If you are a male over the age of 50, prostate problems are a hot topic. This is because prostate problems are very common at this age. In this article we are going to review symptoms and screenings for the two most common prostate conditions: benign prostatic hyperplasia (BPH) and prostate cancer.
How Do I Know Which Condition I Have?
BPH and prostate cancer can have very similar symptoms. These symptoms may include trouble urinating, frequent urination, blood in the urine of semen, pain in the back or hips or painful ejaculation. If you experience any of the 
symptoms described above, you should see your doctor so that he can determine the cause. Only your doctor can determine which condition you have or if the problem is not related to either of these conditions. It is important to see your doctor if something does not feel right to you.
Since the prevalence of prostate problems is so you high, the American Cancer Society (ACS) has come up with recommendations to help men and their doctors with screenings. For example, it is recommended by the ACS that all men over the age of 50 get a digital rectal exam (DRE) and a Prostate Specific Antigen (PSA) test once a year. (1)
The PSA test is a simple test that measures the amount of prostate antigen in the blood. The level of this antigen can be elevated in men with prostate cancer and in those with benign prostatic hyperplasia (BPH). The digital rectal exam involves inserting a gloved finger into the rectum to feel the size and shape of the prostate. The digital rectal exam can tell the doctor if the prostate is enlarged or irregular.
Patients at a higher risk of prostate cancer (African Americans and those with a first degree relative that has been diagnosed before the age of 65) should consider these tests annually beginning at age 45. (1) Men at even higher risk, such as those with more than one first degree relative diagnosed before age 65, should start these tests as early as age 40. If their PSA is less than 1ng/ml, no further testing is recommended until age 45. If the PSA is greater than 1ng/ml but less than 2.5 ng/ml, annual testing is recommended. If the PSA is greater than 2.5 ng/ml, then further evaluation with a biopsy is recommended. (1)
It is important to remember that an increased PSA or an enlarged prostate does not necessarily mean that prostate cancer is present. As we will discuss in a moment, many men experience a benign enlargement of the prostate that is not life threatening.
To help further determine the cause of your symptoms, your doctor may recommend further testing. Special x-rays, scans or urine flow studies may be done to check your prostate, urethra and bladder. This will help rule out problems with other organs in the affected area. Your doctor will also ask you a series of questions about your symptoms and past medical history. Finally, your doctor may obtain a urinalysis. Based on these results, your doctor might recommend a biopsy.
It is important for men to be familiar with the symptoms of prostate problems and know what to do if they experience them. It is also important to know what and when screenings should occur for prostate problems. Early detection of prostate conditions, particularly prostate cancer, can help increase chances for successful treatment.
Author: Christi Larson, Pharm. D.
Dr. Larson is a Clinical Infusion Pharmacist, author of Empowered Medicine; A Guide for Consumers and creator of www.empoweredmedicine.com. You can read more about her by visiting www.EmpoweredMedicine.com and clicking on the 'About Us' tab. EmpoweredMedicine.com is committed to providing evidence-based medical information.
