Housecall

There's no denying that the prostate gland is a common source of trouble for men as they get older. So it's good to know that great care for prostate problems is available right here in our area.

Here are four important questions men may have about prostate health, with information from Brett Hill, MD, a urologist with UroHealth Partners in Columbus.

Why do prostate problems happen as men age?

The prostate is a reproductive gland that helps make semen. It's typically about the size of a walnut in your 20s, but it can grow to the size of a lemon by the time you're 60. In many men, the prostate grows large enough to interfere with urination, a condition called benign prostatic hyperplasia (BPH).

Symptoms include:

• Trouble starting a urine stream.
• A weak urine stream.
• Dribbling after you urinate.
• Waking up to urinate at night.
• Having an urgent need to urinate.
• Feeling like your bladder hasn't emptied fully.

Treatments for BPH include medications that relax muscles near the prostate or shrink the prostate gland. But if that doesn't help, a minimally invasive procedure may offer you relief. Options range from traditional transurethral resection of the prostate (TURP) to newer laser and thermal treatments, as well as a procedure that lifts the prostate out of the way.

Do I need prostate cancer screening?

Prostate cancer is another condition that becomes more common as men age. It often causes no early symptoms, which is why screening is important. One method is the prostate-specific antigen (PSA) test, which looks for elevated levels of PSA in the blood.

Talk with your doctor about the pros and cons of prostate cancer screening. "In general, men ages 55 to 70 with a life expectancy of at least 10 years and an average risk of prostate cancer should consider screening every two years," Hill said. Men at higher risk, including African American men or those with a strong family history of prostate cancer, may need to begin earlier or get screened more often.

Conditions other than cancer can cause a high PSA. A magnetic resonance imaging (MRI) prostate scan can help define the right next step. "It's an excellent test to clarify whether a high PSA requires a biopsy," Hill said.

What's more, MRI allows the medical team to target suspicious areas of the prostate more precisely for highly accurate results.

What if prostate cancer is found?

Not every prostate cancer requires immediate treatment. Because many cases are low-risk and grow slowly, active surveillance may be the best approach. That means closely monitoring the cancer with tests but only treating it if it starts to change in a way that could threaten a man's health.

"If we find cancer with a biopsy, there are newer tests we can do to help assess the risk of the disease — to see if treatment or active surveillance is appropriate," Hill said.

For instance, genomic testing on biopsy tissue taken at CCH can help estimate how likely the cancer is to grow or become harmful.

"It's testing the expression of proteins on different cancers, because they all come from different mutations," Hill noted.

MRI prostate scans at CCH have also become an important part of surveillance. MRI helps provide a clear view of whether anything is changing over time.

What if I need treatment?

Treatment options available locally may include surgery or radiation. For surgical treatment, the advanced da Vinci® Xi™ Robotic System is often preferred over more traditional methods.

"It's a more accurate approach," Hill said. "So you have less post-surgery pain and quicker recovery of function."

Categories: Men's health