Let’s Talk—About a Below-the-Belt Issue

Your prostate is a gland, roughly the shape and size of a walnut and weighing about 3/4 oz (22 mL), that is part of the male reproductive system. It’s located between the bladder and urethra and in front of the rectum.

What does it do?

Your prostate’s main function is to make fluid, containing various enzymes, zinc, and citric acid, that makes up one third of semen. While semen (and urine, of course) are flowing through the urethra, they pass by the prostate where the fluid made within the prostate is released into the semen. This prostate fluid mixed with sperm is important to men’s fertility.

What can go wrong?

Because all men have prostates, all men are at risk of developing prostate problems. Good reason to pay attention to that tiny, out-of-sight gland.

Benign prostatic hyperplasia (BPH)

With age, testosterone levels decrease, stimulating prostate growth. By age 40, the prostate gland begins to enlarge as benign tissue cells multiply, which may lead to a narrowing of the urethra and subsequent bladder problems, one of the chief symptoms of BPH. These symptoms can include waking often to urinate, an unusual smell or colour to the urine, or pain while urinating.

BPH is not linked to, and doesn’t increase risk of getting, prostate cancer—but BPH symptoms can be similar to those of prostate cancer, so don’t ignore them.

Prostatitis

Most often affecting younger men, prostatitis is an inflammation, or swelling, of the prostate that may be caused by bacteria. It’s often thought of as a type of men’s urinary tract infection. Prostatitis may cause symptoms involving urinating and bladder control—going to the bathroom frequently or trouble urinating when you’re there.

Importantly, having prostatitis doesn’t increase your risk of developing prostate cancer.

Prostate cancer

The most common cancer in Canadian men, prostate cancer usually grows slowly and can often be completely removed or managed successfully when diagnosed. Many older men have this disease without even knowing it, and often die of other causes.

How is it detected?

Digital rectal examination (DRE) to check the health of the prostate. A health care practitioner inserts a gloved finger into the rectum and feels the prostate for hard, lumpy, or abnormal areas. This test is usually recommended for men 50 and older. If there’s a family history of prostate cancer, a DRE may be recommended at a younger age.

Prostate-specific antigen (PSA) testing

PSA is a protein made by prostate gland cells that makes up part of the seminal fluid; testing PSA levels in the blood is used, along with other diagnostic tests like biopsies, to help detect prostate cancer and to monitor the recurrence or progression of cancer. But the presence of PSA in the blood does not necessarily mean there is a cancer: it could signal other issues such as BPH. It may also yield a false positive result.

How to prevent it

Unlike genetics, we may be able to control some of the environmental causes of prostate cancer.

• quit smoking; it may play a role in aggressive types of prostate cancer
• adopt a plant-based diet; vegan diets may reduce prostate cancer risks and increase your odds of surviving it
• limit alcohol consumption
• limit saturated fat, red meat, and dairy if you have other risk factors
• embrace soy (tofu, tempeh, etc.) and cooked (also canned) tomatoes to reduce risk
• get walking—outdoors!
• be mindful and take up meditation
• get enough quality sleep

Don’t procrastinate, men! You can advocate for your own prostate health. If you suspect you may have a problem “below the belt,” take charge of your health and visit your health care practitioner.