The prostate gland is about the size of a walnut when a man is in his 20s. By the time he is 40, it may have grown to the size of an apricot. Learn about the main causes of prostate change, including prostatitis, enlarged prostate, and prostate cancer, and know what to ask the doctor about prostate cancer screening tests.
Human Prostate ProstateZones
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About the Prostate
MRI Slices of the Prostate
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MRI Slices of the Prostate
Radiologists view different cross-sectional slices of the prostate, including the sagittal and axial slices, in order to detect any abnormalities.
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About the Prostate
The prostate is a small gland in men. It is part of the male reproductive system. The prostate is about the size and shape of a walnut. It sits low in the pelvis, below the bladder and just in front of the rectum. The prostate helps make semen, the milky fluid that carries sperm from the testicles through the penis when a man ejaculates. The prostate surrounds part of the urethra, a tube that carries urine out of the bladder and through the penis.
How the Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren't noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
Are passing urine more during the day
Have an urgent need to pass urine
Have less urine flow
Feel burning when you pass urine
Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation (prostatitis), enlarged prostate (BPH, or benign prostatic hyperplasia), and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
Source: National Cancer Institute (NCI)
Additional Materials (39)
Prostate with Ejaculatory Duct and Prostatic Urethra cross section lateral view
Prostate with Ejaculatory Duct and Prostatic Urethra cross section lateral view : Seminal fluid mixes with sperm to make semen in the ejaculatory duct, inside the prostate. As semen travels through the urethra, the prostate adds prostatic fluid. The prostatic urethra carries urine through the prostate.
Image by TheVisualMD
What Is The Prostate Gland? - How Prostate works
Video by Dr. DAVID B. SAMADI/YouTube
Visualizing the Prostate
MRI is currently the most effective tool for visualizing the prostate. Here, radiologist and prostate specialist Dr. Aytekin Oto of the University Of Chicago Hospital takes you on a tour of the prostate through Magnetic Resonance Imaging (MRI).
Image by TheVisualMD
Prostate and Surrounding Anatomy
The prostate sits within the pelvic bone, directly behind the pubic symphysis. It is situated below the bladder and in front of the rectum. The urethra, which carries both semen and urine, runs through the prostate. The two ejaculatory ducts merge with the urethra at about the center of the gland. The ejaculatory ducts carry the contents of the seminal vesicles and ductus deferens. The seminal vesicles, which produce seminal fluid, are perched on the top rear part of the prostate. The ductus deferens carry sperm up from the testicles and wrap around the back of the bladder, merging with the seminal vesicles to enter the prostate. The prostate receives its blood supply from the prostatic branches of the inferior vesical artery.
Image by TheVisualMD
Structure of the penis: urogenital system (preview) - Human Anatomy | Kenhub
Video by Kenhub - Learn Human Anatomy/YouTube
Introduction to Male Reproductive Anatomy - Part 2 - Vas Deferens and Accessory Glands
Video by AnatomyZone/YouTube
Reproductive System - Male Overview
Video by Armando Hasudungan/YouTube
The Reproductive System: How Gonads Go - CrashCourse Biology #34
Video by CrashCourse/YouTube
Male Pelvis Showing Prostate and Bladder
Male Pelvis Showing Prostate and Bladder: Visualization of an axial cut of the mail torso revealing the prostate gland. About the size of a walnut, the prostate gland is the largest accessory gland of the male reproductive system. Two thirds of the prostate is glandular while the remaining third is fibromuscular. The glandular tissue secretes a lubricant that helps to prevent infection in the urethra and protects and energizes sperm; this makes up to one third of the seminal plasma in semen. The smooth muscle of the prostate helps to expel semen upon ejaculation. The seminal vesicles also contribute to the make-up of seminal plasma: they secrete a thick alkaline fluid that mixes with the sperm as it passes into the ejaculatory ducts and the urethra.
Image by TheVisualMD
Cross-section diagram of transrectal prostate biopsy with ultrasound probe guiding the needle to the prostate. An inset shows a close-up of a needle entering the prostate
Transrectal ultrasound and prostate biopsy
Image by NIDDK Image Library
Prostate and Surrounding Anatomy
The prostate sits within the pelvic bone, directly behind the pubic symphysis. It is situated below the bladder and in front of the rectum. The urethra, which carries both semen and urine, runs through the prostate. The two ejaculatory ducts merge with the urethra at about the center of the gland. The ejaculatory ducts carry the contents of the seminal vesicles and ductus deferens. The seminal vesicles, which produce seminal fluid, are perched on the top rear part of the prostate. The ductus deferens carry sperm up from the testicles and wrap around the back of the bladder, merging with the seminal vesicles to enter the prostate. The prostate receives its blood supply from the prostatic branches of the inferior vesical artery.
Image by TheVisualMD
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Prostate Specific Antigen: Prostate
The prostate gland sits below the bladder; the prostate contributes fluid that helps carry ensure survival of sperm in the vaginal tract. The fluid contains a protein called prostate-specific antigen (PSA), which, if found in the blood, sometimes indicate cancer.
Image by TheVisualMD
Prostate Gland and Seminal Vesicle
Medical visualization of a an anterior view of the prostate gland. In this view, the bladder has been removed in order to visualize the seminal vesicles as well as the junction of the seminal vesicles and ductus deferens. A section of the prostate has also been taken out to show the urethra passing through the prostate. About the size of a walnut, the prostate gland is the largest accessory gland of the male reproductive system. Two thirds of the prostate is glandular while the remaining third is fibromuscular. The glandular tissue secretes a lubricant that helps to prevent infection in the urethra and protects and energizes sperm; this makes up to one third of the seminal plasma in semen. The smooth muscle of the prostate helps to expel semen upon ejaculation. The seminal vesicles also contribute to the make-up of seminal plasma: they secrete a thick alkaline fluid that mixes with the sperm as it passes into the ejaculatory ducts and the urethra.
Image by TheVisualMD
Prostate Gland
Prostate and Seminal Vesicles sagittal and axial slices : Derived from magnetic resonance imaging (MRI) data, the axial and sagittal slices (cross sections) through the prostate reveal the glandular tissue of the prostate as well as the ejaculatory ducts and the urethra. The inner coils of the seminal vesicles are also visible within the slices. Seminal fluid from the seminal vesicles mixes with sperm from the testes, via the ductus deferens, within the ejaculatory duct. The contents of the ejaculatory duct are then deposited into the urethra. There prostatic fluid is added to the mix along with contributions from the bulbourethral glands, forming semen. The prostatic urethra most often carries urine from the bladder and through the prostate.
Image by TheVisualMD
Prostate Gland
Visualization of the prostate gland. The prostate gland is the largest accessory gland of the male reproductive system. Two thirds of the prostate is glandular while the remaining third is fibromuscular. Prostatic secretions help to prevent infection in the urethra, energizes sperm and keep the urethral lining moist.
Image by TheVisualMD
Prostate Cross Sections
Derived from magnetic resonance imaging (MRI) data, the axial and sagittal slices (cross sections) through the prostate reveal the glandular tissue of the prostate as well as the ejaculatory ducts and the urethra. The inner coils of the seminal vesicles are also visible within the slices. Seminal fluid from the seminal vesicles mixes with sperm from the testes, via the ductus deferens, within the ejaculatory duct. The contents of the ejaculatory duct are then deposited into the urethra. There prostatic fluid is added to the mix along with contributions from the bulbourethral glands, forming semen. The prostatic urethra most often carries urine from the bladder and through the prostate.
