Prostate Disease

Facts about the prostate gland:
The prostate is a sex gland in men. It is about the size of a walnut, and surrounds the neck of the bladder and urethra -- the tube that carries urine from the bladder. It is partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It is made up of three lobes: a center lobe with one lobe on each side.

The prostate gland secretes a slightly alkaline fluid that forms part of the seminal fluid, a fluid that carries sperm.  

Types of non-cancerous prostate problems:
There are clinical conditions of the prostate gland that are not cancer, including:

• infections
• inflammations
• benign prostatic hyperplasia (BPH) - an enlarged prostate

These problems are quite common and may happen to men of all ages.

Specific non-cancerous prostate problems:

• prostatism - a general term that describes any condition of the prostate that causes interference with the flow of urine from the bladder.

• prostatitis - a general term that describes an inflamed condition of the prostate gland. It may be accompanied by discomfort, pain, frequent or infrequent urination, and sometimes fever.

• prostatalgia - a term that describes pain in the prostate gland.

• benign prostatic hyperplasia (BPH) (sometimes called benign prostatic hypertrophy) - a specific term that defines the condition of an enlarged prostate. BPH is the most common non-cancerous prostate problem. It can cause discomfort and problems urinating. Although it is not cancer, BPH symptoms are often similar to those of prostate cancer.

• impotence - the inability to have or keep an erection.

• urinary incontinence - the loss of bladder control.  

Procedures used to evaluate prostate problems and/or cancer:
In addition to an annual physical examination that includes blood, urine, and possibly other laboratory tests, the National Cancer Institute and the American Cancer Society suggest talking with your physician about these recommendations for the evaluation of the prostate gland:

• DRE (digital rectal examination) - annually for men over the age of 50. In a digital rectal examination, the physician feels the prostate through the wall of the rectum. Hard or lumpy areas may indicate that cancer is present.

• PSA (prostate-specific antigen) testing - annually for men over the age of 50. The PSA test measures a substance called prostate-specific antigen made by the prostate. It is normal to find small quantities of PSA in the blood. PSA levels differ according to age and tend to rise gradually in men over age 60. PSA may become elevated due to infection (prostatitis), enlargement of the prostate, or cancer. Consult your physician to determine what is considered an elevated PSA level for your age.

Additional diagnostic tests for prostate cancer:
Based on results of the physical examination and laboratory tests, your physician may order additional diagnostic tests, including:

• transrectal ultrasound (TRUS) - this test uses sound wave echoes to create an image of an organ or gland so that physicians or technologists can visually inspect it for abnormal conditions, such as gland enlargement, nodules, penetration of tumor through capsule of the gland, and/or invasion of seminal vesicles. This procedure is also extremely useful for guidance of needle biopsies of the prostate gland and guiding the nitrogen probes in cryosurgery.

• other imaging techniques, such as computerized tomography (CT), magnetic resonance imaging (MRI), or intravenous pyelogram.

• cystoscopy (also called cystourethroscopy) - an examination in which a scope, a flexible tube and viewing device, is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.

• biopsy - the removal of a small tissue sample for microscopic examination. In a traditional biopsy, a large hollow needle removes a core or plug of the tissue. In a fine needle aspiration, the tissue is aspirated, or sucked out, of the suspected area.

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