The Location And Function Of The Prostate
The prostate is located behind the pubic bones in a mans pelvis, between the bladder and the rectum. When healthy, it is about the size of a walnut. A tube, called the urethra, runs through the middle of the prostate and drains urine from the bladder out of the penis. Two sex nerves for erection of the penis run next to and alongside the prostate. The purpose of the prostate is to produce seminal fluid, which when mixed with the sperm from the testicles, creates semen. Prostate cells also secrete proteins into the bloodstream, one of which is called Prostate Specific Antigen this protein plays a key role in detecting cancer. See Figure 3 below.
A lateral view of a mans pelvis showing the relationship of the prostate gland to the normal structures. The transparent blue plate is used to demonstrate a cross-section of the anatomy.
What Happens After A Prostate Ultrasound
Once the test is done, you can take off the gown and put your clothes back on. Your rectum may feel tender for a few days, but you wont need to follow any specific aftercare instructions. Your doctor may prescribe an antibiotic to prevent infection.
In some cases, your doctor or technician may ask you to wait in the facility until your results are available. Youll usually need to wait a few days for a radiologist to look at the images and diagnose any conditions, however. Depending on where the test was done, you may wait up to two weeks for results.
Your doctor will schedule a follow-up appointment to discuss your test results. If you have any abnormalities or conditions that are visible on the images, your doctor will point out these areas. Excess tissue, prostate enlargement, or cancerous tumors will appear on the ultrasound images as bright white areas that represent the dense tissue.
Proton Therapy Vs Other Prostate Cancer Treatments
Is proton therapy superior to hormone therapy or chemotherapy? The answer might not be that simple because it depends on what you need.
Each treatment method has its pros and cons. They also have specific applications, and using them or not in a determined patient depends on comprehensive studies that evaluate what works better for most.
However, for educative purposes, lets make a brief comparison between proton therapy and other prostate cancer treatments:
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What Is Prostate Surgery
The prostate is a walnut-sized gland in men that is located near the bladder and wraps around the urethra. Cancer of the prostate is one of the most common cancers in men. To be more specific,it is thesecond most common cancer and the sixth leading cause of cancer death among men worldwide, with 1.1 million cases and 307,000 deaths in 2012. 1,2
Prostate surgery is a procedure that involves the complete or partial surgical removal of the prostate gland. Prostate surgery is also known as prostatectomy. It is performed on patients with prostate cancer, enlarged prostate or benign prostatic hyperplasia . Prostate cancer can be metastatic which means that it can spread to other parts of the body, such as surrounding bones and lymph nodes. Therefore, surgical removal of the prostate can stop cancer from spreading.
Let us elaborate on prostate surgery in todays article.
- When is Prostate Surgery done?
- Which medical conditions can be treated by Prostate Surgery?
- In which areas of the prostate do the diseases requiring surgery occur?
- What is the purpose of prostate surgery?
- How is the examination done prior to Prostate Surgery?
- What are the investigations done before Prostate Surgery?
- What is the procedure of Prostate Surgery?
- What happens after Prostate surgery?
- How to take care after Prostate Surgery?
- What are the urinary problems noticed after prostate surgery?
- What are the risks of Prostate Surgery?
- What is the cost of Prostate Surgery in India?
Is Proton Therapy Safer Than Traditional Radiation
Traditional radiation therapy delivers radiation to the tumor and to healthy tissues around the tumor. With proton therapy , the majority of the radiation is delivered to the tumor.
A type of radiation treatment called proton beam radiation therapy may be safer and just as effective as traditional radiation therapy for adults with advanced cancer. That finding comes from a study that used existing patient data to compare the two types of radiation.
Traditional radiation delivers x-rays, or beams of photons, to the tumor and beyond it. This can damage nearby healthy tissues and can cause significant side effects.
Plus, proton therapy is more expensive than traditional radiation, and not all insurance companies cover the cost of the treatment, given the limited evidence of its benefits. Nevertheless, 31 hospitals across the country have spent millions of dollars building proton therapy centers, and many advertise the potential, but unproven, advantages of the treatment.
In the new study, patients treated with proton therapy were much less likely to experience severe side effects than patients treated with traditional radiation therapy. There was no difference in how long the patients lived, however. The results were published December 26 in JAMA Oncology.
These results support the whole rationale for proton therapy, said the studys lead investigator, Brian Baumann, M.D., of the Washington University School of Medicine in St. Louis and the University of Pennsylvania.