Image by TheVisualMD
Bone Pain Symptom
Prostate Cancer Bone Pain Symptom - Prostate cancer usually causes no symptoms in its early stages. Unless detected through screening, the disease may not be discovered until it has spread beyond the prostate gland. Symptoms can include pain in the lower back, pelvis, hips, or thigh bones
Image by TheVisualMD
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Prostate and bladder, sagittal section.
Illustration of anatomy of Prostate and bladder, sagittal section
Image by National Cancer Institute
Male Pelvis Showing Prostate Gland
Medical visualization of a superior-frontal view of the prostate gland. About the size of a walnut, the prostate gland is the largest accessory gland of the male reproductive system. Two thirds of the prostate is glandular while the remaining third is fibromuscular. The glandular tissue secretes a lubricant that helps to prevent infection in the urethra and protects and energizes sperm; this makes up to one third of the seminal plasma in semen. The smooth muscle of the prostate helps to expel semen upon ejaculation. The seminal vesicles also contribute to the make-up of seminal plasma: they secrete a thick alkaline fluid that mixes with the sperm as it passes into the ejaculatory ducts and the urethra.
Image by TheVisualMD
Male Pelvis Showing Prostate Gland
Medical visualization of a superior-oblique view of the prostate gland. About the size of a walnut, the prostate gland is the largest accessory gland of the male reproductive system. Two thirds of the prostate is glandular while the remaining third is fibromuscular. The glandular tissue secretes a lubricant that helps to prevent infection in the urethra and protects and energizes sperm; this makes up to one third of the seminal plasma in semen. The smooth muscle of the prostate helps to expel semen upon ejaculation. The seminal vesicles also contribute to the make-up of seminal plasma: they secrete a thick alkaline fluid that mixes with the sperm as it passes into the ejaculatory ducts and the urethra.
Image by TheVisualMD
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Prostate
Prostate and Urethra with Rectum and Bladder Surrounded by Nerves: The side effects of prostate cancer treatment can be severe and sometimes permanent. They include impotence, incontinence, bleeding, and nerve damage.
Image by TheVisualMD
human male reproductive system - Prostate Gland
Male Reproductive System: The prostate sits behind the base of the penis, underneath the bladder, and in front of the rectum. The urethra, which carries both semen and urine, runs through the prostate and is joined by the two seminal ducts at about the center of the gland. The seminal vesicles are located at the top rear part of the prostate. The gland is composed of five lobes: the anterior (front) lobe, the median (middle) lobe, the two lateral (side) lobes, and the posterior (rear) lobe.
Image by TheVisualMD
Prostate Cross Sections
Derived from magnetic resonance imaging (MRI) data, the axial and sagittal slices (cross sections) through the prostate reveal the glandular tissue of the prostate as well as the ejaculatory ducts and the urethra. The inner coils of the seminal vesicles are also visible within the slices. Seminal fluid from the seminal vesicles mixes with sperm from the testes, via the ductus deferens, within the ejaculatory duct. The contents of the ejaculatory duct are then deposited into the urethra. There prostatic fluid is added to the mix along with contributions from the bulbourethral glands, forming semen. The prostatic urethra most often carries urine from the bladder and through the prostate.
Image by TheVisualMD
Male Pelvis Showing Prostate and Bladder
3D visualization of an anterior view of a male revealing the prostate and bladder.
Image by TheVisualMD
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Prostate and Seminal Vesicles with Penis and Testicles superior view
The prostate gland is located below the bladder. It secretes a thin, milky-white liquid called prostatic fluid that is rich in zinc, citric acid, choline, and various proteins and hormones, which provide a protective medium that helps ensure the survival of sperm as they make their way through the vaginal tract. Prostatic fluid contributes about 30% of the volume of semen. The nearby seminal vesicles contribute about 60%; one of the most important components of seminal fluid is the sugar fructose, which provides energy for the sperm on their journey.
Image by TheVisualMD
Normal Prostate with Pelvis Anatomy lateral view
The prostate sits behind the base of the penis, underneath the bladder, and in front
Image by TheVisualMD
Normal Prostate with Erect Penis cross section
The prostate gland's main function is to secrete prostatic fluid. Prostatic fluid constitutes about 30% of semen, and contains many different proteins and hormones that nourish sperm and protect them in their journey through a woman's vagina. The prostate is a muscular gland. During ejaculation, its contractions help propel semen out of the penis.
Image by TheVisualMD
Prostate Anatomy
The prostate gland is found only in males and is an essential part of the male reproductive system. It's about the size and shape of a walnut or a small plum in young men. In older men it normally grows to about the size of a lemon. It fits snugly into its position, sitting about 2 inches above the perineum, the muscular area between the scrotum and anus. The prostate's tissue is both glandular and nonglandular. It is made up of thousands of tiny fluid-producing glands interspersed with blood vessels, within a fibromuscular framework.
Image by TheVisualMD
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Prostate and Seminal Vesicles with Penis and Testicles close up
The prostate gland is located below the bladder. It secretes a thin, milky-white liquid called prostatic fluid that is rich in zinc, citric acid, choline, and various proteins and hormones, which provide a protective medium that helps ensure the survival of sperm as they make their way through the vaginal tract. Prostatic fluid contributes about 30% of the volume of semen. The nearby seminal vesicles contribute about 60%; one of the most important components of seminal fluid is the sugar fructose, which provides energy for the sperm on their journey.
Image by TheVisualMD
Normal Prostate with Erect Penis cross section
The prostate gland's main function is to secrete prostatic fluid. Prostatic fluid constitutes about 30% of semen, and contains many different proteins and hormones that nourish sperm and protect them in their journey through a woman's vagina. The prostate is a muscular gland. During ejaculation, its contractions help propel semen out of the penis.
Image by TheVisualMD
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Male Reproductive System
Visualization reconstructed from scanned human data of a cross-section of the male reproductive organs. Remaining dormant until puberty, the ultimate goal of the male reproductive system is to produce and deliver the male gamete, sperm to the female where fertilization can occur. The male gonads, the testes, serve two functions: to manufacture motile sperm and produce male sex hormones. The accessory ducts serve to aid in the delivery of sperm from its production site to the exterior of the body. These accessory structures include the epididymis, ductus deferens and urethra. Accessory glands, the prostate, seminal vesicles and bulbourethral glands serve to produce semen made up of proteins which facilitate the motility of sperm.
Image by TheVisualMD
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Male Genitourinary Anatomy
Illustration of the male genitourinary anatomy; drawing shows side view of bladder, lymph nodes, seminal vesicle, rectum, prostate gland, penis, urethra, and testicle.
Image by National Cancer Institute (NCI) / NIH Medical Arts
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Genitourinary Anatomy
Male Genitourinary Anatomy
Image by National Cancer Institute (NCI) Creator: NIH Medical Arts
Vasectomy
A diagram of the human male genitalia surrounding a vasectomy. A.) Penis; B.) Urethra; C.) Scrotum; D.) Testicle; E.) Epididymis; F.) Vasectomy; G.) Prostate; H.) Seminal vesicle; I.) Bladder; J.) Pubic bone; K.) Vas deferens
Image by Rhcastilhos
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Male reproductive system
Male reproductive system
Image by Male_anatomy.png: alt.sex FAQ derivative work: Tsaitgaist (talk)
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Male reproductive system
Diagram of a cross-section of the human male reproductive system.
