The prostate is one of the most misunderstood organs in the male body. Yet, prostate cancer is the most common cancer in men – with around 52,300 men being diagnosed in the UK every year.
Below, we’ll take a closer look at what the prostate is, how it can change with age, and some of the warning signs and symptoms to look out for.
What is the prostate?
Only men have a prostate – and it’s a small gland, about the size of a walnut, that sits below the bladder and in front of the rectum. The urethra (the tube that carries urine and semen in men) runs through it.
The prostate gland is made up of muscle and glandular tissue, and its main job is to secrete a milky white alkaline fluid. This fluid nourishes and protects sperm from acidity in the vagina (which would otherwise destroy it), allowing it to reach and fertilise an egg.
The fluid also contains a protein-specific antigen (PSA) which makes sperm more watery so it can be transported more easily.
Prostate fluid makes up 20-30% of semen’s total volume – and although it’s made in the prostate gland, it’s stored in another small tube-shaped gland, called the seminal vesicle. This sits just above the prostate behind the bladder. During sex, fluid from the seminal vesicle and sperm from the testes are forced into the urethra and carried to the penis.
The function and development of the prostate is determined by testosterone (also known as the male sex hormone). Testosterone plays an important role in a number of different functions in the male body including sperm production, sex drive, and muscle size and strength.
How does the prostate change with age?
The prostate has two main growth phases – one during puberty when it doubles in size, and another when a man reaches the age of 25 (approximately). From the age of 25, it will continue to increase in size at a steady rate throughout a man’s life and may reach the size of a lemon.
It’s still not fully understood why the prostate continues to grow as men get older. Though it’s been suggested that it happens as a result of hormonal changes.
Prostate problems to look out for
Benign prostate enlargement (BPE)
Some men won’t experience any issues as their prostate grows with age. But The Urology Foundation says that 3.2 million men in the UK experience symptoms of benign prostate enlargement (BPE) or enlarged prostate.
BPE is more common in older men, and it typically describes what happens when the prostate gland puts pressure on the bladder and urethra as it grows – making urination more difficult or frequent. It can also make it difficult to fully empty your bladder.
If BPE is affecting your quality of life, it can be treated in a number of ways. For example, lifestyle changes such as cutting down your alcohol intake, drinking less before bed, and getting regular exercise, can help.
There are also medications available that can reduce prostate size, and relax your bladder to make urination easier. Plus, surgery may be recommended in severe cases after all other treatment options have been exhausted.
In some cases, BPE can cause complications, such as a urinary tract infection (UTI) or the inability to pass urine at all (acute urinary retention or AUR). AUR can cause severe pain and swelling in the lower tummy. If this happens, you should attend your nearest A&E department straight away.
BPE isn’t related to cancer and the NHS highlights that the condition doesn’t make you more likely to develop prostate cancer. However, while BPE isn’t usually a threat to health, the discomfort it causes can place a strain on daily life. Many men also find it embarrassing and can experience a loss of self-esteem as a result.
However, some symptoms of BPE can be similar to those associated with prostate cancer (such as an increased need to urinate). Therefore, if you experience any changes at all in your urination habits, it’s important to make an appointment with your GP who can investigate further.
Prostatitis
Prostatitis occurs when the prostate gland becomes inflamed and can cause pain in the surrounding areas. It occurs when bacteria from the urinary tract leaks into the prostate gland, and can also be caused by an infection that started in the bladder.
Prostatitis can occur at any age, though it’s most common between the ages of 30 and 50 – and the acute form of it affects one in every 10,000 men.
Symptoms of prostatitis can include…
- Pain in genitals, lower stomach, or back
- Pain when pooing or urinating
- Needing to urinate more often (particularly at night), problems starting to urinate, or a sudden need to urinate
- Blood in your urine
- Pain when ejaculating
- Not being able to urinate (acute urinary retention)
- Aching muscles and joints, sometimes coupled with fever and chills and generally feeling unwell
Acute prostatitis comes on suddenly and may last only a few days or weeks, whereas chronic prostatitis might last for three months or more. Men with chronic prostatitis can have symptoms that come and go over months or years.
If you have symptoms of prostatitis (particularly if they’re sudden or severe), it’s best to make an appointment with your GP who’ll ask you some questions and examine your stomach (and possibly your rectum) to feel for anything unusual. They might also ask you for a urine sample, as this can show signs of infection. If your GP is unsure about the prognosis, they might rule out other conditions by sending you to a specialist for more tests.
The bacterial infection that causes prostatitis can often be cleared with a course of antibiotics (usually tablets). Or, if you’re particularly unwell, your doctor might recommend that you receive antibiotics in hospital through an IV drip.
Alpha-blockers are also sometimes given to men with chronic prostatitis to make urinating easier – because they can help to relax the muscles around the neck of the bladder.
Prostate cancer
Prostate cancer is the most common cancer in men, and there are around 52,300 new prostate cancer cases in the UK every year.
While the causes are largely unknown, what we do know is that most cases of prostate cancer are seen in men over the age of 50.