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Enlarged Prostate Treatments In The Pipeline
Researchers continue to investigate new therapies for enlarged prostates. âAnother category of drugs is under development,â says Slawin. âWeâve come a long way in treating BPH. Itâs no longer the life-threatening disease it once was. Now, in treatment, weâre working on quality of life issuesÃââìÃæ reducing side effects of treatment.â
Also being studied is a procedure called water-induced thermotherapy , an experimental procedure that involves destroying excess prostate tissue utilizing heated water and an air-filled balloon, which protects normal prostate tissue. The procedure is performed with only local anesthesia. Results may not be fully apparent for three to four months. However, preliminary studies examining WIT have shown positive results, with a near doubling in urine flow. However, the American Urological Association has not thus far endorsed WIT as a viable treatment option for symptoms of BPH.
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Are Prostate Problems Always A Sign Of Prostate Cancer
Not all growths in the prostate are cancerous, and not all prostate problems indicate cancer. Other conditions that cause similar prostate cancer symptoms include:
- Benign prostatic hyperplasia : At some point, almost every man will develop benign prostatic hyperplasia . This condition enlarges the prostate gland but doesnt increase cancer risk. The swollen gland squeezes the urethra and blocks the flow of semen and urine. Medications, and sometimes surgery, can help.
- Prostatitis: Men younger than 50 are more prone to prostatitis, inflammation and swelling of the prostate gland. Bacterial infections are often the cause. Treatments include antibiotics or other medications.
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Does Saw Palmetto Treat Enlarged Prostate
Study Shows Saw Palmetto Is No Better Than Placebo in Treating Symptoms of BPH
Sept. 27, 2011 â For years, men with enlarged prostate glands have turned to a supplement called saw palmetto to ease their trouble with urination and other symptoms.
Exactly how saw palmetto was thought to relieve the symptoms is unclear, but the fruit of saw palmetto dwarf palm tree remains widely used.
Now, a new study shows that this popular remedy is no more effective than a placebo or dummy pill at relieving these symptoms â even in high doses.
The study is published in The Journal of the American Medical Association.
The technical name for an enlarged prostate gland is benign prostatic hyperplasia .
Symptoms of BPH include:
- Frequent urination, especially at night
- Not feeling empty after urination
As a result, men run the risk of developing urinary tract infections and/or needing surgery because of a blockage of urine flow.
What Will I Experience During And After The Procedure
Most MRI exams are painless. However, some patients find it uncomfortable to remain still. Others may feel closed-in while in the MRI scanner. The scanner can be noisy. Sedation may be arranged for anxious patients, but fewer than one in 20 require it.
You may feel pressure while the doctor inserts the endorectal coil into your rectum. This is similar to that experienced during a digital rectal exam.
It is normal for the area of your body being imaged to feel slightly warm, but if it bothers you, notify the radiologist or technologist. It is important that you remain perfectly still while the images are being recorded, which is typically only a few seconds to a few minutes at a time. For some types of exams, you may be asked to hold your breath. You will know when images are being recorded because you will hear tapping or thumping sounds when the coils that generate the radiofrequency pulses are activated. You will be able to relax between imaging sequences, but will be asked to maintain your position as much as possible.
You will usually be alone in the exam room during the MRI procedure. However, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centers allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment.
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What Does The Prostate Gland Actually Do
The prostate gland isnt essential for life, but it is vital for reproduction and is part of the male reproductive system.
The function of the prostate is to produce a slightly alkaline fluid called the prostatic fluid that makes up part of the seminal fluid, or semen.
The rest of semen is composed of sperm cells from the testicles, fluid from the seminal vesicles, and secretions from the pea-sized bulbourethral gland.
The prostatic fluid contains substances that are important to the functioning and survival of sperm cells, such as the enzyme prostate-specific antigen , which thins or loosens up semen, helping the tadpole-like sperm cells swim freely to reach the egg.
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Life After A Radical Prostatectomy: A Real
Reposted from Greater Boston Urology.
In October of 2013, Les Cavicchi underwent a radical prostatectomythe removal of the prostate gland. Les had been diagnosed with prostate cancer a month earlier after undergoing a TRUS biopsy.
Less cancer was localized, meaning it was contained within the prostate gland itself. He didnt need further treatment for prostate cancer after the surgery, only regular monitoring of his PSA.
However, Les did suffer from common side effects associated with radical prostatectomies, specifically urinary incontinence and erectile dysfunction.
Q: So lets get right to it: You were dealing with incontinence after your radical prostatectomy?Les: The thing about any kind of prostate procedure is youve got to deal with incontinence. This was a big issue for me for a while. I had purchased padded undergarmentsa whole case of them, because I didnt know how long this was going to last.