Image by PD-USGOV
Male Urinary System
Male pelvic structures
Image by User:Indolences
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Male Reproductive System
Male Reproductive System
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Anatomy of the Male Reproductive System
Anatomy of the Male Reproductive System
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Prostate with Ejaculatory Duct and Prostatic Urethra cross section lateral view
TheVisualMD
1:13
What Is The Prostate Gland? - How Prostate works
Dr. DAVID B. SAMADI/YouTube
Visualizing the Prostate
TheVisualMD
Prostate and Surrounding Anatomy
TheVisualMD
3:30
Structure of the penis: urogenital system (preview) - Human Anatomy | Kenhub
Kenhub - Learn Human Anatomy/YouTube
7:10
Introduction to Male Reproductive Anatomy - Part 2 - Vas Deferens and Accessory Glands
AnatomyZone/YouTube
19:20
Reproductive System - Male Overview
Armando Hasudungan/YouTube
12:02
The Reproductive System: How Gonads Go - CrashCourse Biology #34
CrashCourse/YouTube
Male Pelvis Showing Prostate and Bladder
TheVisualMD
Cross-section diagram of transrectal prostate biopsy with ultrasound probe guiding the needle to the prostate. An inset shows a close-up of a needle entering the prostate
NIDDK Image Library
Prostate and Surrounding Anatomy
TheVisualMD
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Prostate Specific Antigen: Prostate
TheVisualMD
Prostate Gland and Seminal Vesicle
TheVisualMD
Prostate Gland
TheVisualMD
Prostate Gland
TheVisualMD
Prostate Cross Sections
TheVisualMD
Bone Pain Symptom
TheVisualMD
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Prostate and bladder, sagittal section.
National Cancer Institute
Male Pelvis Showing Prostate Gland
TheVisualMD
Male Pelvis Showing Prostate Gland
TheVisualMD
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Prostate
TheVisualMD
human male reproductive system - Prostate Gland
TheVisualMD
Prostate Cross Sections
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Male Pelvis Showing Prostate and Bladder
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Prostate and Seminal Vesicles with Penis and Testicles superior view
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Normal Prostate with Pelvis Anatomy lateral view
TheVisualMD
Normal Prostate with Erect Penis cross section
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Prostate Anatomy
TheVisualMD
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Prostate and Seminal Vesicles with Penis and Testicles close up
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Normal Prostate with Erect Penis cross section
TheVisualMD
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Male Reproductive System
TheVisualMD
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Male Genitourinary Anatomy
National Cancer Institute (NCI) / NIH Medical Arts
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Genitourinary Anatomy
National Cancer Institute (NCI) Creator: NIH Medical Arts
Prostatitis is an inflammation of the prostate gland that may result from a bacterial infection. It affects at least half of all men at some time during their lives. Having this condition does not increase your risk of any other prostate disease.
Symptoms of prostatitis
Trouble passing urine
A burning or stinging feeling or pain when passing urine
Strong, frequent urge to pass urine, even when there is only a small amount of urine
Chills and high fever
Low back pain or body aches
Pain low in the belly, groin, or behind the scrotum
Rectal pressure or pain
Urethral discharge with bowel movements
Genital and rectal throbbing
Sexual problems and loss of sex drive
Painful ejaculation (sexual climax)
Several tests, such as DRE and a urine test, can be done to see if you have prostatitis. Correct diagnosis of your exact type of prostatitis is key to getting the best treatment. Even if you have no symptoms you should follow your doctor's advice to complete treatment.
Types of Prostatitis and Treatments
Acute bacterial prostatitis: This type is caused by a bacterial infection and comes on suddenly (acute). Symptoms include severe chills and fever. There is often blood in the urine. Your PSA level (see PSA test) may be higher than normal. You must go to the doctor's office or emergency room for treatment. It's the least common of the four types, yet it's the easiest to diagnose and treat.
Most cases can be cured with a high dose of antibiotics, taken for 7 to 14 days, and then lower doses for several weeks. You may also need drugs to help with pain or discomfort. If your PSA level was high, it will likely return to normal once the infection is cleared up.
Chronic bacterial prostatitis: Also caused by bacteria, this type of prostatitis doesn't come on suddenly, but it can be bothersome. The only symptom you may have is bladder infections that keep coming back. The cause may be a defect in the prostate that lets bacteria collect in the urinary tract.
Antibiotic treatment over a longer period of time is best for this type. Treatment lasts from 4 to 12 weeks. This type of treatment clears up about 60 percent of cases. Long-term, low-dose antibiotics may help relieve symptoms in cases that won't clear up.
Chronic prostatitis or chronic pelvic pain syndrome: This disorder is the most common but least understood type of prostatitis. Found in men of any age from late teens to the elderly, its symptoms can come and go without warning. There can be pain or discomfort in the groin or bladder area. Infection-fighting cells are often present, even though no bacteria can be found.
There are several different treatments for this problem, based on your symptoms. These include anti-inflammatory medications and other pain control treatments, such as warm baths. Other medicines, such as alpha-blockers, may also be given. Alpha-blockers relax muscle tissue in the prostate to make passing urine easier. Some men are treated with antibiotics in case the symptoms are caused by an undetected infection.
Asymptomatic inflammatory prostatitis: You don't have symptoms with this condition. It is often found when you are undergoing tests for other conditions, such as to determine the cause of infertility or to look for prostate cancer. If you have this form of prostatitis, your PSA test may show a higher number than normal.
Men with this condition are usually not treated, but a repeat PSA test will usually be done if the PSA number is high.
Source: National Cancer Institute (NCI)
Additional Materials (14)
Acute Bacterial Prostatitis
Abscess of the prostate resulting in urinary retension
Image by James Heilman, MD
Drawing of a middle-aged Asian man and a younger Asian man sitting in doctor's waiting room
For younger men, the most common prostate problem is prostatitis. For older men, it's an enlarged prostate.
Recognizing Prostatitis vs Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD
Prostate Cancer Research Institute/YouTube
2:06
What are the symptoms of prostatitis that should not be ignored?
Top Doctors UK/YouTube
2:15
Prostatitis | Healthy Male
Healthy Male/YouTube
4:50
Diagnosing Prostatitis
Bottom Line Inc/YouTube
Enlarged Prostate
Healthy Prostate / Enlarged Prostate
Healthy Prostate vs Enlarged Prostate
Interactive by TheVisualMD
Healthy Prostate / Enlarged Prostate
Healthy Prostate vs Enlarged Prostate
Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy or enlarged prostate, is the noncancerous growth of the prostate gland. BPH is very common: in the US, most men over the age of 60 have the disorder. The enlarged prostate can start to squeeze the urethra and make urination difficult.
Interactive by TheVisualMD
Prostate Changes That Are Not Cancer: Enlarged Prostate (BPH)
BPH stands for benign prostatic hyperplasia. Benign means "not cancer," and hyperplasia means abnormal cell growth. The result is that the prostate becomes enlarged. BPH is not linked to cancer and does not increase your risk of getting prostate cancer—yet the symptoms for BPH and prostate cancer can be similar.
Urine flow in a normal (left) and enlarged (right) prostate. In diagram on the left, urine flows freely. On the right, urine flow is affected because the enlarged prostate is pressing on the bladder and urethra.
Symptoms of BPH
Trouble starting a urine stream or making more than a dribble
Passing urine often, especially at night
Feeling that the bladder has not fully emptied
A strong or sudden urge to pass urine
Weak or slow urine stream
Stopping and starting again several times while passing urine
Pushing or straining to begin passing urine
At its worst, BPH can lead to: a weak bladder, backflow of urine causing bladder or kidney infections, complete block in the flow of urine and kidney failure.