The risk might also be higher in obese men, men who have a brother or father who has had the disease, or black men (one in four chance, compared with the one in eight chance that other men have).
Prostate cancer develops slowly over a number of years, and there may be no symptoms at first. Symptoms often won’t appear until the cancer has grown to a size where it’s putting pressure on the urethra and causing issues with urination.
Signs and symptoms of prostate cancer to look out for include…
- Needing to urinate more often
- Having to rush to the toilet very suddenly
- Waking often to urinate during the night
- Not emptying your bladder fully
- Having a weak flow of urine (even when the urge to use the toilet is strong)
- Straining to urinate, or taking longer than usual
- Finding it hard to start urinating, even when you feel desperate
- Blood in urine or semen
Having these symptoms doesn’t necessarily mean that you have prostate cancer, but it’s crucial to make an appointment with your GP who can run some tests and help you get to the bottom of what’s going on.
The first step will usually be to have a PSA test. This is a blood test, which will measure the amount of protein-specific antigen (PSA) in your blood. PSA is made in the prostate and can be used to make certain indications about its health.
Having high levels of PSA can sometimes indicate that there’s a problem (though not necessarily cancer). Your doctor might also do a urine sample, ask you to keep a bladder diary, and/or do a physical examination of your stomach area, penis, and prostate (which can be felt through the wall of your rectum).
The reason that PSA tests are not given routinely to all men is that although they can help to detect cancer in some cases, they can also miss cancer or produce a false-positive result. This can lead to false reassurance if there’s cancer, or extra tests (and worry) if there’s no cancer.
PSA tests also can’t distinguish between slow and fast-growing cancers. Some slow-growing cancers can be actively monitored for years and never cause any problems – so not being able to provide more early detailed information for patients about their prognosis can result in unnecessary worry.
However, whether you have symptoms or not, it’s important to note that you’re still entitled to a PSA test in the UK if you’re over the age of 50, and are aware of the pros and cons of testing.
If you have a PSA test and your levels are raised, or your doctor is concerned about the results of any other tests or about your symptoms, they may send you an MRI scan of your prostate to confirm whether or not there’s a problem. If the scan shows anything abnormal, a biopsy will be able to determine more about what the problem is, and whether cancerous cells are present.
To find out more about how prostate cancer is diagnosed, and what tests are used, have a read of our article; Prostate cancer – who’s at risk and what are the warning signs?
The prognosis for men with prostate cancer is usually good (and may not shorten a man’s life) if it hasn’t spread beyond the prostate. Treatment will usually depend on factors such as age and prognosis, but can also include options such as active surveillance, prostate removal, radiotherapy, chemotherapy, and hormone therapy.
How can I improve my prostate health?
At present, there are no proven methods for preventing prostate cancer. However, we do know that factors like age, ethnicity, and family history can play a role.
With that said, there are some things you can do to improve your prostate health and become more aware of your risk.
Maintain a healthy weight
Lifestyle is particularly important, as research shows that the risk of developing prostate cancer is higher in men who are overweight or obese.
So, taking steps to reach a healthy weight by making healthy food choices and getting regular exercise can help to lower your risk.
You’ll find plenty of healthy diet tips and ideas for how to become more active in the diet and nutrition and fitness and exercise sections of our website.
Make an appointment with a doctor straight away if you feel something isn’t right
Both men and women sometimes find it difficult to approach their GP if they feel something isn’t right with their health. This could either be because they don’t particularly like medical environments, don’t want to bother anyone, or have had a negative experience with a GP in the past (such as being dismissed or misdiagnosed).
If this sounds familiar, try to keep in mind that although going to the doctor is rarely favourable for anyone, it’s one of the most important things we can do for our health.
Prostate cancer is usually treatable if caught early, so it’s always worth speaking to your GP if you have any of the symptoms – or if you don’t have symptoms but are over 50 and would like to have a PSA test.
Remember, symptoms don’t necessarily indicate something serious, but it’s always best to get this confirmed by a doctor.
If you’ve had a negative experience with a particular doctor in the past, you can always request to see someone else. You can also request to see a male doctor if preferred.
Some men might also choose to go private – you can find information about 20,000 different private health professionals in this directory from Private Healthcare UK.
Where can I find more information about prostate health?
- Prostate Matters – information on prostate disease made available to everyone.
- NHS – Prostate problems – reliable information on a wide range of prostate issues.
- Prostate Cancer UK – funds life-changing research, and provides information, advice, and stats about prostate cancer.
- Men’s Health Forum – a British registered charity that aims to improve the health of men and boys in England, Scotland, and Wales.
- The Prostate Project – established in 1998 by prostate cancer patient Colin Stokes and his surgeon, it aims to give men the best chance at beating the disease.
- Orchid: Fighting Male Cancer – a charity that exists to save more men’s lives, by raising awareness of male cancers, offering support services, and carrying out pioneering research.
Do you (or have you had) any prostate problems? Do you have any tips, advice, or experiences that you’d like to share? We’d be interested to hear from you in the comments below.