The Prostate: It Keeps Growing and Growing
By SSM Health
When it comes to a man’s prostate, it really is a growing problem. In fact, doctors say all men will develop at least an enlarged prostate if they live long enough – it’s just part of the aging process.
“Everybody’s prostate is growing throughout their lives,” says SSM Health urologist Dr. Mitchell Kopnick. “It starts in your 40s and by your 50s the size of the prostate can lead to difficulty in urination.”
The prostate is a walnut-sized gland located near the bladder. An enlarged prostate is known medically as benign prostatic hyperplasia or BPH. It starts out as a nuisance and can stay just that. But, for some men, it progresses into something more dangerous.
“When it starts to cause permanent damage, it’s serious,” says Dr. Kopnick. “If it takes a long time to go to the bathroom, that’s an inconvenience. But if things get worse, the bladder may no longer being able to contract and push urine out. People who aren’t able to empty their bladder can develop kidney issues. And bladder stones - while not damaging – also won’t go away on their own and require surgery to fix.”
The most serious problem of all is prostate cancer, which is the second most common cancer next to skin cancer in men. Men who are diagnosed with prostate cancer have several treatment options, including surgery and radiation. Any treatment plan will be discussed with your doctor and may depend, in part, on your age.
“A watch-and-see approach will help you avoid the side effects of treatment,” says Dr. Kopnick. “Many times we find, especially in older men, they will die from other natural causes before the cancer can grow large enough to cause harm. That’s because prostate cancer is frequently slow-growing and slow to spread.”
Just hearing the word “cancer” can be unsettling for some people. But Dr. Kopnick says not all forms are cancer are the same.
“Hearing the word cancer in the 1970s meant you were likely going to die, but as patients are becoming more educated they realize not all cancer carries the same weight,” he says. “When you’re talking about screening for cancer I find most patients are willing to have the discussion. The danger comes in the patients who never have the discussion.”
So how do you detect prostate cancer? If you wait for signs and symptoms, the cancer could be already widespread. Instead, men should talk to their doctors about a prostate screening called PSA testing.
“For men with no family history, PSA testing should be done beginning at age 55. But for people with a family history and African Americans, this testing should really begin around age 40,” says Dr. Kopnick.
The question then becomes when to stop. Critics argue that long-term testing leads to overdiagnosing cancer in men whose lives wouldn’t have been impacted. Dr. Kopnick says that’s why guidelines now say you can stop looking for prostate cancer beginning around age 70 or when your life expectancy is 15 years or less.
Dr. Kopnick says there’s a lot of opinion out there on the topic of prostate health and it’s important for all men to be educated. “The key is for a patient to get informed, know your family history, and make a plan for themselves.”