Men wonder why this particular side effect happens. The prostate gland is the primary organ for controlling urinary flow in normal physiology. When you are rising frequently during the night, and/or having difficulty starting urination, these are signs that the prostate is beginning to grow in size and interfere with this specific function. Every mans prostate gets larger with age it does not necessarily have anything to do with having cancer. It is a separate reality.
Women dont have a prostate. What do they use? Kegel muscles!
About Greater Boston Urology
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Positioning For Proton Beam Treatment
Positioning the body is very important. It can take several minutes for the team to adjust both you and the instruments to make sure the proton beam will reach the exact spot of the tumor.
While the treatment is happening, you must be very still on the table. The team will work with you to help keep you in place. For example, a custom-fitted mask can help those who are getting treatment for brain tumors. The mask is made of mesh that allows patients to see and breathe.
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How Do I Prepare For A Prostate Ultrasound
You dont need to do much to prepare for a prostate ultrasound. Its an outpatient procedure that usually takes less than an hour. Your doctor may refer you to a hospital or clinic that has the proper ultrasound equipment for this test. You may also need to sign a consent form before the test.
Some possible instructions that your doctor might give you before the test include:
- Dont eat for a few hours before the test.
- Take a laxative or enema to help clear out your intestines a few hours before the test.
- Stop taking any medications that can thin your blood, such as nonsteroidal anti-inflammatory drugs or aspirin, about a week before the procedure. This is usually recommended if your doctor plans to take a biopsy of your prostate.
- Dont wear any jewelry or tight clothes to the clinic on the day of the procedure.
- Take any medications recommended to help you relax during the procedure. Your doctor may recommend a sedative, such as lorazepam .
- Make sure someones available to take you home in case your doctor gives you a sedative.
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What Causes Benign Prostatic Hyperplasia
The cause of benign prostatic hyperplasia is not well understood however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.
Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.
Another theory focuses on dihydrotestosterone , a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.
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Who Is A Good Candidate
In most cases, you will be a good candidate for proton therapy if you were initially offered radiotherapy as an option. Patients who receive radiotherapy usually have no problems being a candidate for proton treatment. They are usually patients in an early stage or those with localized prostate cancer. It is also useful to keep advanced cancer under control for as long as possible and treat recurrent prostate cancer cases.
However, some patients may not benefit from proton therapy if they have one of these problems :
- In patients with hip replacements, because proton beams often cant reach beyond the prosthesis. In some proton therapy centers, these patients can still get a session when a hip replacement is limited to one side. But bilateral replacement makes it impossible to treat the patient with proton beam therapy.
- In patients with advanced prostate cancer in which treating the pelvic lymph nodes is fundamental. Since proton beam radiation is less likely to reach other tissues than the prostate, it is not applicable when treating surrounding lymph nodes.
- In overweight patients, because the proton beam can only go through a determined depth. This depth depends on the beams energy, and some centers may have a higher energy device that solves the problem.
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Side View Of The Prostate
The prostate is a walnut-sized gland located between the bladder and the penis. The prostate is just in front of the rectum. The urethra runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body.
The prostate secretes fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and itâs expelled with sperm as semen.
The vasa deferentia bring sperm from the testes to the seminal vesicles. The seminal vesicles contribute fluid to semen during ejaculation.
Recovery From Proton Therapy
After being treated with the proton beam, most people can go home and resume their activities. For certain tumors, your doctor might order tests to see how the treatment is affecting the tumor, and adjust your treatment if necessary.
The Johns Hopkins Proton Therapy Center
Located at Sibley Memorial Hospital in Washington, D.C., our center combines advanced proton therapy technology, the latest research and caring specialists who provide tailored treatments for a variety of adult and pediatric cancers.
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What Men And Women 35 And Older Must Know About Fertility Infertility And Getting Pregnant
The prostatic fluid mixes with sperm and fluid from the seminal vesicles which makes up the majority of semen and contains various other components, including the fructose that provides the main energy source for sperm outside of the body inside of the urethra.
Changes in the composition or secretion of the prostatic fluid affects the health and function of sperm, impacting male fertility. These changes may arise due to various health issues with the prostate.
Learn More About the Form and Function of the Prostate
How To Prepare For A Prostate Massage
Because this practice isnt widely supported in the medical community, finding a qualified prostate massage therapist may be difficult. Ask your doctor for a list of recommendations.
You can also call your local hospitals outreach office. Many of these offices keep information on certified medical practitioners in the area. They may be able to provide you with a list of names.
Most health insurance companies wont cover the cost of going to a prostate massage therapist. However, if your doctor performs the massage during an office visit, your medical insurance may cover the cost of the service.
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