9 Things Your Prostate Secretly Wants to Tell You

The little gland has lot to say about aging, cancer, and mispronunciations.

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My name is prostate, not prostrate

iStock/john shepherd

Prostrate—with that r—means lying face down on your bed, on the floor, wherever. It can also describe being completely overcome or made unable to function, such as someone who is prostrate from the heat, by grief, or ... from being confused with another word so. many. times. What prostrate cannot describe is the gland located directly below the bladder and in front of the rectum. That is the prostate—no r—that is part of a man’s reproductive system. Now please, go forth and correct everyone else who makes that mistake.

I help chauffer your sperm

iStock/Ugurhan Betin

That’s essentially this small gland’s big job—to produce fluid that makes semen, which helps nourish, protect, and transport sperm. The prostate gland surrounds part of the urethra, the tube through which urine and semen flow. When you climax, the muscles of the prostate contract, forcefully squeezing the stored fluid into the urethra, which mixes with sperm from the testicles before being ejaculated as semen. That milky-looking fluid contains enzymes which help thin and loosen semen so sperm can reach the egg during intercourse, as well as a hormone-like substance spermine, which helps sperm cells move.

My growth spurt never ends

iStock/delihayat

In early puberty, the prostate doubles in size and holds steady at a walnut shape until you hit your mid 20s. Then for reasons still unclear, it starts growing again, and doesn’t stop: by age 40, the gland may reach apricot size; by age 60, as big as a lemon. What can, and often does, happen is that the enlarged prostate presses up against the bladder and squishes the urethra that runs through it, which can mess with urine flow. And by ‘mess with’ we mean it becomes difficult to start peeing, even when you feel like your bladder is going to explode; then once you start, it’s tough to stop. Some men may feel a constant need to pee, day or middle of the night. The medical name for this enlargement is benign prostatic hyperplasia (BPH); it affects about half of all men between the ages of 51 and 60, and up to 90 percent over age 80. Talk to your doctor if you experience symptoms—in some cases, medications can help treat symptoms, in others, minimally invasive therapies or surgery may be recommended. Here's how an enlarged prostate can give you UTIs.

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Peeing fire water? Probably my fault

iStock/Ridvan çelik

That’s a sign your prostate is inflamed, a condition called prostatitis, which one in 10 men will experience at least once in their life. Sometimes it’s caused by a bacterial infection, other times the culprit is unknown; sometimes the pain comes and goes quickly, other times it’s a more gradual onset and lasts for months. And any which way, it’s just not pleasant. Depending on the underlying cause, your doctor may prescribe antibiotics to treat an infection, or alpha blockers to help relax muscle fibers in your prostate and lessen symptoms.

Sorry about that exam

iStock/AJ_Watt

But really, it’s the only way the doctor can feel the prostate gland for any enlargement, tenderness, lumps, or hard spots. Digital rectal exams (DRE) can help distinguish between prostate cancer and non-cancerous conditions, such as an enlarged prostate. File DREs under the necessary evils category.

Please don’t freak out if your PSA levels are high

iStock/Renee Keith

Prostate-specific antigen, or PSA, is a protein produced by cells of the prostate gland. Testing for elevated levels in your blood is one way to screen for prostate cancer. That said, many other conditions, such as an enlarged prostate or prostate infection, can also increase PSA levels. In fact, studies have shown that about three out of four men with an elevated PSA do not have prostate cancer. If cancer is suspected, however, your doctor may perform other tests, including a digital rectal exam (sorry again), an ultrasound and a biopsy to confirm a diagnosis.

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Screening me for cancer is a tough (and personal) decision

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It’s understandable why you want to—after skin cancer, prostate cancer is the most common cancer in American men; about one man in seven will be diagnosed in his lifetime. And in its early stages, prostate cancer often has no symptoms; it’s not until the more advanced stages of prostate cancer that you’ll experience trouble urinating, blood in your semen, or other prostate cancer signs. But whether or not a healthy man with no symptoms should screen for prostate cancer is controversial, at best. The benefits of a PSA test is that it may identify cancer early on, when treatment is most effective; the downsides: the test is not foolproof, and may miss some prostate cancers, or result in a false-positive—giving you anxiety and perhaps leading to unneeded medical procedures, such as a prostate biopsy. Or, a PSA test may detect prostate cancer, but one that probably never would have caused any problems. Studies have estimated up to 42 percent of men with prostate cancer detected by PSA tests have tumors that wouldn’t result in prostate cancer symptoms during their lifetimes. Treating tumors that are not life threatening unnecessarily exposes men to the potential complications and harmful side effects of treatments, including surgery and radiation therapy. Some medical organizations recommend men consider prostate cancer screening in their 50s, or sooner for those who have risk factors; other organizations advise against PSA screenings altogether. What should you do? Talk to your doctor about the risks, uncertainties, limitations, and potential benefits to help you make an informed decision about PSA testing.

Living here affects my chances of getting cancer

iStock/Alex Potemkin

It sounds crazy, but calling North America home puts you at a higher risk for prostate cancer. It’s also more common in northwestern Europe, Australia, and on Caribbean islands. Your friends in Asia, Africa, Central America, and South America are at a lower risk. Experts don’t know why exactly, but suspect more intensive screenings and lifestyle factors play a role. Another possible risk factor for developing prostate cancer: a diet high in dairy foods and calcium, according to some studies. What scientists know for sure: increasing age, family history and race affect your odds.

Exercise reduces my risk of cancer

iStock/DaniloAndjus

Regular physical activity improves your overall health and helps you maintain a healthy weight, and some evidence shows men who who work out regularly may have a lower risk of prostate cancer. If you’re diagnosed with prostate cancer, sticking to a moderate or intense exercise regimen may improve your odds of surviving, according to a new study recently presented at the American Association for Cancer Research annual meeting. Learn more ways to prevent prostate cancer.


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