All men have prostate gland, but do you know what it does and what can go wrong with it? It plays an important role in your reproductive health, and several common conditions can affect it.
The prostate is a walnut-sized gland that weighs about an ounce. It can be found just beneath the bladder and right in front of your rectum. It surrounds a section of the urethra, a small tube that extends from your bladder through your penis. Both urine and semen flow through your urethra and out of the body.
Behind and just above your prostate are two smaller glands called seminal vesicles. Together, the prostate and seminal vesicles produce semen, which helps carry and protect sperm during ejaculation. This function makes your prostate critical for reproduction. While you could live without your prostate, it would be difficult to have children without it.
What can go wrong with your prostate?
The three most common conditions that can affect your prostate are:
- Benign prostate hyperplasia (BPH), or enlarged prostate
- Prostatitis, or infection/inflammation of the prostate
- Prostate cancer
What is BPH?
The first thing to know about BPH: It’s not cancer, and having BPH does not raise your risk of prostate cancer. BPH refers to the growth of your prostate as you get older, and it is the most common prostate problem. Half of all men will have BPH by age 60. Nine out of ten men will have it by age 85.
Early in life, around the start of puberty, your prostate doubled in size. But it’s the next period of growth that you are much more likely to notice, as it can lead to symptoms of BPH. This growth period begins around age 25, and your prostate will continue to grow throughout your life. In some men, it could grow to the size of an orange.
Experts don’t know what causes BPH, but some research suggests that it could be due to age-related changes in the balance of the sex hormones testosterone and estrogen. As men get older, their testosterone levels tend to decline while estrogen levels stay the same. That means that the proportion of estrogen, a female sex hormone, rises. This could trigger the growth of prostate cells.
As the prostate grows, it begins to squeeze your urethra. This makes it more difficult for urine to flow from the bladder. As the bladder works harder to push urine out, it thickens and eventually becomes weaker and less able to empty.
This results in the following symptoms:
- Frequent need to pee
- Urgent need to pee
- A weak stream of urine
- Incomplete emptying of your bladder
- Waking up at least two times to pee during the night (a condition called nocturia)
Retaining urine in your bladder can cause bladder infections. It also can lead to kidney infections and other damage, including kidney failure. If you can’t empty your bladder at all, that’s a medical emergency. Go to the hospital right away!
What is prostatitis?
Often painful, prostatitis is inflammation of the prostate. About two million men see a urologist for some type of prostatitis each year, and nearly one in ten men will develop prostatitis at some point in their lives.
The different types of prostatitis include:
- Acute Bacterial Prostatitis is caused by a bacterial infection. Symptoms start suddenly and should not be ignored. They include:
- Burning or stinging when urinating
- Frequent and urgent need to pee, especially at night
- Severe chills and fever
- Pain around your genitals, lower back, and/or abdomen
If you’re experiencing these symptoms, go to the doctor’s office or the emergency room. Though treatable with antibiotics, the course of treatment can take four to six weeks.
- Chronic Bacterial Prostatitis may cause similar but less severe symptoms than the acute type of prostatitis. They develop slowly rather than suddenly and last for three months or more.
- Chronic Prostatitis (also called Chronic Pelvic Pain Syndrome) is the most common type of prostatitis. However, doctors don’t know a lot about its causes, and it’s hard to treat. This condition causes pain or discomfort in many places, including your penis, your bladder, your anus, and elsewhere. You may have difficulty and pain with urination. It can be painful to ejaculate as well.
- Asymptomatic Inflammatory Prostatitis causes no symptoms, and it usually does not require any treatment. However, it does tend to raise your PSA level. PSA, or prostate-specific antigen, is a protein produced by your prostate. When it rises above a certain level, it may indicate prostate cancer. Prostatitis does not cause cancer, but your doctor may want to do further tests to be sure it’s prostatitis that has boosted your PSA.
What is prostate cancer?
Prostate cancer occurs when cells in the prostate begin to multiply uncontrollably and form tumors. Why does this happen? Experts aren't sure. The disease develops very slowly, and many men never have symptoms. They die of prostate cancer but not from it. For such men, treatment may never be necessary, because they will die of another disease or old age before their prostate cancer causes any harm.
But in some men, prostate cancer can be quite aggressive, meaning that cancer grows and spreads quickly to other parts of your body. That makes it a particularly dangerous and difficult to treat form of the disease.
Except for skin cancer, prostate cancer is the most common cancer among men in the US. The American Cancer Society estimates that one in eight men will develop the disease. That’s a scary statistic. However, fewer than one in 40 men die from prostate cancer. Nearly 100% of men live at least five years after a prostate cancer diagnosis.
Who gets prostate cancer?
It’s very rare in men under 40; instead, it becomes more and more common with age. The average man with prostate cancer is 66 at the time he’s diagnosed. Nearly two-thirds of men with prostate cancer develop the disease after age 65.
The following factors can determine your prostate cancer risk:
- Advancing age
- Family’s health history: Have men in your family, particularly your father or a brother, had prostate cancer? If so, that puts you at higher risk, especially if your relative developed the disease before the age of 65. Don’t focus only on the men, however. Some genes involved in breast cancer and ovarian cancer also have been linked to prostate cancer, so if your mother or sister had one of those diseases, there’s cause for concern.
- African-American men: This demographic has a higher-than-average risk of prostate cancer as well as a higher risk of developing a more aggressive cancer. It’s not clear why.
- Overweight and obese men: This demographic tends to be diagnosed with more aggressive prostate cancer.
Treatment for prostate cancer is most effective in its early stages. However, symptoms of prostate cancer don’t usually occur until after the disease has advanced significantly. But here’s where things get complicated. Experts still debate whether men should be screened for prostate cancer. Why? Because the disease moves so slowly and often causes no harm, so treatment may do more damage than the disease itself. Experts recommend that men talk with their doctor about the pros and cons of screening and testing for prostate cancer.
American Cancer Society (2020). Prostate cancer risk factors
Cleveland Clinic (2020). Benign prostatic enlargement/hyperplasia
Mayo Clinic (n.d.) Prostate cancer
National Cancer Institute (n.d.) Prostate cancer
National Institute of Diabetes and Digestive and Kidney Diseases (2014). Prostate enlargement (benign prostatic hyperplasia)
Prostate Cancer Foundation (n.d.). About prostate cancer
Urology Care Foundation (n.d.) Prostatitis (infection of the prostate)
Zero - The End of Prostate Cancer (n.d.). What the BRCA gene means for men and families