The prostate gland is about the size of a walnut when a man is in his 20s. By the time he is 40, it may have grown slightly larger, to the size of an apricot. By age 60, it may be the size of a lemon. The enlarged prostate can press against the bladder and the urethra. This can slow down or block urine flow. Some men might find it hard to start a urine stream, even though they feel the need to go. Once the urine stream has started, it may be hard to stop. Other men may feel like they need to pass urine all the time, or they are awakened during sleep with the sudden need to pass urine. Early BPH symptoms take many years to turn into bothersome problems. These early symptoms are a cue to see your doctor.
Treatments for BPH
Some men with BPH eventually find their symptoms to be bothersome enough to need treatment. BPH cannot be cured, but drugs or surgery can often relieve its symptoms. Talk with your doctor about the best choice for you. Your symptoms may change over time, so be sure to tell your doctor about any new changes.
Watchful waiting
Men with mild symptoms of BPH who do not find them bothersome often choose this approach. Watchful waiting means getting annual checkups. Treatment is started only if symptoms become too much of a problem.
If you choose watchful waiting, these simple steps may help lessen your symptoms:
Limit drinking in the evening, especially drinks with alcohol or caffeine.
Empty your bladder all the way when you pass urine.
Use the restroom often. Don't wait for long periods without passing urine.
Some medications can make BPH symptoms worse, so talk with your doctor or pharmacist about any medicines you are taking such as:
Over-the-counter cold and cough medicines (especially antihistamines)
Tranquilizers
Antidepressants
Blood pressure medicine.
Drug Therapy
Many American men with mild to moderate BPH symptoms have chosen prescription drugs over surgery since the early 1990s. Two main types of drugs are used. One type relaxes muscles near the prostate, and the other type shrinks the prostate gland. Some evidence shows that taking both drugs together may work best to keep BPH symptoms from getting worse.
Alpha-blockers are drugs that help relax muscles near the prostate to relieve pressure and let urine flow more freely, but they don't shrink the size of the prostate. For many men, these drugs can improve urine flow and reduce the symptoms of BPH within days. Possible side effects include dizziness, headache, and fatigue.
5 alpha-reductase inhibitors are drugs that help shrink the prostate. They relieve symptoms by blocking the activity of an enzyme known as 5-alpha reductase. This enzyme changes the male hormone testosterone into dihydrotestosterone (DHT), which stimulates prostate growth. When the action of 5-alpha reductase is blocked, DHT production is lowered and prostate growth slows. This helps shrink the prostate, reduce blockage, and limit the need for surgery.
Taking these drugs can help increase urine flow and reduce your symptoms. You must continue to take these drugs to prevent symptoms from coming back. 5-alpha reductase inhibitors can cause the following side effects in a small percentage of men including: decreased interest in sex, trouble getting or keeping an erection, and smaller amount of semen with ejaculation.
It's important to note that taking these drugs may lower your PSA test number. There is also evidence that these drugs lower the risk of getting prostate cancer, but whether they can help lower the risk of dying from prostate cancer is still unclear.
Surgery
The number of prostate surgeries has gone down over the years. But operations for BPH are still among the most common surgeries for American men. Surgery is used when symptoms are severe or drug therapy has not worked well. Be sure to discuss options with your doctor and ask about the potential short- and long-term benefits and risks with each procedure.
Types of surgery for BPH include:
TURP (transurethral resection of the prostate). The most common surgery for BPH, TURP accounts for 90 percent of all BPH surgeries. The doctor passes an instrument through the urethra and trims away extra prostate tissue. A spinal block (anesthesia) is used to numb the area. Tissue is sent to the laboratory to check for prostate cancer. TURP generally avoids the two main dangers linked to another type of surgery called open prostatectomy (complete removal of the prostate gland through a cut in the lower abdomen): including incontinence and/or impotence. However, TURP can have serious side effects, such as bleeding. In addition, men may have to stay in the hospital and need a catheter for a few days after surgery.
TUIP (transurethral incision of the prostate). This surgery, which is similar to TURP, is used on slightly enlarged prostate glands. The surgeon places one or two small cuts in the prostate. This relieves pressure without trimming away tissue. It has a low risk of side effects. Like TURP, this treatment helps with urine flow by widening the urethra.
TUNA (transurethral needle ablation). Radio waves are used to burn away excess prostate tissue. TUNA helps with urine flow, relieves symptoms, and may have fewer side effects than TURP. Most men need a catheter to drain urine for a period of time after the procedure.
TUMT (transurethral microwave thermotherapy). Microwaves sent through a catheter are used to destroy excess prostate tissue. This can be an option for men who should not have major surgery because they have other medical problems.
TUVP (transurethral electroevaporation of the prostate). An electrical current is used to vaporize prostate tissue.
Laser surgery. The doctor passes a laser fiber through the urethra into the prostate, using a cystoscope, and then delivers several bursts of laser energy. The laser energy destroys prostate tissue and helps improve urine flow. Like TURP, laser surgery requires anesthesia. One advantage of laser surgery over TURP is that laser surgery causes little blood loss. The recovery period for laser surgery may be shorter too. However, laser surgery may not be effective on larger prostates.
Open prostatectomy. This may be the only option in rare cases, such as when the obstruction is severe, the prostate is very large, or other procedures can't be done. General anesthesia or a spinal block is used, and a catheter remains for 3 to 7 days after the surgery. This surgery carries the highest risk of complications. Tissue is sent to the laboratory to check for prostate cancer.
Source: National Cancer Institute (NCI)
Additional Materials (11)
Prostate (Normal and Enlarged)
A two-panel illustration of the flow of urine with a normal prostate and then with an enlarged prostate/BPH. Image is included in this publication:
See also http://www.cancer.gov/cancertopics/understanding-prostate-changes/.
Image by National Cancer Institute / Alan Hoofring (Illustrator)
Normal vs enlarged prostate
BPH - Prostate enlargement problems
Image by Akcmdu9
What Is The Prostate Gland? - How Prostate works
Video by Dr. DAVID B. SAMADI/YouTube
BRCA Testing and Prostate Cancer Treatment Decisions | Ask a Prostate Expert, Mark Scholz, MD
Video by Prostate Cancer Research Institute/YouTube
Mayo Clinic Minute: Steam treatment for enlarged prostate
Video by Mayo Clinic/YouTube
Living with an Enlarged Prostate, or Benign Prostatic Hyperplasia (BPH)
ENLARGED PROSTATE GLAND, Causes, Signs and Symptoms, Diagnosis and Treatment.
Medical Centric/YouTube
1:58
Botox for Enlarged Prostate-Mayo Clinic
Mayo Clinic/YouTube
Prostate Cancer
Extracapsular Extension of Prostate Cancer Cells
Image by TheVisualMD
Extracapsular Extension of Prostate Cancer Cells
Extracapsular extension refers to the point at which the prostate cancer cells have extended into, and possibly through, the prostate capsule (the outer lining of the prostate gland). The cancer cells may extend through parts of one or both lobes of the gland. Extracapsular extension does not mean the same thing as metastatic cancer.
Image by TheVisualMD
Prostate Changes Leading to Prostate Cancer
Prostate cancer means that cancer cells form in the tissues of the prostate. Prostate cancer tends to grow slowly compared with most other cancers. Cell changes may begin 10, 20, or even 30 years before a tumor gets big enough to cause symptoms. Eventually, cancer cells may spread (metastasize). By the time symptoms appear, the cancer may already be advanced.
By age 50, very few men have symptoms of prostate cancer, yet some precancerous or cancer cells may be present. More than half of all American men have some cancer in their prostate glands by the age of 80. Most of these cancers never pose a problem. They may never cause symptoms or become a serious threat to health.
