Your health: Tips for coping with an enlarged prostate

When a man reaches about age 25, his prostate begins to grow. This natural growth is called benign prostatic hyperplasia (BPH) and it is the most common cause of prostate enlargement. BPH is a benign condition that does not lead to prostate cancer, though the two problems can coexist.

Although 50 percent to 60 percent of men with BPH may never develop any symptoms, others find that BPH can make life miserable. The symptoms of BPH include: a hesitant, interrupted, weak urine stream; urgency, leaking, or dribbling; a sense of incomplete emptying; and more frequent urination, especially at night.

There are some things men dealing with BPH can do on their own, Harvard Medical School report. Four simple steps can help relieve some of the symptoms of BPH:

  • Some men who are nervous and tense urinate more frequently. Reduce stress by exercising regularly and practicing relaxation techniques such as meditation.
  • When you go to the bathroom, take the time to empty your bladder completely. This will reduce the need for subsequent trips to the toilet.
  • Talk with your doctor about all prescription and over-the-counter medications you’re taking; some may contribute to the problem. Your doctor may be able to adjust dosages or change your schedule for taking these drugs, or he or she may prescribe different medications that cause fewer urinary problems.
  • Avoid drinking fluids in the evening, particularly caffeinated and alcoholic beverages. Both can affect the muscle tone of the bladder, and both stimulate the kidneys to produce urine, leading to night-time urination.

For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication. Often this will be enough to relieve the worst symptoms and prevent the need for surgery.

Hormone therapy may pose a risk

Black men treated with hormone therapy for prostate cancer may have a higher risk of death than white men undergoing the same therapy, according to a new study, The Washington Post reports.

But the deaths aren’t actually caused by prostate cancer.  Androgen deprivation therapy, or ADT, is a hormone treatment that shrinks prostate tumours. Researchers from the Brigham and Women’s Hospital in Boston found that black men undergoing the therapy had a 77 percent higher risk of death than nonblack men. Researchers at Brigham and Women’s Hospital looked through medical records of about 1,500 men from the Chicago Prostate Cancer Centre with low- or intermediate-risk prostate cancer who were treated with ADT. About 7 percent were black.

The small study, in the journal Cancer, found that black men were usually younger, treated later and more likely to have other health issues. Black men had a higher incidence of death after only four months of hormone therapy, the researchers found, but none of the causes of death in the study were actually prostate cancer.

Konstantin Kovtun, one of the lead researchers for the study, said the deaths seem to be related to cardiovascular health issues that existed prior to a cancer diagnosis.

“African American men have an onset of cardiovascular problems that are linked to ADT use,” he said. The study noted that earlier research has found shorter survival rates among intermediate- to high-risk prostate cancer patients using ADT because of an increased risk in fatal heart attack.

Jonathan Simons, president and chief executive officer of the Prostate Cancer Foundation, said the study was interesting but needs to be followed by more research, including a closer examination of the causes of death. “We don’t know the real reason for the number of deaths,” he said.

Black men typically fare worse with prostate cancer than white men, Simons said, and the reasons for the differences are understudied and poorly understood. “You can have a man of European and a man of African descent,” he said. “Even if they get the same health care, insurance and doctors, black men still have it worse with prostate cancer.” Kovtun hopes that the study helps inform decisions about treatment. “If I was a physician and I had the data now available for the study, I would be more careful in using ADT for African American men,” he said.