All jokes about latex gloves and ice-cold lube aside, if you were to name the top 10 things most men—gay and straight—would rather just avoid, prostate exams would be high on the list. But there’s no good excuse to ignore the walnut-sized gland that forms part of the normal male reproductive system. Located just below the bladder, the prostate’s primary function is the production of fluid in semen; it also contains some smooth muscles that help expel semen during ejaculation, and its stimulation plays an important role in the so-called "male g spot" of receptive anal sex. But this small gland is also prone to inflammation and disease, particularly in older men. Three main problems can occur in the prostate gland: infection, enlargement, and cancer. Here’s what you need to know today, to protect your prostate tomorrow.
Feel the Burn: Prostate Infection
Prostatitis is a term that describes a wide range of infections affecting the prostate. But it can also be an inflammation with no sign of infection. Types of prostatitis include:
- Acute bacterial prostatitis is a sudden bacterial infection marked by inflammation of the prostate. This is the least common form of prostatitis but the symptoms are usually severe. Men with this condition often experience a concurrent acute urinary tract infection (with increased urinary frequency and pain), pain in the pelvis and genital area, as well as fever, chills, nausea, and vomiting.
- Chronic bacterial prostatitis is the result of recurrent urinary tract infections that have entered the prostate gland. The symptoms are similar to acute bacterial prostatitis, but are generally much less severe.
- Chronic nonbacterial prostatitis is the most common form of the disease, accounting for 90 percent of the cases of prostatitis. The condition is marked by urinary and genital pain for at least three months, but with no bacteria in the urine.
When Bigger Definitely Isn't Better: Prostate Enlargement
Normally the prostate is quite small, but with time and age it can enlarge. An enlarged prostate, nowadays called BPH (benign prostatic hyperplasia), forces pressure on the urethra (like a clamp on a garden hose) and interferes with the normal flow of urine. The blocking of the urethra, and the gradual loss of bladder function, which results in partial emptying of the bladder, are responsible for many of the problems associated with BPH.
Benign means not cancerous and hyperplasia means excessive growth, and while BPH is not linked to cancer and does not raise your chances of getting prostate cancer, the symptoms for BPH and prostate cancer can be similar. Common, annoying symptoms include frequent urination, an urgent need to urinate, and dribbling. And although these aggravating symptoms rarely show up before age 40, more than half of men in their sixties, and as many as 90 percent in their seventies and eighties have some symptoms of BPH.
While it is extremely common for the prostate to become enlarged as a man ages (as common as gray hair in fact), the exact cause is not well understood. The only established risk factors for BPH are age and family history. Researchers believe, however, that over time the prostate becomes more vulnerable to the effects of male hormones, including testosterone. Men who use testosterone supplements have a higher risk of prostate enlargement.
While science has developed plenty of treatments for an enlarged prostate, ideally you should do your best to prevent it before the trouble begins. Prostate dysfunction has been called a nutritional disease and it is much more common in developed Western countries that emphasize animal-derived foods, such as red meat, dairy products, and eggs, than in Asia, where diets include more fruits and vegetables.
Foods strongly influence sex hormones, including testosterone, and researchers have found that cutting down on meats and dairy products, and pumping up the vegetables, can turn down the hormonal stimulation of the prostate and help stave off prostate problems. In fact, daily meat consumption triples the risk of prostate enlargement, regular milk consumption doubles the risk, and failure to consume vegetables regularly nearly quadruples the risk.
Studies also link high caloric intake with prostate enlargement. Research suggests that excess calorie consumption may directly stimulate prostate enlargement through excess body fat and its effects on hormone levels. And because regular exercise directly affects hormone levels and helps maintain a healthy weight, regular physical activity may also discourage BPH.
One in Six Men: Prostate Cancer
The third major problem that can occur in the prostate is cancer. Because it grows quietly for years, most men with the early stages of the disease have no obvious symptoms.
"Prostate cancer is the most commonly diagnosed cancer among American men, and it is estimated that one out of every six men will develop prostate cancer," says Jonathan W. Simons, MD, chief executive officer and president of the Prostate Cancer Foundation, and founding director of the Winship Cancer Institute at Emory University in Atlanta. "As the prostate grows, it does not bump up against something that can be felt internally. It can only be detected in an annual exam by a physician or urologist using a digital rectal exam (DRE)."
When prostate cancer symptoms do occur, they may be similar to those of an enlarged prostate. Symptoms of prostate cancer include a need to urinate frequently; difficulty starting or stopping urination; dribbling or weak urine flow; painful urination; difficulty in getting or maintaining an erection; painful ejaculation; blood in the urine or semen; and pain in the lower back and hips.
Prostate cancer has become increasingly treatable in recent years. With treatment options now ranging from radiation to hormone therapy to surgery and beyond, survival rates from prostate cancer are now higher than 90 percent in the U.S. The earlier the cancer is detected, the higher the survival rates; the American Cancer Society recommends that men should begin getting screened annually starting at age 50, and that men at higher risk, such as African American men and those with a strong family history of prostate cancer, should begin yearly testing at age 45.
As treatment research continues, so does concurrent research on prostate cancer prevention, a fast-growing area of medical research with much of the research focusing on nutrition and lifestyle choices.
“We are busy funding research into the unanswered questions regarding nutrition and lifestyle choices," says Dr. Simons. "We know that the genes you're born with and the environment you're in, including what you're fed as a child and as a young adult, interact in creating a risk over a man's lifetime for prostate cancer. We're also funding research on whether or not there are 'hit-and-run' viruses and infections that might cause the later occurrence of prostate cancer. Yet, we still don't have all the answers to these very important questions.”
While current research does not fully support definite nutritional guidelines for preventing prostate cancer, according to Dr. Simons, more than 20 minutes of exercise per day and a diet rich in fruits and vegetables are very good recommendations. Below, some of the most recent data on diet and exercise and their effects on the prevention of prostate cancer:
- Fat: Prostate cancer rates vary greatly from one country to another, with the highest rates appearing in countries where people tend to consume a lot of fat. In fact, the number of prostate cancer deaths in a given country rises in direct proportion to the average total calories from fat in that country's diet.
- Fruits and vegetables: Studies link a diet high in vegetables to a lower risk of prostate cancer. Soybeans and lycopene-rich fruits and veggies such as tomatoes, pink grapefruit, and watermelon seem to be particularly protective.
- Fish: One study found that men who ate no fish were two to three times more likely to develop prostate cancer as men who ate moderate to large amounts of fish. Types of fish that are rich in the fatty acids that protect against prostate cancer and other diseases include salmon, herring, and mackerel.
- Obesity: Studies have suggested that carrying around too much extra weight might affect levels of hormones related to prostate cancer risk.