Symptoms of Prostate Cancer
Trouble passing urine
Frequent urge to pass urine, especially at night
Weak or interrupted urine stream
Pain or burning when passing urine
Blood in the urine or semen
Painful ejaculation
Nagging pain in the back, hips, or pelvis
Prostate cancer can spread to the lymph nodes of the pelvis. Or it may spread throughout the body. It tends to spread to the bones. So bone pain, especially in the back, can be a symptom of advanced prostate cancer.
Risk Factors For Prostate Cancer
Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesn't mean that you will get prostate cancer. It just means that your risk of the disease is greater.
Age. Men who are 50 or older have a higher risk of prostate cancer.
Race. African-American men have the highest risk of prostate cancer—the disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a man's relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.
Prostate Cancer Screening
Screening means testing for cancer before you have any symptoms. A screening test may help find cancer at an early stage, when it is less likely to have spread and may be easier to treat. By the time symptoms appear, the cancer may have started to spread.
The most useful screening tests are those that have been proven to lower a person's risk of dying from cancer. Doctors do not yet know whether prostate cancer screening lowers the risk of dying from prostate cancer. Therefore, large research studies, with thousands of men, are now going on to study prostate cancer screening. The National Cancer Institute is studying the combination of PSA testing and DRE as a way to get more accurate results.
Although some people feel it is best to treat any cancer that is found, including cancers found through screening, prostate cancer treatment can cause serious and sometimes permanent side effects. Some doctors are concerned that many men whose cancer is detected by screening are being treated—and experiencing side effects—unnecessarily. Talk with your doctor about your risk of prostate cancer and your need for screening tests.
Large research studies are looking at how prostate cancer can be prevented. Studies have shown that 5-alpha reductase inhibitors finasteride and dutasteride can lower the risk of developing prostate cancer, but whether they can decrease the risk of dying of prostate cancer is still unclear.
Talk with your doctor about your risk of prostate cancer and your need for screening tests.
Source: National Cancer Institute (NCI)
Additional Materials (20)
Prostate Cancer - T1-3 stages
Prostate cancer pressing on the urethra, which can cause symptoms
Prostate cancer that has spread to the lymph nodes
Prostate cancer that has spread to the bones
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Prostate Cancer Staging
Prostate Cancer - T1-3 stages
Diagram showing prostate cancer pressing on the urethra.
Interactive by Cancer Research UK / Wikimedia Commons
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Prostate and Seminal Vesicles with Penis and Testicles
Prostate cancer is a malignant growth in the prostate, a walnut-sized gland found only in men that helps produce semen. Some prostate cancers are aggressive, but many grow slowly and may never metastasize (spread). In the US, prostate cancer is the second leading cause of cancer death among men, after lung cancer. One in six men will be diagnosed with prostate cancer during his lifetime, and one man in 35 will die of the disease. But the death rate for prostate cancer is decreasing, and the disease is being diagnosed earlier as well.
Image by TheVisualMD
Prostate Anatomy by Zones with insets
Prostate cancer usually starts in certain zones of the prostate. Knowledge of these different zones helps the doctor to decide where to biopsy tissue and where to look for cancer spread. In this image, the central zone is shown as orange, the transition zone is shown as green, and the peripheral zone is shown as yellow.
Image by TheVisualMD
Prostate cancer that has spread to the lymph nodes
Prostate cancer that has spread to the bones
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Prostate Cancer Spread , Lymph and Bone
Diagram showing prostate cancer that has spread to the lymph nodes.
Diagram showing prostate cancer that has spread to the bones.
Interactive by Cancer Research UK / Wikimedia Commons
Prostate Cancer Animation
Video by Blausen Medical Corporate/YouTube
CT
PET/CT
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Prostate Cancer PET/CT 1) CT Scan 2) CT/Pet Scan 3) Pet Scan
Positron emission tomography (PET) scans produce pictures of the body's metabolic functions, such as where glucose is concentrated in cancerous tumors. Computed tomography (CT) scans use X-rays to create images of the body's anatomical structures. PET/CT scans combine PET with CT to show both metabolic functions and anatomical structures. PET/CT is the best imaging technology for detecting cancer recurrence.
Interactive by TheVisualMD
What is prostate cancer? | Cancer Research UK
Video by Cancer Research UK/YouTube
NHS Prostate Cancer Screening Module 1
Video by AS&K Communications - Visual Science/YouTube
NHS Prostate Cancer Screening Module 3
Video by AS&K Communications - Visual Science/YouTube
NHS Prostate Cancer Screening Module 4
Video by AS&K Communications - Visual Science/YouTube
NHS Prostate Cancer Screening Module 2
Video by AS&K Communications - Visual Science/YouTube
Genetic Testing for Advanced Prostate Cancer (Royal Stage) | Prostate Cancer Staging Guide
Video by Prostate Cancer Research Institute/YouTube
Prostate Cancer Monitoring and Staging with PSA | Prostate Cancer Staging Guide
Video by Prostate Cancer Research Institute/YouTube
Reducing Side Effects of Hormone Therapy for Prostate Cancer | Prostate Cancer Staging Guide
Video by Prostate Cancer Research Institute/YouTube
African Americans and Prostate Cancer | Ask a Prostate Oncologist, Mark Scholz, MD
Video by Prostate Cancer Research Institute/YouTube
The Five Stages of Prostate Cancer | Prostate Cancer Staging Guide
Video by Prostate Cancer Research Institute/YouTube
What are the Signs and Symptoms of Prostate Cancer? | Cancer Research UK
Video by Cancer Research UK/YouTube
Prostate Cancer Treatment | Cancer Research UK
Video by Cancer Research UK/YouTube
Does Stress Cause Prostate Cancer? | Ask a Prostate Cancer Expert, Mark Scholz, MD
Video by Prostate Cancer Research Institute/YouTube
Foods To Help Prevent Prostate Cancer - Anti Prostate Cancer Diet
Video by Dr. DAVID B. SAMADI/YouTube
Prostate Cancer Staging
Cancer Research UK / Wikimedia Commons
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Prostate and Seminal Vesicles with Penis and Testicles
TheVisualMD
Prostate Anatomy by Zones with insets
TheVisualMD
Prostate Cancer Spread , Lymph and Bone
Cancer Research UK / Wikimedia Commons
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Prostate Cancer Animation
Blausen Medical Corporate/YouTube
Prostate Cancer PET/CT 1) CT Scan 2) CT/Pet Scan 3) Pet Scan
TheVisualMD
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What is prostate cancer? | Cancer Research UK
Cancer Research UK/YouTube
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NHS Prostate Cancer Screening Module 1
AS&K Communications - Visual Science/YouTube
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NHS Prostate Cancer Screening Module 3
AS&K Communications - Visual Science/YouTube
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NHS Prostate Cancer Screening Module 4
AS&K Communications - Visual Science/YouTube
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NHS Prostate Cancer Screening Module 2
AS&K Communications - Visual Science/YouTube
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Genetic Testing for Advanced Prostate Cancer (Royal Stage) | Prostate Cancer Staging Guide
Prostate Cancer Research Institute/YouTube
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Prostate Cancer Monitoring and Staging with PSA | Prostate Cancer Staging Guide
Prostate Cancer Research Institute/YouTube
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Reducing Side Effects of Hormone Therapy for Prostate Cancer | Prostate Cancer Staging Guide
Prostate Cancer Research Institute/YouTube
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African Americans and Prostate Cancer | Ask a Prostate Oncologist, Mark Scholz, MD
Prostate Cancer Research Institute/YouTube
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The Five Stages of Prostate Cancer | Prostate Cancer Staging Guide
Prostate Cancer Research Institute/YouTube
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What are the Signs and Symptoms of Prostate Cancer? | Cancer Research UK
Cancer Research UK/YouTube
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Prostate Cancer Treatment | Cancer Research UK
Cancer Research UK/YouTube
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Does Stress Cause Prostate Cancer? | Ask a Prostate Cancer Expert, Mark Scholz, MD
Prostate Cancer Research Institute/YouTube
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Foods To Help Prevent Prostate Cancer - Anti Prostate Cancer Diet
Dr. DAVID B. SAMADI/YouTube
Common Tests
Growth of Prostate Cancer _01
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Growth of Prostate Cancer
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Growth of Prostate Cancer
Interactive by TheVisualMD
Prostate Tests
What is the prostate?
