### Prostate Cancer: A Silent Disease
The prostate is a walnut-sized gland that assists in producing semen, the fluid that carries sperm to the ovum during ejaculation for fertilization. It surrounds the urethra, the conduit that transports semen and urine out of the body, meaning an enlarged prostate can press on the urethra.
Among men over 50, the most common prostate issue is its enlargement, medically referred to as benign prostatic hyperplasia (BPH). While older men are at higher risk for prostate cancer, it is significantly less common than BPH. Many men stay silent about their prostate issues, but ignoring these health concerns doesn’t make them go away.
Approximately one in eight men will be diagnosed with prostate cancer in his lifetime, while half of men aged 51 to 60 will experience benign prostate enlargement. This figure rises to 70 percent in men aged 60 to 69, and 90 percent in those over 85.
Prostate cancer originates when cells within the prostate start growing uncontrollably. These cancers develop from the glandular cells, responsible for producing the prostate fluid added to semen. Some prostate cancers grow and spread quickly, but most progress slowly, making detection challenging. There are studies suggesting that prostate cancer may start as a precancerous condition, though this isn’t definitively known. These conditions are sometimes found when a biopsy, which involves the removal of small prostate fragments to check for cancer, is performed on men.
Prostate-specific antigen (PSA) is a protein produced by prostate cells, both normal and cancerous. While PSA is mainly found in semen, small amounts are also present in the blood. Most men without prostate cancer have PSA levels below 4 ng/ml of blood. When prostate cancer develops, PSA levels often rise above 4, though a level below 4 doesn’t eliminate the risk of cancer; about 15 percent of men with PSA levels under 4 will show prostate cancer if biopsied. For those with PSA levels over 10, the likelihood of having prostate cancer exceeds 50 percent.
PSA testing is done through a blood test, and based on the results, a urologist may examine the prostate enlargement via a digital rectal exam, a test often rejected by men uncomfortable with its nature.
It’s detrimental for men, irrespective of age, to avoid sexual activity. The prostate produces ejaculate, and regular ejaculation is necessary to prevent deterioration of prostate fluid. In the absence of a partner, regular masturbation is a healthy alternative.
Prostate cancer is seven times more likely in men with erectile dysfunction than in healthy men.
For men over 50, yearly PSA tests are recommended. If PSA levels approach 4, testing should be done biannually, and a consultation with a urologist is advised to determine the necessity of a biopsy, the most effective way to diagnose prostate cancer.
Roberto Bautista is a sexual and couples therapist with a master’s degree in Mediation.