Men struggle with discussing prostate woes
By Dolly A. Butz
Men realize that an enlarged prostate is a problem, but they're not always willing to discuss it with their doctor, according to Cindy Lewin, a family nurse practitioner at UnityPoint Clinic Family Medicine at Sergeant Bluff.
Prostate problems tend to crop up after the age of 50. Uncertainty about treatment options, fear of cancer and embarrassment, Lewin said, keep them tight-llipped.
"A lot of men will not talk about it. They'll be in for something else and they'll say, 'Oh, by the way' or 'I was wondering about this,'" she said. "They usually do not come in front line for this."
Benign Prostatic Hyperplasia (BPH) or enlargement of the prostate is a common consequence of getting older. The condition results in the formation of large nodules that compress the urethral canal and interfere with urine flow.
"They'll usually have trouble with urination," Lewin said. "They can't get a stream started or have trouble stopping their stream."
Having an enlarged prostate, she cautioned, doesn't mean that the patient has prostate cancer.
Patients with prostate cancer, she said, don't always have symptoms until the disease is advanced. Erectile dysfunction, swelling, bone pain and fatigue are warning signs.
Lewin recommends encouraging your father or grandfather to talk to his doctor when prostate issues arise, because seeking treatment in the form of medications or surgery could ultimately increase his longevity and quality of life.
"If you have symptoms, the best thing is to get checked by your provider and then to make sure that you come in for an annual prostate exam, usually after age 40," she said.
Surgery, Lewin said, isn't utilized as often to treat prostate problems as in the past.
Radioactive seed implants, a form of internal radiation therapy where seeds are inserted into the prostate gland using ultrasound, can eradicate cancer.
Medications, alpha-1 blockers and alpha reductase inhibitors, are available to shrink the prostate in cases of BPH. A drug commonly used to treat erectile dysfunction has also been proven effective, according to Lewin.
"Cialis just came with indications recently that it can be used for both," she said. "You'd have to take it on a daily basis."
Side effects from these medications, Lewin said are usually minor. The most common is dizziness caused by a decrease in blood pressure.
"The erectile dysfunction medications are about $12 a pill," she said. "It's a little cheaper if you take the daily one. I'd say it's probably around $200 a month."