The prostate is a walnut-shaped gland that is part of the male reproductive system. It has two or more lobes, or sections, enclosed by an outer layer of tissue. The prostate is located in front of the rectum and just below the bladder, where urine is stored. It surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen.
Side view of male urinary tract
What are some common prostate problems?
The most common prostate problem in men younger than age 50 is inflammation, called prostatitis. Prostate enlargement, or benign prostatic hyperplasia (BPH), is another common problem. Because the prostate continues to grow as a man ages, BPH is the most common prostate problem for men older than age 50. Older men are at risk for prostate cancer as well, but it is much less common than BPH.
What are the symptoms of prostate problems?
The symptoms of prostate problems may include
urinary retention—the inability to empty the bladder completely
urinary frequency—urination eight or more times a day
urinary urgency—the inability to delay urination
urinary incontinence—the accidental loss of urine
nocturia—frequent urination at night
trouble beginning a urine stream
weak or interrupted urine stream
blockage of urine
urine that has an unusual color or odor
pain after ejaculation or during urination
Different prostate problems may have similar symptoms. For example, one man with prostatitis and another with BPH may both experience urinary urgency. Sometimes symptoms for the same prostate problem differ among individuals. For example, one man with BPH may have trouble beginning a urine stream, while another may experience nocturia. A man in the early stages of prostate cancer may have no symptoms at all. Because of this confusing array of symptoms, a thorough medical exam and testing are vital.
How are prostate problems diagnosed?
To diagnose prostate problems, the health care provider will perform a digital rectal exam (DRE). The health care provider will also ask the patient
when the problem began and how often it occurs
what symptoms are present
whether he has a history of recurrent urinary tract infections
what medications he takes, both prescription and those bought over the counter
the amount of fluid he typically drinks each day
whether he consumes caffeine and alcohol
about his general medical history, including any major illnesses or surgeries
Answers to these questions will help the health care provider identify the problem or determine what medical tests are needed. Diagnosing BPH may require a series of medical exams and tests.
How is a digital rectal exam (DRE) performed?
A DRE is a physical exam of the prostate. The health care provider will ask the patient to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to it. The DRE may be slightly uncomfortable, but it is brief. This exam reveals whether the prostate has any abnormalities that require more testing. If an infection is suspected, the health care provider might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first. Many health care providers perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.
Digital rectal exam
What is the first test for detecting prostate problems?
The first test for detecting prostate problems is a blood test to measure prostate-specific antigen (PSA), a protein made only by the prostate gland. This test is often included in routine physical exams for men older than age 50. Because African American men have higher rates of getting, and dying from, prostate cancer than men of other racial or ethnic groups in the United States, medical organizations recommend a PSA blood test be given starting at age 40 for African American men. Medical organizations also recommend a PSA blood test be given starting at age 40 for men with a family history of prostate cancer. Some medical organizations even recommend a PSA blood test be given to all men starting at age 40.
If urination problems are present or if a PSA blood test indicates a problem, additional tests may be ordered. These tests may require a patient to change his diet or fluid intake or to stop taking medications. If the tests involve inserting instruments into the urethra or rectum, antibiotics may be given before and after the test to prevent infection.
Why is a prostate-specific antigen (PSA) blood test performed?
A PSA blood test is performed to detect or rule out prostate cancer. The amount of PSA in the blood is often higher in men who have prostate cancer. However, an elevated PSA level does not necessarily indicate prostate cancer. The U.S. Food and Drug Administration has approved the PSA blood test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret a PSA blood test, its ability to discriminate between cancer and problems such as BPH and prostatitis, and the best course of action if the PSA level is high.
When done in addition to a DRE, a PSA blood test enhances detection of prostate cancer. However, the test is known to have relatively high false-positive rates. A PSA blood test also may identify a greater number of medically insignificant lumps or growths, called tumors, in the prostate. Health care providers and patients should weigh the benefits of PSA blood testing against the risks of follow-up diagnostic tests. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection.
What are additional tests for detecting prostate problems?
If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging (MRI) or computerized tomography (CT) scan.
Urinalysis
Urinalysis is the testing of a urine sample for abnormal substances or signs of infection. The urine sample is collected in a special container in a health care provider’s office or commercial facility and can be tested in the same location or sent to a lab for analysis.
If an infection is suspected, the health care provider may ask that the urine sample be collected in two or three containers during a single urination to help locate the infection site. After the first collection, the health care provider will have the patient stop the urine stream for a prostate massage before collecting more urine. If signs of infection appear in the first container but not in the others, the infection is likely to be in the urethra. If the urine contains significantly more bacteria after the prostate massage or bacteria are in the prostate fluid itself, the infection is likely to be in the prostate.
Urodynamic Tests
Urodynamic testing is any procedure that looks at how well the bladder, sphincters, and urethra are storing and releasing urine. Most urodynamic tests focus on the bladder’s ability to hold urine and empty steadily and completely. If the prostate problem appears to be related to urine blockage, the health care provider may recommend tests that measure bladder pressure and urine flow rate. One test involves urinating into a special device that measures how quickly the urine is flowing and records how many seconds it takes for the peak flow rate to be reached. Another test measures postvoid residual, the amount of urine left in the bladder when urination stops. A weak urine stream and urinary retention may be signs of urine blockage caused by an enlarged prostate that is squeezing the urethra. Some urodynamic tests are performed in a health care provider’s office without anesthesia. Other urodynamic tests are performed in a health care provider’s office, outpatient center, or hospital with local anesthesia.
Cystoscopy
Cystoscopy is a procedure that allows the health care provider to look for blockage in the lower urinary tract. A cystoscope is a tubelike instrument used to look inside the urethra and bladder. After a solution numbs the inside of the penis, the health care provider inserts the cystoscope through the opening at the tip of the penis and into the lower urinary tract. By looking through the cystoscope, the health care provider can determine the location and degree of the urine blockage. A cystoscopy is performed in a health care provider’s office, outpatient center, or hospital with local anesthesia. The procedure is usually performed by a urologist, a doctor who specializes in treating problems of the urinary tract and the male reproductive system.
Abdominal Ultrasound
Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The transducer can be moved to different angles to make it possible to examine different organs. In abdominal ultrasound, the health care provider applies a gel to the patient’s abdomen and moves a handheld transducer over the skin. The gel allows the transducer to glide easily, and it improves the transmission of the signals. The procedure is performed in a health care provider’s office, outpatient center, or hospital by a specially trained technician and interpreted by a doctor, usually a radiologist—a doctor who specializes in medical imaging. Anesthesia is not needed. An abdominal ultrasound can create images of the entire urinary tract. The images can show damage or abnormalities in the urinary tract resulting from urine blockage at the prostate.
