Prostate and its care

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The gender differences in the biological determinants of health and illness include differential genetic vulnerability to illness, reproductive and hormonal factors, and differences in physiological characteristics during the life-cycle. Prostrate is one such glaring difference between men and women that strikes the former in the very face.

Many men aren't sure what their prostate is, what it does, or when to call a doctor if they think they might have a problem. So, information is the best tool they have in dealing with this aspect of men’s health.

It’s true that prostate problems are common after age 50. The good news is there are many things one can do to resolve them. After age 40, for reasons that may be hormonal, the prostate gland begins to enlarge.

The gland in the male body that is essential for fertility but not for erections, and just happens to enlarge, rather than shrink, with age, is the prostate. It is a small gland resembling the shape and size of a walnut in men that helps in making some of the fluid in semen, which carries sperms from one’s testicles when one ejaculates.

Located just below the bladder in front of the rectum, it wraps around the tube that carries urine and semen out of the body. It tends to grow larger as one gets older. It’s a normal part of aging for most men.

By age 40, one’s prostate might have gone from the size of a walnut to the size of an apricot and by age 60, it might be the size of a lemon. In terms of weight, it may grow from 20 grams to almost 100 grams.

If the prostate gets too large, it can cause a number of health issues. Because it surrounds part of the urethra, the enlarged prostate can squeeze that tube, which causes problems when one urinates. Typically, these problems are not visible until age 50 but these can start earlier.

Frequent urge to urinate, need to get up many times during the night to urinate, blood in urine or semen, pain or burning urination, painful ejaculation, frequent pain or stiffness in lower back, hips, pelvic or rectal area, or upper thighs and dribbling of urine are the most common symptoms of Benign prostatic hyperplasia. Prostate cancer is common among American men.

Benign prostatic hyperplasia, (BPH for short), is very common in older men. It means that the prostate is enlarged but not cancerous. Treatments for BPH include watchful waiting, also called active surveillance, medications, surgery or other treatments.

Sometimes radio waves, microwaves, or lasers are used to treat urinary problems caused by BPH. These methods use different kinds of heat to reduce extra prostate tissue.

If the symptoms are not too pronounced or bad, the doctor may advise 'wait and watch' to see if these get worse before starting treatment. Medicines can help shrink the prostate or relax muscles around it to ease symptoms. If nothing else works, the doctor may suggest surgery to help urine flow.

Acute bacterial prostatitis usually starts suddenly from a bacterial infection. See your doctor right away if you have fever, chills, or pain in addition to prostate symptoms.

Most cases can be cured with antibiotics. One may also need some medication to help with pain or discomfort. Chronic bacterial prostatitis is an infection that comes back again and again. This rare problem can be hard to treat.

Sometimes, taking antibiotics for a long time may work and requires consultation with a qualified doctor. Chronic prostatitis, also called chronic pelvic pain syndrome, is a common prostate problem. It can cause pain in the lower back, in the groin, or at the tip of the penis. Treatment may require a combination of medicines, surgery, and lifestyle changes.

Men aged 50 and above run a greater risk of a malignant prostrate. Prostate cancer is most common among African American men, followed by Hispanic and Native American men. Asian American men have the lowest rates of prostate cancer.

It can be traced to the family history as well. The risk of prostate cancer may be higher for men who eat high-fat diets. Until recently, many doctors encouraged yearly PSA testing for all men beginning at age 50, or even earlier for men at high risk of prostate cancer.

As doctors have learned more about the benefits and harms of prostate cancer screening, they have begun to caution against annual PSA testing. Yearly PSA testing in men without symptoms is generally not recommended.

However, in men who report prostate symptoms, PSA testing (along with digital rectal examination) can help doctors determine the nature of the problem. In men who have been treated for prostate cancer, the PSA test may be used to see if the cancer has come back.

Treatment for prostate cancer depends on whether cancer is in part or all of the prostate, or if it has spread to other parts of the body. It also depends on one’s age and overall health. If the cancer is not causing problems, one may decide not to get treated right away.

Instead, a regular medical check-up to monitor changes in one’s condition may be necessary. Treatment may start if the cancer begins to grow. If a surgery becomes necessary, the most common type of surgery removes the whole prostate and some nearby tissue.

In Radiation therapy, radiation is used to kill cancer cells and shrink tumours. Men having other treatments, like radiation therapy, also may be treated with drugs to stop the body from making testosterone for which hormone therapy is done. Hormone therapy also can be used for prostate cancer that has spread beyond the prostate.

One should reconcile to the fact that every man will have prostate enlargement if he lives long enough. The good news, however, is that there are lifestyle changes that can help men after 40 to maintain optimum prostate health.

We all know that prevention is better than cure. If we take precautionary measures, we may not have to undergo these treatments and surely, if we cannot fully prevent the onset of this disease, we can surely delay it considerably depending upon how rigorously we follow the prescribed preventive measures.

We should take a close look at our diet. 33 percent of all cancers, according to the US National Cancer Institute, are related to what we eat. Red meat everyday triples our chances of prostate disease; milk everyday doubles our risk and not taking fruits / vegetables daily quadruples our risk. Smoking enhances the risk several fold and should be avoided. It also affects blood vessels and impacts circulation around the groin.

Tomatoes are very good for men. It has loads of lycopene. Lycopene is the most potent natural antioxidant. Foods that are rich in zinc are also good for men. Zinc is about the most essential element for male sexuality and fertility. Men need more zinc than women.

Every time a man ejaculates, he loses 15mg of zinc. Zinc is also important for alcohol metabolism. As men begin to have urinary symptoms associated with prostate enlargement, it is important they review their alcohol consumption. More fluid in means more fluid out. So, drink less and drink slowly.

Exercise helps build the muscle tone. Every man should exercise. Men over 40 should avoid high impact exercise like jogging. It puts pressure on the knees. Cycling is bad news for the prostate.

Brisk walking is a better option. When we sit, two-third of our weight rests on the pelvic bones. Men who sit longer are more prone to prostate symptoms. Do not sit for long hours. Walk around as often as one can. Sit on comfortable chairs.

Men should avoid tight underwear. It impacts circulation around the groin and heats it up a bit. While the physiological temperature is 37 degrees, the groin has an optimal temperature of about 33 degrees. Pant is a no-no for men. Wear boxers. Wear breathable clothing.

Regular sex is good for the prostate. Celibates are more prone to prostate illness. While celibacy is a moral decision, it is not a biological adaptation. Your prostate gland is designed to empty its contents regularly.

A practical tip: "Pieces of lemon in a glass of hot water can save you for the rest of your life," says Professor Chen Horin, Chief Executive of the Beijing Military Hospital. “Hot lemons can kill cancer cells! Cut the lemon into three pieces and place it in a cup, then pour hot water, it will become (alkaline water), drinking it every day will certainly benefit everyone. Hot lemons can also release an anti-cancer drug. Hot lemon juice has an effect on cancerous tumours and has shown treatment for all types of cancer. Treatment with this extract will only destroy the malignant cells and will not affect healthy cells. Moreover, the acids and mono-carboxylic acid in lemon juice can regulate hypertension and protect narrow arteries, adjust blood circulation and reduce blood clotting.” Professor Chen Horin points out that anyone who follows these tips is guaranteed to save his own life and someone's life as well.

The author is former Indian Revenue Service and retired as Director General of Income Tax (Investigation), Chandigarh. He is also the Chairman of Vitasta Health Care Trust.

Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.

The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.

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