Cardura

It's 10 o'clock. Do you know where your prostate is? Despite the vital role this particular gland plays in male sexual function, 89 percent of us aren't sure where to find it, according to a recent survey, while 69 percent don't have a clue to its purpose or importance. Even more embarrassing: Women interviewed for the same study knew more about the prostate than men did--and they don't even have one.

So in case some pollster corners you, here are the basics:

* The prostate gland lies between the penis and rectum at the base of the bladder.

* The prostate's function is to secrete a fluid that lubricates the urethra (the canal that carries urine and semen) and protects sperm as it exits.

* From the onset of puberty until adulthood, the prostate enlarges from the size of a grain of wheat to that of a walnut.

* Trouble usually begins when midlife hormonal changes cause the gland to grow significantly, but prostate problems--from inflammation to cancer--can afflict a man at any age.

* Measures taken now may dramatically decrease your risk of serious illness in the future.

IS IT CANCER?

When the prostate becomes enlarged because of infection or spasm, it squeezes on the urethra or presses against the neck of the bladder, causing urinary problems and sometimes sexual dysfunction. An inflamed prostate is a nuisance, but it's relatively easy to treat with antibiotics, urinary antiseptics, muscle relaxants and/or rest.

Things get more complex when swelling indicates benign prostatic hypertrophy or cancer. BPH, a nonmalignant growth that afflicts one-third of all men over age 50, can be treated noninvasively if symptoms aren't severe. Otherwise, laser, microwave or traditional surgery is used to remove part of the gland, making it possible to urinate normally again. Usually, neither libido nor sexual ability are affected, notes Mitchell Kaye, M.D., a urologist in Scottsdale, Ariz., though "retrograde ejaculation," the failure to ejaculate--which can reduce fertility--may result.

Like BPH, prostate cancer is more common in--but not exclusive to--older patients. It's the second-leading cause of cancer death in men, after lung cancer. "We're expecting 189,000 new cases of prostate cancer among American men this year," says Judd W. Moul, M.D., director of the Department of Defense Center for Prostate Disease Research in Rockville, Md. "One in six of us is at risk for the disease, and 30,000 men will die from it in the next 12 months alone."

There's no apparent cause for prostate cancer, though more and more evidence traces increased risk to both heredity and a diet laden with fatty foods. Unfortunately, when the disease is in its earliest, most curable stage, it shows no symptoms. "If a man waits for signs like blood in his urine or back pain to develop," says Moul, "the cancer has likely advanced to a stage where it's less treatable." Care options include hormones, radiation, and partial or radical surgery.

THE YOUNG MAN'S PROSTATE

Moul recommends annual rectal exams beginning at age 40. (You know, that 60 seconds of bending over during your checkup that you try not to think about during the rest of the year.) "But young men, too, should familiarize themselves with the signs of prostate trouble," he cautions, "because it's likely to affect them as they get older. Pay particular attention to prostate health if other men in your family have had a history of problems."

It's never too early to request a prostate specific antigen test, which measures the levels of gamma seminoprotein in the blood, a substance released only by prostate cells--and in much higher quantities by prostate-cancer cells.

"It's the greatest screening test for any type of cancer ever," says Moul, "but it's not infallible. People with prostate inflammation can test positive for cancer on a PSA. [So can recent ejaculators, so abstain for 48 hours before having the test.] Further testing will determine which condition you have, and--in either case--the sooner you know, the better."

A recent federal study suggested that men with very low PSA results can take an extra year between tests, but don't do so without your doctor's approval.

HAIRY DRUGS AND PALM TREES

The most popular drug for prostate enlargement is finasteride, which goes by the brand name Proscar (and moonlights as the baldness drug Propecia). It can have unfortunate side effects, however, such as diminished libido. It can also cause birth defects in male infants; therefore a pregnant woman should never touch a crushed Proscar tablet, and any sexual partner taking the drug should wear a condom to protect her from small amounts of medication in his semen.

A new study presented at this year's meeting of the American Urological Association found that combining finasteride with doxazosin (brand name Cardura) can improve finasteride's performance significantly.

Clinical studies have also shown that herbal treatments are. helpful for prostatitis. The best known is saw palmetto, extracted from a palm tree rich in fatty acids and plant sterols that may reduce swelling by blocking cholesterol. The primary ingredient in supplement products such as Prostate Plus is nearly always saw palmetto.

Pygeum, the powdered bark of the African prune tree, has cholesterol-fighting sterols as well, notes Mark Moyad, a cancer researcher at the University of Michigan and co-author of The ABCs of Prostate Cancer.

Additionally, Moyad recommends stinging-nettle root; the sterols it contains have a potent anti-inflammatory effect on prostate tissue by inhibiting unhealthy cell growth.

