Male Health: Prostate Gland Enlargement Awareness Campaigns

By Dr. Ita Udosen

Prostate gland enlargement commonly occurs in some Black-American males from 45 years and above and also in some African males from 50 years and above. The warning symptoms and signs may include some or all of the followings:
i) Frequent Urination mainly at night (Nocturia) initially and later both day and night

ii) Hesitation during urination

iii) Urinary Urgency

iv) Drippling urinary incontinence

v) Painful urination

vi) Straining to pass urine because of the bladder neck obstruction by the enlarged prostate gland

vii) At time there may be bleeding or blood in urination.

Types of Enlarged Prostate Gland (Tumor):

i) Benign Prostatic Hyperplasia (BPH) – which is not cancerous, not life threatening but causes a lot of urinary obstructive and discomforting symptoms.

ii) Malignant Prostatic Hypertrophy (Ca Prostate) – which is a malignant tumor that starts growing in the prostate gland and may be life threatening when ignored, not detected early and treated timeously. During the past 25 years or more, the overall 5-year survival rates for all stages of prostate cancer combined have shown remarkable increase from 69% to close to 100%. The reasons advanced for this increase are increased public awareness, early detection and intervention.

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Who May Get Prostate Cancer?

i) Generally, over 65% of all prostate cancers are diagnosed in men over the age of 65.years.

ii) Genetic factor – positive family history of prostate cancer in first-degree relatives (e.g. father). This shows 2 to 10% increased chances of having prostate cancer.

iii) Black Race – Blacks have 2 times more chances of having prostate cancer than the Caucasians. Because of this it is generally recommended that earlier prostate cancer screening (PSA) be carried out for Blacks beginning from age 45.

Possible Causes of Prostate Cancer:

There are no known specific causes but the risk factors include:

i) Old Age

ii) Black Race

iii) Environment factors

iv) Diet

v) Genetics

vi) Positive Family history

Symptoms of Prostate Cancer:

Early prostate cancer usually does not cause any symptoms. Some early symptoms may include but not limited to:

i) Frequent urination (especially at night)

ii) Weak urinary stream

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iii) Inability to urinate

iv) Interruption of urinary stream (stopping and starting)

v) Pain or burning sensation on passing urine

vi) Blood in the urine

vii) Pain in the lower back, pelvis or upper thighs.

Social Issues Associated with Prostate Cancer:

A diagnosis of prostate cancer in an individual requires a very diligent and careful handling by the Attending Physician as it may result in a range of emotions like:

i) Confusion

ii) Depression

iii) Frustration

iv) Fear

Early Detection of Prostate Enlargement (Screening):

Men 50 plus and those 45 plus from high-risk groups (African, African-American and men with positive family history of prostate cancer) as listed above should undergo yearly Prostate Specific Antigen (PSA) and digital rectal examination (DRE) for early detection of enlarged prostate.

What is Prostate Specific Antigen (PSA)?

PSA is a substance produced by the prostate cells. PSA check in the blood measures its level in the blood stream. Very little PSA escapes into the blood from a healthy prostate but certain abnormal prostate condition may cause larger leak of PSA into the blood.

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PSA level of 0-4ng/ml is regarded as normal for men while any PSA level above 4ng/ml signals abnormal prostate gland. Note that about 25% of men with prostate cancer may have PSA level of 4ng/ml or below.

Possible Causes of High PSA Level:

  1. A benign enlargement of the prostate called Benign Prostate Hyperplasia (BPH)
  2. Prostate Cancer (Ca Prostate)
  3. Prostatitis – infection (inflammation) of the prostate.

Confirmation of Prostate Disease:

This requires;

i) Diligent History and general physical examination

ii) Digital Rectal examination (DRE)

iii) PSA level test

iv) Prostate Biopsy for Histopathology and Gleason Staging if the above three items suspect prostate cancer.

Treatment Protocols:

i) Consult a Urologist for detailed advice and early intervention as may be necessary.

ii) Be advised that NO NATIVE nor TRADITIONAL INTERVENTION may treat your prostate disease.

Dr Ita Udosen is the Medical Director, Alma Clinic & Surgery

And a Public Commentator on Health Matters