The Prostate Gland In Men – What is it? Where is it? Important? Annual Screening?

Opinionn

What is it? The prostate, a walnut-sized gland, is part of the male reproductive system.

Where is it? The prostate gland is located just below the bladder in men and surrounds the top portion of the tube (the urethra) that drains urine from the bladder out through the penis located just below the prostate gland.

Important? The prostate’s most important function is the production of a fluid that, together with sperm cells from the testicles and fluids from other glands, makes up semen. The muscles of the prostate also ensure that the semen is forcefully pressed into the urethra and then expelled outwards during ejaculation.

Annual Screening? It has been my experience as a worldwide online mentor to men diagnosed with Prostate Cancer (PCa) and their caregivers for three decades that most men have not even been aware they have a prostate gland, let alone its importance, until they experienced urinary issues or were diagnosed with Prostate Cancer. This lack of awareness is an ongoing, continuing problem that was exacerbated by the U.S. Preventive Services Task Force (USPSTF) recommendations against prostate cancer screening. That recommendation was then associated with changes in clinical policy and/or practice wherein, particularly family practice physicians, never brought up the subject of the prostate, prostate issues, or prostate cancer to their male patients; this same practice continues to this day by these physicians who should be at the forefront of initiating awareness to their male patients entering advanced aging of 50 years and beyond (for some men explained below even earlier) of the variety of urinary problems of the prostate that come with this aging - frequent urge to urinate, need to get up many times during the night to urinate, blood in urine or semen, pain or burning urination, painful ejaculation, frequent pain or stiffness in lower back, hips, pelvic or rectal area, or upper thighs, dribbling of urine – and what may be causing these issues.

The necessity of awareness becomes even more so when cancer develops in that prostate gland! And that is where Prostate Cancer screening become important.

The necessity continues that all men be explained and encouraged annual prostate-specific antigen (PSA) blood level testing as well as digital rectal examination (DRE) of the prostate gland since the PSA remains one of the earliest signs of PCa development. In some patients their PSA level can remain low while PCa may be in development; the DRE for them is then particularly important. This examination includes the physician inserting a gloved, lubricated finger into the rectum and softly feeling the prostate gland periphery to determine if supple (a good thing) or whether feeling hard surfaces or nodules (of further concern). Elevated PSA blood level and/or adverse DRE support something is occurring in the prostate now supporting imaging prior to the invasiveness of biopsy, with Magnetic Resonance Imaging (MRI) with contrast currently found reliable in soft tissue observation. MRI has improved significantly as a next step that could then support whether a biopsy may be required to identify specifically the extent of development. The MRI also aids to guide locations of particular interest to target during biopsy. With collected information, physician and patient are aware whether active surveillance may be a safe option or further treatment is required.

I have always been a strong proponent that testing be started at age 35 for all men with a family history of PCa and black American men since these men have been proven to be prone to PCa development. All others no later than 45. Though one study of which I am aware concluded the DRE had been found to not be effective in identifying prostate cancer development in men these ages, it remains at least a choice for these men after being explained what the DRE might determine. As a mentor to men and their caregivers locally and online for three decades, I have personally known of many men in these age groups/categories who, by the time of testing, had cancer already in development - and too many with advanced, high-grade cancer already present resulting in their early demise from this insidious disease, Thankfully, over recent years and early diagnosis, many advances in imaging and treatment have saved, or at least extended, the lives of these men.

Annual screening for men to determine if Prostate Cancer is in development must be encouraged - The Life Saved May Be Yours, Your Family Member, Your Friend!.