Several vitamins and minerals are proven to promote prostate health. Zinc helps suppress a key enzyme called 5-alpha-reductase, which converts testosterone to dihydrotestosterone, an enzyme that can cause an excessive overgrowth of prostate tissue. Vitamin [B.sub.6] enhances zinc absorption, so combining [B.sub.6] with zinc is a good idea. Vitamin E is a potent antioxidant, and vitamin D may check prostate-cancer cell growth. Also, a combination of the amino acids glycine, alanine and glutamic acid can relieve symptoms of prostatitis.

STARTING EARLY

Prostate trouble can be foiled by early prevention. Exercise stimulates blood flow in the prostate, and a healthful diet and plenty of sleep are also beneficial. (See "6 Prostate Preventatives," below.)

"But it's not as simple as taking your vitamins or getting enough rest," Moyad says. "Regular screenings for cancer, a good diet of supplements, and an early knowledge of what your prostate does will help keep the disease at bay. The sooner you start familiarizing yourself with your own prostate health, the better your chances for a healthy life."

RELATED ARTICLE: A prostatis primer.

Inflammation of the prostate, known as prostatitis, usually manifests itself in symptoms such as lower-back pain, frequent or incomplete urination, and irritation during urination. There are several variants:

* Acute prostatitis is generally brought on by a bladder infection, Its symptoms resemble thos of a sudden attack of the flu: chills, fever and muscle aches, along with urinary difficulties. Antibiotics and rest are the cure.

* Chronic prostatitis, also bacterial-based, is often caused by a reflux of urine into prostate ducts. It's been linked to stress as well. Symptoms are more subtle, and the condition is sometimes indicated by a urinary-tract infection.

* Congestive prostatitis, marked by discomfort near the perineum or below the navel, is the buildup of unejaculated semen. Massage and other hands-on remedies can relieve the pressure.

* Prostatalgia or prostatodynia is marked by general pain or discomfort in the gland, perhaps due to muscle spasm associated with anxiety or tension.

* Benign prostatic hyperplasia, where a nonmalignant adenoma, or tumor, squeezes the urethra like a clamp, has no known cause. Epidemic in men over age 50, it can occur in younger men as well, and sometimes requires surgery.

* Prostate cancer can be fatal if left untreated. A slow-growing cancer, it is asymptomatic in the early stages. Have your prostate examined every two or three years, or every year if you're over 40 or have a personal or family history of prostate problems.

SYMPTOMS

Consult an internist or urologist if you are experiencing any of the following:

* A painful burning sensation when urinating.

* Blood in the urine.

* The need to get up several times a night to urinate.

* A full-bladder feeling, even after you've urinated.

* A sudden and often uncontrollable need to urinate.

* A meager, frequently interrupted urine stream.

* Difficulty initiating a urine stream.

* Involuntarily dribbling at the beginning or end of urination.

* Decreased libido or sexual energy.

* Sudden onset of fever and chills.

* Pelvic, genital or lower-back pain.

* Urinary obstructions.

* Pain during ejaculation.

* Chronic urinary-tract infections.

RELATED ARTICLE: 6 Prostate preventatives.

Regardless of age, the well-being of your insides is directly related to your lifestyle. These simple, noninvasive measures will ensure a healthy, happy prostate.

1. Exercise. Sitting all day constricts the prostate, a gland that's already susceptible to poor circulation. Regular activity brings blood and nutrients to the area. If you miss a workout, go for a walk at lunch or hit the stairs rather than the elevator.

2. Eat right. A balanced diet helps maintain prostate health. Eat high-fat and high-carbohydrate foods in moderation, and keep an eye on your consumption of spicy foods, citrus, alcohol and caffeine, all of which can irritate the genitourinary tract. Meanwhile, boost your intake of prostate-friendly lycopene (abundant in cooked tomato products), soy and fiber.

3. Supplement. Daily doses of zinc and vitamins B, C and E are known to promote prostate health (A large-scale study is currently trying to confirm the value of vitamin E and the mineral selenium, which earlier research inadvertently--and fortuitously--found to orotect against prostate cancer.) Certain herbs; especially saw palmetto, can prevent or improve symptoms of prostatitis without side effects. Pumpkin seeds and flower pollen, both available in powdered form, also reduce swelling of the prostate.

4. Supplement more. Combining glycine, an amino acid found in prostate fluid, with equal amounts of the amino acids alanine and glutamic acid may reduce symptoms of benign prostatic hypertrophy. All three aminos come in capsules.

5. Relax. Because stress increases the production of prolactin, a hormone found to cause prostate inflammation, urologists recommend stress management techniques such as daily meditation and deep-breathing exercises.

6. Lay off. Although congestive prostatitis can be relieved by more-frequent ejaculations, some studies indicate that increased sexual activity may compromise the prostate's store of vital nutrients and exacerbate symptoms of other forms of prostatitis.

COPYRIGHT 2002 Weider Publications
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