How Are Prostate Problems Treated?
Treatment depends on which kind of prostate problem you develop.
Benign prostatic hyperplasia needs treatment only if the urinary symptoms become bothersome. BPH often responds to drugs that either:
- Relieve the tension around the urethra (Cardura, Flomax, Hytrin, and Uroxatral)
- Reduce the size of the prostate itself (Avodart and Proscar)
The FDA is revising labels on several BPH drugs -- Proscar, Avodart, and Jalyn -- to include a warning that the drugs may be linked to an increased risk of prostate cancer.
If medication does not relieve the symptoms, surgery may be required. Several herbs showed promise as treatment for BPH in some studies, but results are incomplete or conflicting. These include saw palmetto, beta-sitosterol, and Pygeum africanum.
Prostate cancer treatment is complex. When designing a prostate cancer treatment plan, doctors consider a man's age, overall health, and how aggressive or widespread the prostate cancer is. Each man's cancer is unique, and his treatment will be unique. Some treatment options include:
- No treatment (watchful waiting)
- Radiation (either external-beam or implantable "seeds")
- A combination of these
Prostatitis is usually a bacterial infection. Prostatitis is most often treated with antibiotics, usually for at least four weeks.
Should I Be Screened for Prostate Cancer?
Prostate cancer screening is controversial. Some doctors and organizations recommend regular screening while others don't.
The American Cancer Society says men should talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested. The group's guidelines make it clear that prostate-specific antigen (PSA) blood testing should not occur unless this discussion happens. The discussion about screening should start at age 50 for most men with average risk for prostate cancer and earlier for men at higher risk.
The American Urological Association recommends that men ages 55 to 69 who are considering screening should talk with their doctors about the risks and benefits of testing and proceed based on their personal values and preferences. The group also adds:
- PSA screening in men under age 40 years is not recommended.
- Routine screening in men between ages 40 to 54 years at average risk is not recommended.
- To reduce the harms of screening, a routine screening interval of two years or more may be preferred over annual screening in those men who have decided on screening after a discussion with their doctor. As compared to annual screening, it is expected that screening intervals of two years preserve the majority of the benefits and reduce over diagnosis and false positives.
- Routine PSA screening is not recommended in men over age 70 or any man with less than a 10-15 year life expectancy.
The U.S. Preventive Services Task Force, however, doesn't recommend routine PSA screening for men in the general population, regardless of age. They say the tests may find cancers that are so slow-growing that medical treatments -- which can have serious side effects -- would offer no benefit.