November is Prostate Cancer Awareness Month. If you don’t know what your prostate is, where it is, or how it affects your health we’ve got you covered with our guide to prostate health.
Frequently Asked Questions
What and where is the prostate?
The prostate is the male reproductive gland that produces fluid for semen. It is roughly the size of a walnut and sits at the base of your bladder and in front of your rectum (back passage).
Are prostate problems common?
Prostate problems are common in men, particularly in those over 50 years of age. The older you get, the more common it is for your prostate gland to grow bigger. An enlarged prostate can put pressure on the urethra (the tube that drains the bladder), and sometimes this can cause problems passing urine.
It’s important to note that an enlarged prostate is a benign condition and not related to prostate cancer.
Signs of an enlarged prostate can include:
- A slow flow of urine
- Trouble starting or stopping the flow
- Passing urine more often, especially at night
- Pain when passing urine
- Blood in the urine or semen
- Feeling of not emptying your bladder fully.
See your GP if you notice any problems with, or changes to, your usual pattern of urination.
Does an enlarged prostate increase my risk of cancer?
Many men worry that having an enlarged prostate means they have an increased risk of developing prostate cancer. This isn't the case. The risk of prostate cancer is no greater for men with an enlarged prostate than it is for men without an enlarged prostate. It's not known why the prostate gets bigger as you get older, but it is believed to be linked to hormonal changes as a man ages. The balance of hormones in your body changes as you get older and this may cause your prostate gland to grow.
What help is available for prostate enlargement?
In some men, the symptoms are mild and don't need treatment. In others, they can be more problematic. Simple lifestyle changes such as drinking less alcohol and caffeine (particularly before bed) and exercising regularly can sometimes help control the symptoms. In more moderate to severe cases, your GP may prescribe medication which can help reduce the size of your prostate and relax the muscles of your bladder.
Are there other prostate problems I should be aware of?
Unlike prostate enlargement or prostate cancer, which usually affects older men, prostatitis (a condition where the prostate gland becomes inflamed) can develop in men of all ages. However, it's generally more common in men between 30 and 50 years of age.
Symptoms of prostatitis can include:
- pain in the pelvis, genitals, lower back and buttocks
- pain when urinating
- a frequent need to urinate
- difficulty urinating
- pain when ejaculating
- pain in the perineum (the area between the anus and scrotum), which is often made worse by prolonged sitting
See your GP right away if you have any of these symptoms.
How is prostatitis treated?
Prostatitis can be treated using a combination of painkillers and a course of antibiotics Medication that shrinks the prostate gland may also be helpful.
Your chances of developing prostate cancer increase as you get older. The condition mainly affects men over 65, although men over 50 are also at risk. Prostate cancer usually develops slowly, so there may be no signs you have it for many years. Furthermore the symptoms can be difficult to distinguish from those of prostate enlargement - like an increased need to urinate, straining while urinating and a feeling that your bladder has not fully emptied. You should see your GP if you have any of these symptoms. It's much more likely to be prostate enlargement, but it’s important to rule out cancer.
How is prostate cancer diagnosed?
Because early prostate cancer does not usually cause any symptoms, it is sometimes identified through prostate cancer screening. This involves your GP checking for the possibility of prostate cancer when you have no symptoms. The screening involves an examination of the prostate gland (called a digital rectal exam) and a special blood test called the PSA which measures a protein made by the prostate gland called prostate specific antigen.
It is important that these tests (DRE and PSA) are carried out in combination with each other.
What’s involved in a digital rectal exam?
A digital rectal exam (DRE) involves your doctor putting a gloved finger into your rectum (back passage) to feel for abnormalities like an area of hardening or a lump on the prostate or an enlarged prostate.
It sounds embarrassing. Is it uncomfortable?
Some people find having a rectal examination embarrassing, but it is quick and isn't usually painful.
What happens if my GP finds an abnormality?
A rectal examination isn't a guaranteed way of diagnosing prostate cancer, so it should be used in combination with other tests, such as a PSA blood test and if required a biopsy (where a small sample of the prostate gland is removed for further testing).
Should I be screened for prostate cancer?
While routine screening may identify prostate cancer, there has been debate in the medical community about how to properly use the PSA test and how effective it is.
The PSA test can only indicate a possible prostate problem - it doesn’t specifically diagnose prostate cancer. PSA screening may thus result in false positive results which risk leading to over-investigation or over-treatment, or on the other hand to falsely reassuring negative results i.e. negative results despite the presence of a cancer. It is important to remember that the level of PSA in the blood stream can rise if you have prostate cancer but it can rise for other reasons as well, so a raised PSA does not necessarily mean you have prostate cancer.
It’s worth noting that two out of three men with a raised PSA do not have prostate cancer, and some men with prostate cancer do not have a raised PSA level. We recommend our patients discuss the risks and benefits with their GP before decide to undergo screening.
At Briarhill Family Practice we are happy to discuss your concerns and help guide you an informed decision on prostate cancer screening.
How do I know if I am at risk?
Risk factors that can increase your chance of getting prostate cancer include:
- Age: Your risk increases as you get older. Most men diagnosed with prostate cancer are aged over 50 years.
- Family history: Men whose brother or father developed prostate cancer at a young age have an increased risk.
- Race: African-American and African-Caribbean men are more at risk than other ethnic groups.
- Diet: Men who eat a lot of red meat and high-fat dairy products and not enough green vegetables may have a slightly higher chance of getting prostate cancer.
Can I do anything to reduce my risk?
Being physically active, reducing your intake of red meat, and maintaining a healthy weight are some of the best ways to protect yourself from getting cancer.
What is the outlook for prostate cancer?
In Ireland, prostate cancer is the second most common cancer in men, after skin cancer. Each year over 3,400 men are diagnosed with prostate cancer in Ireland. This means that one in eight men will be diagnosed with prostate cancer during their lifetime. The outlook for prostate cancer is generally good because, unlike many other types of cancer, it usually progresses very slowly. If the cancer is at an early stage and not causing symptoms, a policy of careful monitoring may be adopted. If required, treatments include surgically removing the prostate, radiotherapy and hormone therapy. All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary incontinence. For this reason, many men choose to delay treatment until there is a risk the cancer might spread.
Read the Irish Cancer Society’s booklet Understanding Early Prostate Cancer for more information.
This content was developed from HSE, NHS, Irish Cancer Society and Patient sources and is adapted for Briarhill Family Practice by Briarhill Family Practice GPs.
Date Last Reviewed: 14/11/2017