The Prostate: Its Function and Diseases

The prostate is a gland of the male reproductive system about the size and shape of a walnut. Located in front of the rectum, it wraps around the urethra (the tube that carries urine from the bladder out through the tip of the penis). The Prostate's main function is to produce fluid for semen, which transports sperm.

• BPH is a non-cancerous enlargement of the prostate. Symptoms result when the enlargement squeezes the urethra where it runs through the prostate. BPH is the most common of prostate conditions among men. It is more common among older men, because as a man ages, his prostate naturally enlarges. Starting at about age 40, levels of a hormone called prolactin begin increasing in men; this stimulates an increased production of the enzyme 5-alpha reductase. This in turn increases the metabolism of testosterone, resulting in an increase of the metabolic by-product di-hydro-testosterone or DHT. DHT is very unhealthy and has the undesirable effect of stimulating prostate cells into dividing and multiplying which causes the prostate enlargement. More than 50 percent of men age 60, and 80 percent of men age 80, are estimated to suffer from BPH. It is important to note that BPH does not necessarily lead to cancer; however, a man can have BPH and cancer at the same time.

• Prostatitis is an inflammation of the prostate.It is not contagious. Prostatitis is a mysterious ailment and most urologists will admit that, though in some cases they do understand its cause, many times they do not. Prostatitis is sometimes caused by bacteria similar to those which cause other types of urinary infections. Some patients however, have no evidence of bacteria in their prostates yet are thought to carry micro organisms such as Chlamydia or Ureaplasma, which are harder to identify by standard culture techniques. Still other patients have no evidence of any micro organisms at all. This makes it very difficult to diagnose and treat. Many urologists will "blindly" prescribe antibiotics, which seldom work, it is important to note that prostatitis sometimes develops from untreated BPH.

• Prostate cancer is a malignant tumour that most often begins in the outer part of the prostate. As the tumour grows, it may spread to the inner part of the prostate. Treatment options for prostate cancer include watchful waiting, hormonal therapy, radiation, brachytherapy and surgery.

Two tests critical to detecting men at higher risk of prostate cancer and other prostate diseases are the digital rectal exam (DRE) and the prostate-specific antigen test (PSA test). A high PSA can indicate a greater chance of developing prostate cancer. However, a high PSA does not necessarily mean cancer is present; many men with BPH also have elevated PSA levels