A Wee Problem That’s More Common Than You Think
Prostate symptoms are extremely usual in males over the age of 50, yet many are putting off seeing their doctor about it. Abi Jackson sorts the men from the boys
Men are notorious for burying their heads in the sand about their health, and it seems this is especially true when it comes to things going on ‘down there’ potentially relating to the prostate, the gland which sits underneath men’s bladders, surrounds the urethra and produces semen.
One in five UK men would turn a blind eye to prostate problems, according to a recent survey by herbal brand A.Vogel. In fact, 20% admitted that if they experienced symptoms like needing to pee more frequently or urgently, feeling that they’re unable to fully empty their bladder, or difficulty urinating, they would “just ignore it and hope it got better by itself”.
“It can be tough for men talking about their health in general, let alone when it relates to something so sensitive,” says GP Dr Roger Henderson. “In my experience, there are three main reasons men delay coming forward: embarrassment, fear that it may be cancer, or the belief that it’s just a natural part of ageing and there’s nothing they can do.”
Hashim Ahmed, a consultant urologist at the Bupa Cromwell Hospital (www.bupa.co.uk), understands the complexity of cancer worries. As well as the fear of being diagnosed, the tests involved can be daunting, as can the prospect of treatment and potential side-effects; impotence and incontinence are often big concerns.
“Men are concerned about what might happen if they did go and get a check of their prostate, things like worrying about a back passage examination, and the subsequent tests that can sometimes involve biopsies.
“And then there’s been a lot of press about the fact that prostate cancer treatment itself is quite controversial,” he explains, referring to how many experts believe that aggressive treatment for early prostate cancer actually offers very little benefit, so may lead to unnecessary distress and side-effects, and the fact that traditional testing methods have been highlighted as being potentially unreliable.
“All of these things have contributed to quite a lot of confusion in the public eye,” Ahmed notes.
This fear and confusion means two things. Firstly, men who do have cancer may be delaying their diagnosis, and secondly, that men whose symptoms are due to benign conditions may be missing out on treatments.
Though prostate cancer is the most common cancer in UK males, it is still relatively rare, affecting around one in eight men, with most diagnosed between the ages of 70-74.
As Ahmed points out though, as with all cancers, early diagnosis is absolutely crucial. And testing methods have come a long way in the last five years, which means more accurate diagnoses can be made and not all men will require the most aggressive forms of treatment. Side-effects are not always inevitable, either.
A COMMON PROBLEM
The vast majority who experience symptoms, however, will not have cancer. These symptoms are extremely common as men get older, and are most often caused by an enlarged prostate, known medically as benign prostatic hyperplasia (BPH), which affects 50% of men over 50. Despite that, the A.Vogel survey also revealed that nearly 70% had never heard of the condition.
“It’s linked with an increase in the size of the prostate gland, due to an increase in cells,” explains Dr Henderson, who has helped launch A.Vogel’s ‘Enlarged Prostate Health Hub’ (www.avogel.co.uk/health/
“BPH is associated with a number of common symptoms, including a need to pass water more frequently and urgently, often at night, with occasional leaking or dribbling, hesitancy in passing water, or a weak stream of straining, and a feeling that the bladder is never fully empty.”
Age is the major risk factor, he points out, though a family history can also play a role, and having high blood pressure or diabetes may also be linked with an increased risk.
Also, men with a history of BPH are not at higher risk of developing cancer. “This is a common misconception,” says Henderson. “Although there can be similarities in the nature of the symptoms, having BPH does not increase your risk of prostate cancer in any way.”
“BPH can have a significant effect on quality of life,” Henderson notes, “affecting sleep, work, relationships and sex. If left untreated, it can result in complications, such as bladder infections, acute or chronic urine retention, which can affect kidneys, and hernia from straining.”
The good news is though, that BPH is most often easily treatable. Some men with mild symptoms may choose to take a “wait and watch” approach, or make some lifestyle changes. “Things such as cutting down on caffeine and alcohol, especially late at night, as these can make you need the toilet more, and stopping smoking, as nicotine can irritate the bladder,” says Henderson. Natural remedies are sometimes cited as offering potential relief too, including saw palmetto supplements (A.Vogel Prostasan Saw Palmetto capsules, £10.90 for 30 capsules, www.avogel.co.uk).
Ahmed notes that an antioxidant-rich diet, particularly containing things like pomegranate juice, cooked tomatoes, broccoli and green tea, could help promote good prostate health.
When symptoms are more severe and are impacting a man’s quality of life, tablets can be prescribed which, usually, are very effective.
Sometimes, though rarely, further treatments, such as laser treatment, may be needed.
Though benign growths or enlargement are the most common cause of prostate symptoms, sometimes other conditions come into play. “The other thing that can occur, particularly in younger men who have these symptoms whose prostates are quite small, is that the prostate can become quite tight, so the muscle cells, for some reason, tighten up all the time,” notes Ahmed. “Again, that can be treated with tablets to relax the prostate and neck of the bladder, to enable urine to pass better.
“Also, you could have an infection, and that would be detected with a simple urine test and easily treated with antibiotics. And very rarely, men can have a narrowing in the wall of the urine passage from scar tissue, but that’s unusual.”
In the case of infections – or inflammation without infection – it tends to be younger men who are affected (mainly aged 30-50) and symptoms may be accompanied by pain and discomfort.
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