Transrectal Ultrasound with Prostate Biopsy
Transrectal ultrasound is most often used to examine the prostate. In a transrectal ultrasound, the health care provider inserts a transducer slightly larger than a pen into the man’s rectum next to the prostate. The ultrasound image shows the size of the prostate and any abnormal-looking areas, such as tumors. Transrectal ultrasound cannot definitively identify prostate cancer.
To determine whether a tumor is cancerous, the health care provider uses the transducer and ultrasound images to guide a needle to the tumor. The needle is then used to remove a few pieces of prostate tissue for examination with a microscope. This process, called biopsy, can reveal whether prostate cancer is present. A transrectal ultrasound with prostate biopsy is usually performed by a doctor in a health care provider’s office, outpatient center, or hospital with light sedation and local anesthesia. The biopsied prostate tissue is examined in a laboratory by a pathologist—a doctor who specializes in diagnosing diseases.
Tansrectal ultrasound with prostate biopsy
MRI and CT Scan
An MRI is a test that takes pictures of the body’s internal organs and soft tissues without using x-rays. The MRI machines use radio waves and magnets to produce detailed pictures. An MRI may also involve the injection of dye. A CT scan uses a combination of x-rays and computer technology to create three-dimensional (3-D) images. A CT scan may also involve the injection of a dye. MRI and CT scan images can help identify abnormal structures in the urinary tract, but they cannot distinguish between cancerous tumors and noncancerous prostate enlargement. Once a biopsy has confirmed cancer, these imaging techniques will show how far the cancer has spread. MRIs and CT scans are usually performed at an outpatient center or hospital by a specially trained technician and interpreted by a radiologist; anesthesia is not needed. For an MRI, light sedation may be used for people with a fear of confined spaces.
What happens after the prostate tests?
Urodynamic tests and cystoscopy may cause mild discomfort for a few hours after the procedures. Drinking an 8-ounce glass of water every half-hour for 2 hours may help reduce discomfort. The health care provider may recommend taking a warm bath or holding a warm, damp washcloth over the urethral opening to relieve discomfort. A prostate biopsy may produce pain in the area of the rectum and the perineum, which is between the rectum and the scrotum. A prostate biopsy may also produce blood in urine and semen.
An antibiotic may be prescribed for 1 or 2 days to prevent infection.
Patients with signs of infection—including pain, chills, or fever—should call their health care provider immediately.
How soon will prostate test results be available?
Results for simple medical tests such as some urodynamic tests, cystoscopy, and abdominal ultrasound are often available soon after the test. The results of other medical tests such as PSA blood test and prostate tissue biopsy may take several days to come back. A health care provider will talk with the patient about the results and possible treatments for the problem.
Eating, Diet, and Nutrition
Eating, diet, and nutrition have not been shown to play a role in causing or preventing prostate problems.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (3)
Standard Biopsy for Prostate Cancer
National Cancer Institute urologist and surgeon Dr. Peter Pinto explains the process of the standard multi-core or "blind" biopsy of the prostate.
Image by TheVisualMD
Urinalysis
Video by University of Dundee Clinical Skills/YouTube
Having a cystoscopy | Cancer Research UK
Video by Cancer Research UK/YouTube
Standard Biopsy for Prostate Cancer
TheVisualMD
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Urinalysis
University of Dundee Clinical Skills/YouTube
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Having a cystoscopy | Cancer Research UK
Cancer Research UK/YouTube
Tests Used to Check the Prostate
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3D Medical Illustration showing vas deferens
Image by Scientific Animations, Inc.
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3D Medical Illustration showing vas deferens
3D medical illustration depicting vas deferens and other major components of the male reproductive system.
Image by Scientific Animations, Inc.
Tests Used to Check the Prostate
This first step lets your doctor hear and understand the "story" of your prostate concerns. You'll be asked whether you have symptoms, how long you've had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing.
Digital Rectal Exam (DRE)
DRE is a standard way to check the prostate. With a gloved and lubricated finger, your doctor feels the prostate from the rectum. The test lasts about 10-15 seconds.
This exam checks for:
The size, firmness, and texture of the prostate
Any hard areas, lumps, or growth spreading beyond the prostate, and
Any pain caused by touching or pressing the prostate
The DRE allows the doctor to feel only one side of the prostate. A PSA test is another way to help your doctor check the health of your prostate.
PSA (Prostate-Specific Antigen) Test
The U.S. Food and Drug Administration (FDA) has approved the use of the PSA test along with a DRE to help detect prostate cancer in men age 50 and older. PSA is a protein made by prostate cells. It is normally secreted into ducts in the prostate, where it helps make semen, but sometimes it leaks into the blood. When PSA is in the blood, it can be measured with a blood test called the PSA test. In prostate cancer, more PSA gets into the blood than is normal. However, a high PSA blood level is not proof of cancer, and many other things can cause a false-positive test result. For example, blood PSA levels are often increased in men with prostatitis or BPH. Even things that disturb the prostate gland--such as riding a bicycle or motorcycle, or having a DRE, an orgasm within the past 24 hours, a prostate biopsy, or prostate surgery--may increase PSA levels.
Also, some prostate glands naturally produce more PSA than others. PSA levels go up with age. African-American men tend to have higher PSA levels in general than men of other races. And some drugs, such as finasteride and dutasteride, can cause a man's PSA level to go down. PSA tests are often used to follow men after prostate cancer treatment to check for signs of cancer recurrence. It is not yet known for certain whether PSA testing to screen for prostate cancer can reduce a man's risk of dying from the disease.
Researchers are working to learn more about the PSA test's ability to help doctors tell the difference between prostate cancer and benign prostate problems, and the best thing to do if a man has a high PSA level. For now, men and their doctors use PSA readings over time as a guide to see if more follow-up is needed.
PSA test results
PSA levels are measured in terms of the amount of PSA per volume of fluid tested. Doctors often use a value of 4 nanograms (ng) or higher per milliliter of blood as a sign that further tests, such as a prostate biopsy, are needed. Your doctor may monitor your PSA velocity, which means the rate of change in your PSA level over time. Rapid increases in PSA readings may suggest cancer. If you have a mildly elevated PSA level, you and your doctor may choose to do PSA tests on a scheduled basis and watch for any change in the PSA velocity.
Free PSA test
This test is used for men who have higher PSA levels. The standard PSA test measures total PSA, which includes both PSA that is attached, or bound, to other proteins and PSA that is free, or not bound. The free PSA test measures free PSA only. Free PSA is linked to benign prostate conditions, such as BPH, whereas bound PSA is linked to cancer. The percentage of free PSA can help tell what kind of prostate problem you have.
If both total PSA and free PSA are higher than normal (high percentage of free PSA), this suggests BPH rather than cancer.
If total PSA is high but free PSA is not (low percentage of free PSA), cancer is more likely. More testing, such as a biopsy, should be done.
You and your doctor should talk about your personal risk and free PSA results. Then you can decide together whether to have follow-up biopsies and, if so, how often.
Prostate Biopsy
If your symptoms or test results suggest prostate cancer, your doctor will refer you to a specialist (a urologist) for a prostate biopsy. For a biopsy, small tissue samples are taken directly from the prostate. Your doctor will take samples from several areas of the prostate gland. This can help lower the chance of missing any areas of the gland that may have cancer cells. Like other cancers, prostate cancer can be diagnosed only by looking at tissue under a microscope. Most men who have biopsies after prostate cancer screening exams do not have cancer.
