If you’re asking “What is a prostate?” — chances are you are just hitting your '50s. Men hear the term from their doctors when they get prostate exams.
What is a prostate?
The prostate is a squishy gland in men about the size of an apricot or ping-pong ball.
Where is the prostate?
Located deep inside the groin, below the bladder, at the base of the penis, it lies in front of the rectum. The prostate surrounds the urethra, the tube that carries urine from the bladder to the penis. It is often described as having four zones.
What does the prostate do?
The prostate produces the milky fluid in semen that keeps sperm alive and propels it forward. Men don’t need a prostate to live, but they do need it to impregnate a woman. When a man ejaculates, the prostate contracts and squirts this fluid into the urethra, pushing the semen through.
The sperm travels from the testes along two tubes — the vas deferens — to the seminal vesicles, which are attached to the prostate and add more fluid.
What can go wrong with the prostate?
The three big possibilities are prostate cancer, benign enlargement of the prostate (BPH, or benign prostatic hyperplasia), and painful inflammation of the prostate, the most common cause of urinary tract infections in men.
An enlarged prostate can make it difficult or even impossible to urinate.
About one in seven men develop prostate cancer. Because of the prostate location, doctors look for lumps in the prostate by inserting a finger into the rectum.
Should every prostate cancer be treated?
Prostate cancer is the most commonly diagnosed cancer among American men, especially since prostate-specific antigen (or PSA) screening began in the late 1980s. The trouble with screening is that men run into false positives, biopsy complications, and over-diagnosis among 20 to 50 percent of the prostate cancers detected, according to a 2018 overview from the U.S. Preventive Services Taskforce.
Many prostate cancers don’t need treatment, as they’ll grow slowly, and you’ll die of something else. In a study of 30,000 American men age 65 and up who had been diagnosed with a low-grade local prostate cancer but who did not have surgery, radiotherapy, cryotherapy, or androgen deprivation therapy in the first six months, less than 6 percent died of prostate cancer in the next 15 years. Why would a man opt not to be treated? Treatments tend to carry the risk of sexual and urinary difficulties.
Who is at risk for an aggressive prostate cancer?
Some cancers are more dangerous, and researchers are looking now for reliable ways to know which require treatment. According to the Prostate Cancer Foundation, the risk factors for an aggressive prostate cancer include being tall, lack of exercise, exposure to Agent Orange, and a family history of the disease. African-Americans are more at risk.
Don’t worry that a vasectomy will increase your risk — that’s a disproven myth. Ejaculating frequently may lower your risk. Taking aspirin and statins may lower your risk as well. There is no link one way or another with alcohol.
March 18, 2020
Janet O’Dell, RN