Enlarged Prostate: Inevitable But Treatable

Dear Savvy Senior,

I have been seeing advertisements on television about older men who have erratic bathroom problems because of prostate enlargement. What can you tell me about this and can it lead to prostate cancer?

Gotta Go Joe

Dear Joe,

It's inevitable. Almost all men develop some prostate enlargement if they live long enough. In fact, prostate gland enlargement is so common, it affects about half of all men over age 50, and 90 percent of men in their 70s and 80s. But the good news is an increasing number of medications and surgical options is now available, making treating it easier than ever. Here's what you should know.

Enlarged Prostate

The medical term for an enlarged prostate is benign prostatic hyperplasia or BPH- a natural occurrence in middle-aged and older men. What happens is, as the prostate enlarges, it can squeeze on the urethra (the tube through which urine passes out of the body) and cause urinary problems. Do you have BPH? Common symptoms include: the frequent need to urinate (especially at night); sudden urge to urinate; a weak or slow urine stream; difficulty starting urination; stopping and starting again while urinating; dribbling after urinating; straining to urinate, and the feeling that you still have to go, even when you have just finished urinating.

Cancer Concern

BPH is not cancer. Although some of the symptoms of BPH and prostate cancer are the same, most men with BPH don't develop prostate cancer, and BPH does not increase the chance of getting prostate cancer. If you're experiencing some of the listed symptoms, and they've become bothersome, it's time to see your doctor. They can do a digital rectal exam to check the size of the prostate and order a prostate-specific antigen (PSA) blood test to rule out prostate cancer. If your doctor does find you have BPH, you'll be referred to a urologist for further testing.

What's Your Risk?

All men over age 50 are at risk of developing BPH, and the risk increases with age. Other factors that can hasten the process include having a family history of the condition, being overweight, smoking and stress. BPH is also more common in white and black men than in Asian men, and married men versus singles.

Treatment Options

If you're diagnosed with BPH, there are a variety of treatment options available depending on your signs and symptoms. If your symptoms are minor and don't bother you too much (see the Mayo Clinics prostate self-assessment tool at www.mayoclinic.com/health/prostatehealth/ MC00046D to help you evaluate your problem), you may want to postpone treatment, but you should still have regular check-ups to keep an eye on the condition. On the other hand, if your symptoms are bothersome, the first step is to try medication. Today, there's a variety of drugs your doctor can prescribe that can help relax or shrink the prostate to relieve symptoms. If medication doesn't do the trick, your next option is either nonsurgical therapy or surgery, both of which are very effective. Ask your doctor about the various treatment options and their possible side effects.

If you're interested in natural remedies, you need to know that saw palmetto, a popular, over-the-counter herbal supplement which is taken by millions of men for enlarged prostate may not be effective after all. A 2006 scientific study of 225 men with enlarged prostate published in the New England Journal of Medicine found that saw palmetto did no better than a placebo pill in relieving symptoms. The herbal supplement Pygeum, however, has shown promising results.

Savvy Tip: For more information, the National Kidney and Urologic Diseases Information Clearinghouse offers a free educational booklet, "What I need to know about Prostate Problems". You can order or see it online at www.catalog.niddk.nih.gov, or call 800- 860- 8747 to request a copy.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to "The NBC Today Show" and author of The Savvy Senior books.

The Gazette does not endorse the contents of The Savvy Senior. Check with professionals about the contents of this column.