men is called prostatitis, and this is where the prostate becomes infected or inflamed, and it's much more common than men think. And it usually appears in men from about the age of 30 - 50, but in fact it can affect men of all ages. But the third condition that we see is prostate cancer, and prostate cancer is certainly more common in men as they get older. Most cases are over the age of 65, but we do see it in men who are 50 years old, and indeed, in a few men even younger than that in their 40's.
As men get older, the prostate slowly enlarges in size.
It starts causing problem in passing urine. The common problems when men who are old they pass urine, is obstruction to the flow of urine. There is increased frequency of urination. There is some urgency when they pass urine and they pass urine more frequently in the night time. So these are the problems with enlarged prostate. Enlarged prostate, if left untreated, can give rise to inconvenience. So the as we discussed, the person will have difficulty in passing urine. He has to use a lot of force to pass urine. He feels like going to the toilet again and again to empty his bladder, and this causes a lot of social embarrassment. For example, whenever a patient person is traveling many, many of these elderly people they ask the bus conductor or the driver to stop the bus or the taxi, that they can go to the visit the nearest toilet by the side of the road and pass urine. So this is a major inconvenience. Also many times they cannot control the urge to pass urine, so they may leak a few drops of urine in their clothes. So an untreated prostate is a cause of social embarrassment, inconvenience and also medical problems. The medical problems could be in the form of frequent urinary tract infections, and also some symptoms like burning sensation when they pass urine
Prostatitis is the most troublesome disease that affects many younger men, and it's characterized by pain on passing year and pain in the perineum, sometimes reduction of flow and sometimes a burning sensation or passing year. It's caused by inflammation in the prostate, sometimes caused by infection. More often it's not associated with infection, and it's just a non infective inflammatory condition. But you can imagine: if your prostate inflamed, you get that burning sensation in the pelvis, which is a very, very troublesome.
Prostatitis is nothing but inflammation of the prostate gland. It can be secondary to infectious causes or it could be a bacterial prostatitis. Also a bacterial prostatitis is usually secondary to reflux of urine from the urinary system into the prostate gland, and urine contains multiple chemicals which can initiate an inflammation of the prostate gland. It all starts with a simple episode of urinary tract infection in the males, after which if it is not treated or if it is not eradicated completely, the bacteria can find rest in one of the corners of the prostate gland. leading to repeated attacks of urinary tract infections, causing destruction of the prostate silently, after which the patient develops severe pain and burning while passing urine. So the symptoms to watch out for to identify prostatitis is severe burning while passing urine. and when the infection reaches beyond a critical point, it can form what we call as an abscess in the prostate land. The treatment definitely depends on the cause. A bacterial prostatitis requires antibiotic administration. It has to be clearly identified with cultures of the urine done both before. The identification depends on the urine culture, and the urine sample, which is identified after your doctor visit with a digital rectal examination, is going to give us the correct diagnosis. Initiation of antibiotics and antibiotic continuation for four to six weeks is recommended and ideal for clearing the infection from the prostate land. If it has formed an abscess, then pus anywhere in the body has to be drained out. and for the prostate land the easiest approach would be to drain the pus through the rectum with the help of a trans-rectal ultrasound probe. If the abscess cavity is very huge and encroaching on to the urinary tract, then we might require a cystoscopic procedure for drainage of the accumulated pus.
What we tend to say, is prostate cancer or any cause of a cancer is multifactorial. In that rather than there being one single cause to cause the cancer, there are multiple factors. If you look at the cancer incidence in Western societies and in India, what you will notice is it's a much higher incidence of prostate cancer in western societies. What that indicates is whatever the environment factors, whatever the dietary factors in western society they seem to be causing prostate cancer. These would include a high calorie diet intake, high fat intake, high processed meat intake, high refined sugar intake, high oil intake and high animal protein intake. These are the diets that we typically associate with western population, and these are the reasons for the higher incidence of prostate cancer. The other common factor that we tend to notice, is obesity is related to prostate cancer obesity, especially truncal obesity, where there is a quite a lot of fat around the tummy. We know that there is an alteration in the way they metabolize their hormones, thereby increasing the risk of prostate cancer.
As with any cancer in the early stages it would not cause any symptoms. The normal symptoms of urine passing difficulties which is passing urine more frequently needing to strain, to pass urine, needing to wake up in the night time to pass urine or presence of any blood in the urine. These are all tend to be symptoms that happen a bit later in the stage. If you want prostate cancer to be detected early, then the only way is we screen for it by doing a psa blood test. So the symptoms of prostate cancer are any difficulty with respect to passing urine and in more advanced stages. In case if the cancer has gone to the bones, you can have pain in relation to that. So symptoms of prostate cancer are related to the stage in early stages you would not have any symptoms.