Prostate health can be one of those topics that’s difficult to discuss. At the same time, it’s important to talk to your provider if you have any concerning symptoms.
“As men get older, it’s common for the prostate gland to enlarge,” says Dr. Andrew Maes, a Urology Specialist at ThedaCare Medical Center-Berlin. “One sign this might be happening is that you need to use the bathroom at night more often, or you might have a harder time starting urination.”
The prostate is a gland that is part of the male reproductive system. It’s about the size of a walnut, and it sits below the bladder. This means it can cause problems with urination if it enlarges. In that case, men also might feel a more frequent or urgent need to urinate, and they might have a urine stream that starts and stops or is weak.
“These symptoms are more than annoying,” Dr. Maes says.
Without treatment, symptoms will worsen over time. An enlarged prostate can cause infections of the urinary tract or bladder. It can also create a sudden inability to urinate or lead to kidney damage.
“When you visit your physician, a few things will take place,” Dr. Maes says. “We’ll perform a digital rectal exam to check the size of your prostate. We’ll also send a urine sample to the lab to rule out any infections that can cause similar health problems.”
In addition, your provider will conduct a blood test to check your prostate-specific antigen (PSA) level, which can increase when you have an enlarged prostate. PSA levels can also rise when you have an infection, have had a recent surgery, or have prostate cancer.
“For an enlarged prostate, generally medication is often the first treatment option,” Dr. Maes says. “Prescription medication can relax the muscles around the neck of the bladder, as well as the muscle fibers in the prostate.”
Medication also can also help shrink the size of the prostate. If medication is not effective, or if you already have severe symptoms, minimally invasive surgery is another option. Dr. Maes offers a minimally invasive, outpatient procedure called UroLift.
Prostate Cancer Screenings
Prostate cancer is one of the most common cancers in men. It’s normally contained to the prostate gland and grows slowly. However, some forms can be aggressive and spread to other parts of the body.
While screening can pose the risk of overdiagnosis and treatment of a cancer that may not become deadly, men who have a family history of cancer may want to get regular screenings. The American Cancer Society recommends men talk with their provider and make decisions about screening based on the available information and their understanding of the risks and benefits.
The organization offers the following recommendations about when to begin screenings:
- Age 50 for those who are expected to live at least 10 more years and have average risk of prostate cancer.
- Age 45 for men at high risk. This includes those with a father or brother who were diagnosed with prostate cancer younger than age 65, as well as Black men, who have a higher risk of developing an aggressive type of prostate cancer.
- Age 40 for males who have had more than one first-degree relative with prostate cancer younger than age 65.
“Always discuss your family history with your provider,” Dr. Maes says. “Other types of cancers in your family — including breast, ovarian, or pancreatic cancer — can mean you are also at higher risk for prostate cancer.”
Decisions about screening should continue as a man’s health status evolves over the years. Early detection can allow for better treatment outcomes for aggressive prostate cancer and for the option to monitor a slower-growing cancer.
“If you are having any symptoms of enlarged prostate, it’s important to be examined because prostate cancer symptoms are similar,” Dr. Maes says.
Additional symptoms that may indicate prostate cancer include:
- Blood in the semen
- Pelvic discomfort
- Erectile dysfunction
- Bone pain
You should see your provider promptly if you have any of these symptoms. If a PSA test and digital rectal exam indicate the possible presence of prostate cancer, your physician will schedule an ultrasound to take a closer look at the prostate.
“The good news is that there are treatment options available,” Dr. Maes says. “Prostate cancer may be treated with surgery, radiation, or hormone therapy, which can decrease the amount of testosterone in the body and either shrink or slow the growth of tumors.”
Depending on the size and location of the prostate cancer, treatment may not be necessary, Dr. Maes says. In that case, the patient would continue monitoring with regular blood tests and rectal exams to follow the progression of the cancer. A physician may recommend further treatments if tests show the cancer is growing.
“We want to encourage men to talk with their providers if they are experiencing any symptoms of an enlarged prostate or prostate cancer,” Dr. Maes says. “Our care teams are here to talk through any concerns men might have and empower them with information to feel confident about their health.”