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The ABCs of prostate health

Florence Morning News - 6/17/2018

One of the concerns many men encounter as they age is prostate health.

Men often hear lots of abbreviations tossed around when discussing this sensitive topic. Two of the most common are BPH and PSA, and it would help all men, and those who love and care for them, to take the mystery out of those terms.

Before discussing those terms, we need to know more about the prostate. The prostate is a gland found only in males and is part of the reproductive system. It sits below the bladder and in front of the rectum. Simply put, three things can happen to a prostate over time: nothing, enlargement of the prostate or prostate cancer.

Benign prostatic hyperplasia (BPH) is a common urological condition caused by the noncancerous enlargement of the prostate gland in aging men. According to the American Urological Association, BPH will affect approximately 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80. In addition to age, risk factors for developing BPH also include a family history.

Many men with BPH have no major symptoms. However, symptoms begin by interfering with urinary problems, and can include:

Weak or slow urinary stream.Feeling of incomplete bladder emptying.Delay in starting urination.Frequent urination, sometimes as often as every one to two hours.Urinary urgency.Awakening frequently at night to urinate.A urinary stream that starts and stops.The need to strain to urinate.

A man and his doctor should talk about the benefits and risks of treatment when a diagnosis of BPH has been determined. The best treatment is not the same for every man. BPH needs to be treated only if the symptoms are severe enough to be a bother. Currently, the main ways of dealing with BPH are watchful waiting, medical treatments, minimally-invasive treatments and surgical treatments.

BPH is not cancer and cannot lead to cancer, although both conditions can exist together. More than 200,000 cases of prostate cancer are diagnosed in the United States each year. It is the most common cancer diagnosed in men (not counting skin cancer) and is also one of the leading causes of cancer death among men, according to the American Cancer Society.

Those numbers can be intimidating, but the good news is that the rate of death from prostate cancer has dropped nearly 40 percent since the 1990s, and much of that change is due to proper screening and detection and advancements in treatment options.

Prostate cancer often can be detected using a simple blood test called a Prostate-Specific Antigen (PSA) test and a physical exam. There has been some controversy about the guidelines of what age men should have this test and how frequently it should be performed. Each person is unique, and it is important to talk to a health care provider about the uncertainties, risks and potential benefits of prostate cancer screening before deciding whether or not to be tested.

Most men do not have prostate cancer. PSA levels are dependent on age. When prostate cancer develops, the PSA usually goes above the normal rage, but a low level does not guarantee that a man does not have cancer. If your PSA level is high, a doctor might advise repeating the test, performing a prostate biopsy or MRI (magnetic resonance imaging) to determine if cancer is present. Factors such as age, race and family history might affect this decision. Should the test results indicate cancer, most treatment plans include either radiation therapy, surgical removal of the prostate or a combination of both. If surgery is appropriate, a urologist can help decide the best course of treatment for a specific diagnosis.

Regular health checkups are key to leading a happy and healthy life, and for the fathers and other men in our lives, prostate health is a topic for now or in the future. If you or someone you love feels like that time is now, see your primary care physician or a urologist for your needs.

Since 1996, Dr. J. Kevin O'Kelly has provided care for the full spectrum of urologic concerns specializing in surgical treatment of cancer of the prostate and bladder. He serves patients at McLeod Urology Associates. For more information, call 843-777-7555.

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