Most guys don’t spare much thought on the prostate — the small gland between the bladder and the penis that releases seminal fluid. But with age, problems ranging from enlargement of the gland to prostate cancer become increasingly important. While Benign Prostatic Hyperplasia (BPH) — commonly referred to as an enlarged prostate — essentially affects all men at some point in life, it’s not always problematic. Still, it’s always good to know when to get checked.
Prostate cancer affects one in six men over 50 and is the cause of death in one out of every three men over 50. Whether you’re a gay, straight or bisexual man, the risk of developing prostate cancer or other prostate problems as you grow older increases. George Suarez, MD, a urologist in private practice in Miami, says there’s no difference in rates of prostate problems based on sexual preference. He does note that all men, gay or straight, often have concerns about being able to perform sexually after treatment for enlarged prostate or prostate cancer. And men who are HIV positive also have specific concerns when it comes to treating prostate problems safely. Fortunately, cutting-edge treatments and procedures now offer viable options for all men.
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One danger with prostate problems is the lack of symptoms. Trouble urinating is the primary symptom of an enlarged or inflamed prostate, but early stage prostate cancer often presents no symptoms at all. Because of this, it’s imperative to have your annual check up.
“Men who have a family history of prostate cancer — father, sibling, uncle or any other male relative — should have a prostate-specific antigen (PSA) test on an annual basis beyond the age of 40,” says Dr. Suarez. “All other men should do the same beginning at the age of 50.” In some cases, a digital rectal exam (DRE) is also recommended.
Prostate treatments vary. Enlarged or inflamed prostates are typically treated with medication. If the problem is severe, a combination of medications is used to reduce the risk of prostate cancer.
Dr. Suarez is at the forefront of utilizing a fairly new treatment for prostate cancer called high-intensity focused ultrasound (HIFU).
“HIFU is a revolutionary technology that delivers an ablative treatment to the prostate cancer, while preserving the surrounding healthy vital tissue,” he says. “[It] is delivered via a trans-rectal ultrasound probe, and the device functions under image-guided, computer-directed therapy.”
Dr. Suarez notes that this approach has several advantages over traditional chemotherapy, radiation therapy or surgery. While these often pose a high risk of impotence or incontinence, the risks are dramatically lowered with HIFU. What’s more, it’s a one-time outpatient procedure minimal recovery time. “It can be used as a first line of treatment or as a salvage treatment if another option has failed,” adds Dr. Suarez. Typically, patients have follow-up appointments to ensure that their treatment was successful.