condition also seems to be uncommon in Chinese and
other Asians, for reasons that are not clear.Causes and symptomsProstate cancer
The precise cause of prostate cancer is not known.
However, there are several known risk factors for
disease including being over the age of 55, African
American heritage, a family history of the disease,
occupational exposure to cadmium or rubber, and a
high-fat diet. Studies suggest that men who eat a diet
high in animal fat or meat may be at increased risk for
prostate cancer, whereas men who eat a diet rich in
fruits and vegetables may have a lower risk. Men with
high plasma (blood) testosterone levels may also have
an increased risk for developing prostate cancer. Fre-
quently, prostate cancer has no symptoms and the
disease is diagnosed when the patient goes for a rou-
tine screening examination. However, when the tumor
is big or the cancer has spread to the nearby tissues, the
following symptoms may be seen:
Weak or interrupted flow of urine
Frequent urination, especially at night
Difficulty starting urination
Inability to urinate
Pain or a burning sensation when urinating
Blood in the urine
Persistent pain in the lower back, thighs, or hips
Painful ejaculationBPH
The cause of BPH is a mystery to medical research-
ers, but age-related changes in hormone levels in the
blood may be a factor. Whatever the cause, an enlarg-
ing prostate gradually narrows the urethra and
obstructs the flow of urine. Even though the muscle
in the bladder wall becomes stronger in an attempt to
push urine through the smaller urethra, in time, the
bladder fails to empty completely at each urination.
When the enlarging prostate gland narrows the ure-
thra, a man will have increasing trouble starting the
urine stream. Because some urine remains behind in
the bladder, he will have to urinate more often, per-
haps two or three times at night. The need to urinate
can become very urgent and, in time, urine may drib-
ble out to stain a man’s clothing. Other symptoms of
BPH are a weak and sometimes a split stream, and
general aching or pain in the perineum (the area
between the scrotum and anus). Some men may have
considerable enlargement of the prostate before even
mild symptoms develop.Diagnosis
Prostate cancer
Prostate cancer is curable when detected early. Yet
there are often no symptoms during the early stages of
prostate cancer, so the disease often goes undetected
until the patient has a routine physical examination.
Diagnosis of prostate cancer can be made using some
or all of the following tests: a digital rectal examina-
tion, blood tests, ultrasound, a needle biopsy, x rays,
computed tomography (CT) scan, and magnetic reso-
nance imaging (MRI).BPH
When a man’s symptoms point to BPH, a physi-
cian will usually do a digital rectal examination, insert-
ing a finger into the anus to feel whether—and how
much—the prostate is enlarged. A smooth prostate
surface suggests BPH, whereas a distinct lump in the
gland might mean prostate cancer. The next step is a
blood test for a substance called prostate-specific anti-
gen (PSA). Between 30-50% of men with BPH have an
elevated PSA level. Studies indicate that the PSA level
can be used as a predictor of a man’s long-term risk of
developing BPH.Treatment
Prostate cancer
Treatment options include surgery, radiation ther-
apy, chemotherapy, and hormone therapy. The doctorKEY TERMS
Androgen—A male sex hormone.
Benign—Non-cancerous.
Benign prostatic hyperplasia (BPH)—A non-
cancerous condition of the prostate that causes
growth of the prostate tissue, thus enlarging the
prostate and obstructing urination.
Prostate-specific antigen (PSA)—A blood test that
helps in the early diagnosis of prostate cancer.
Testosterone—A male sex hormone produced
mainly by the testicles.
Urethra—The tube that carries urine from the blad-
der out of the body and in men carries semen dur-
ing ejaculation.Prostate