Introduction to Prostate Disease Prostate disease is a general term that describes a number of medical conditions that can affect the prostate gland. This information is provided by the NHS
The prostate gland
The prostate gland is a small gland that's only found in men. It's located between the penis and the bladder and it surrounds the urethra (the tube that carries urine from the bladder to the penis). The prostate gland’s main function is to help with the production of semen (the fluid that transports sperm). It produces a thick, white fluid that's liquefied by a special protein known as prostate-specific antigen (PSA). The fluid is mixed with sperm, produced by the testicles, to create semen.
Three main conditions can affect the prostate gland:
inflammation of the prostate gland (prostatitis)
cancer of the prostate
Below is a summary of these three conditions, plus links to more detailed information about each of them. Prostate enlargement Prostate enlargement is a very common condition associated with ageing. It's estimated that a third of men over 50 years old will have symptoms of prostate enlargement (see below). The urethra is a tube that runs from the bladder through the prostate to the end of the penis. Urine passes through the urethra and out of the body when a man urinates. If the prostate becomes enlarged it can place pressure on the urethra. This makes it harder for the bladder to empty. An enlarged prostate can cause symptoms that can affect the normal pattern of urination. For example, it can:
make it difficult for you to start urinating
weaken the flow of urine or cause 'stopping and starting'
cause you to strain to pass urine
cause you to urinate more frequently
wake you up frequently during the night to urinate
Treatment options for prostate enlargement include making lifestyle changes such as reducing the amount of liquid you drink before going to bed. Medications are also available to help relax the muscles within the prostate gland (alpha blockers) or reduce it’s size, making it easier to urinate. In severe cases that fail to respond to treatment with medicines, surgery can be used to remove the inner part of the prostate gland that's blocking the urethra. Read more about prostate enlargement.
Prostatitis is a poorly understood condition where the tissues of the prostate gland become inflamed (red and swollen). Inflammation sometimes occurs in response to infection, but in most cases of prostatitis no evidence of infection can be found.
Symptoms of prostatitis include:
pain when urinating (this is less common and more likely with a urinary tract infection)
pain when ejaculating semen
pain in the perineum (the area between the anus and back of the scrotum), which is often worse with sitting, especially on hard chairs and bicycle saddles
In England, it's estimated that 1 in 7 men will develop at least one episode of prostatitis during their life. Prostatitis can be treated using a combination of painkillers and a type of medication known as an alpha-blocker (see prostate enlargement), which helps to relieve the symptoms of prostatitis. Read more about prostatitis.
Prostate cancer is the most common type of cancer in men. It is responsible for 1 in 4 newly diagnosed cases of cancer in England and Wales every year. The chances of developing prostate cancer increase as you get older. Most cases occur in men who are 70 years old or over. The causes of prostate cancer are largely unknown. For reasons that aren't fully understood, the condition is more common in men of Afro-Caribbean or African descent and less common in men of Asian descent. The symptoms of prostate cancer are often identical to those of prostate enlargement. They include:
needing to urinate more frequently (often during the night)
needing to rush to the toilet
difficulty starting to urinate (hesitancy)
straining or taking a long time while urinating
feeling that your bladder hasn't emptied fully
The outlook for prostate cancer is generally good. This is because, unlike many other types of cancer, prostate cancer usually progresses very slowly. A man can live for many years without any symptoms or needing treatment. Many men die with prostate cancer, rather than as a result of having it.
Prostate cancer can usually be cured if treated in its early stages. Treatments include:
using surgery to remove the prostate gland
radiotherapy – radiation is used to kill the cancerous cells
hormone therapy – the growth of prostate cancer is stimulated by a hormone called testosterone, so hormone therapy involves using medication to block the effects of testosterone
All of the above treatment options carry the risk of significant side effects, including:
For this reason, many men choose to delay treatment until there's a significant risk that the cancer might spread. If the cancer spreads from the prostate gland to other parts of the body (metastasis), typically the bones, it can't be cured. In this case, treatment will aim to relieve the symptoms and prolong life. Approximately 10,000 men die as a result of prostate cancer every year in the UK.