A positive test result after a biopsy means prostate cancer is present. A pathologist will check your biopsy sample for cancer cells and will give it a Gleason score. The Gleason score ranges from 2 to 10 and describes how likely it is that a tumor will spread. The lower the number, the less aggressive the tumor is and the less likely it will spread. Treatment options depend on the stage (or extent) of the cancer (stages range from 1 to 4), Gleason score, PSA level, and your age and general health. This information will be available from your doctor and is listed on your pathology report.
Reaching a decision about treatment of your prostate cancer is a complex process. Many men find it helpful to talk with their doctors, family, friends, and other men who have faced similar decisions.
Source: National Cancer Institute (NCI)
Additional Materials (12)
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Prostate Specific Antigen (PSA), Digital Rectal Exam
The prostate gland is a small gland that sits below the bladder and encircles the urethra; the gland lies close to the wall of the rectum, which allows it to be felt in a digital rectal exam, which is performed to determine the gland is enlarged. The prostate contributes fluid that helps carry ensure survival of sperm in the vaginal tract; the fluid contains a protein called prostate-specific antigen (PSA). Normally, very little of this protein is found in the blood, but higher levels of PSA are associated with prostate cancer.
Image by TheVisualMD
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Exam, Digital Rectal
Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate.
Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal.
Image by National Cancer Institute / National Cancer Institute
What You Need To Know About Men's Health
Video by Prostate Cancer Research Institute/YouTube
Visualizing the Prostate
MRI is currently the most effective tool for visualizing the prostate. Here, radiologist and prostate specialist Dr. Aytekin Oto of the University Of Chicago Hospital takes you on a tour of the prostate through Magnetic Resonance Imaging (MRI).
Image by TheVisualMD
Prostate Cancer
Most prostate cancers are detected early while still confined to the prostate, a walnut-sized gland located below the bladder. While most cases remain harmless - benign - for decades, other subtypes of prostate cancers can be aggressive, and spread to other parts of the body (metastasize), making them extremely difficult to treat. It is currently difficult for healthcare providers to distinguish which cancers will remain harmless and which will metastasize.
Image by Darryl Leja, NHGRI
PET/CT for Prostate Cancer
The PET/CT scanner is a tool that uses two different imaging modalities to determine the spreading (metastasis) of cancer. Here, Dr. Peter Choyke, radiologist at the National Cancer Institute, shows you the machine and the advantages of each modality.
Image by TheVisualMD
How do you Treat Prostate Cancer?
Once someone is diagnosed with prostate cancer, the patient and his doctors decide a course of action, and create a treatment plan. Very often with prostate cancer, that means simply keeping an eye on the progression of the disease. Here, top doctors lay out the most common prostate cancer treatment options, explain the tools and methods used as well as the risk factors involved.
Image by TheVisualMD
Standard Biopsy for Prostate Cancer
National Cancer Institute urologist and surgeon Dr. Peter Pinto explains the process of the standard multi-core or "blind" biopsy of the prostate.
Image by TheVisualMD
Prostate Cancer
Imaging and Radiation in Prostate Cancer: Radiation treatment is one of the major treatment options for prostate cancer. University of Chicago's radiation oncologist Dr. Stanley Liauw explains the crucial role imaging plays in the planning and execution of radiation treatment for prostate cancer.
Image by TheVisualMD
Treatment Options for Prostate Cancer
University of Chicago radiation oncologist Dr. Stanley Liauw explains the two most common treatments when doctors take action against prostate cancer.
Image by TheVisualMD
Moving Forward with Prostate Imaging
University of Chicago Hospital radiologist and prostate specialist Dr. Aytekin Oto is doing research on improving diagnosis and treatment methods for prostate cancer. Here he discusses what he sees the role imaging will play in the near future.
Image by TheVisualMD
MRI for Prostate Cancer
National Cancer Institute radiologist Dr. Peter Choyke explains the use of MRI as a diagnostic tool for prostate cancer.
Image by TheVisualMD
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Prostate Specific Antigen (PSA), Digital Rectal Exam
TheVisualMD
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Exam, Digital Rectal
National Cancer Institute / National Cancer Institute
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What You Need To Know About Men's Health
Prostate Cancer Research Institute/YouTube
Visualizing the Prostate
TheVisualMD
Prostate Cancer
Darryl Leja, NHGRI
PET/CT for Prostate Cancer
TheVisualMD
How do you Treat Prostate Cancer?
TheVisualMD
Standard Biopsy for Prostate Cancer
TheVisualMD
Prostate Cancer
TheVisualMD
Treatment Options for Prostate Cancer
TheVisualMD
Moving Forward with Prostate Imaging
TheVisualMD
MRI for Prostate Cancer
TheVisualMD
Prostate-Specific Antigen Test
Prostate-Specific Antigen (PSA) Test
Also called: PSA, Prostate-Specific Antigen, Total PSA
Prostate-specific antigen (PSA) test is a blood test that checks the level of PSA in the blood. PSA is a protein made by the prostate gland. The amount of PSA may be higher in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate.
Prostate-Specific Antigen (PSA) Test
Also called: PSA, Prostate-Specific Antigen, Total PSA
Prostate-specific antigen (PSA) test is a blood test that checks the level of PSA in the blood. PSA is a protein made by the prostate gland. The amount of PSA may be higher in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate.
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Use the slider below to see how your results affect your
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ng/mL
4
10
Your result is Normal.
PSA is always present in low concentrations in the blood of adult males. However, there is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. Various factors can cause a man’s PSA level to fluctuate, such as inflammation, infections and medications among other factors.
Related conditions
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%
10
25
Your result is Lower risk.
When total PSA is in the range of 4.0-10.0 ng/mL and free PSA is above 25% it indicates a 9% to 16% risk of prostate cancer, depending on age. Studies have shown that men with a total PSA in this "gray area" and a free PSA greater than 25% are more likely to have a benign condition than to have cancer, making a biopsy unnecessary.
Related conditions
A prostate-specific antigen (PSA) test is a blood test that measures the level of PSA in a sample of your blood. PSA is a protein made by your prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes the fluid part of semen.
It's normal to have a low level of PSA in your blood. A high PSA level may be caused by:
Prostate cancer
An enlarged prostate (BPH) (benign prostatic hyperplasia)
Other common prostate problems
Taking certain medicines
A PSA test can't show what is causing abnormal PSA levels. So, if your level is high, you may need other tests.
Other names: total PSA free PSA
A PSA test is used to screen for prostate cancer. Cancer screening means looking for signs of cancer before it causes symptoms. But screening tests can't diagnose cancer. If a screening test finds signs of cancer, you'll need other tests to find out if you have cancer and how serious it may be.
Most types of prostate cancer grow very slowly. They don't spread beyond the prostate and may never cause health problems. In fact, you can live a long life with prostate cancer and never know you have it. The goal of prostate cancer screening is to help find cancers that may be more likely to spread so they can be treated early. But there are challenges and possible harms from using a PSA test to screen for prostate cancer:
A PSA test can't tell the different between abnormal PSA levels from prostate cancer and noncancerous conditions. If your PSA level is high, a prostate biopsy is the only way to find out if the cause is cancer. And prostate biopsies have possible harms.
A PSA test may lead to finding and treating prostate cancer that would never have affected your health. If prostate cancer is found:
It can be difficult to tell the difference between slow-growing cancers and those that are likely to grow faster and spread in your body.
You could have prostate cancer treatment that you never really needed. And cancer treatment may cause serious harms, such as:
Erectile dysfunction
Urinary incontinence
Problems controlling your bowels (poop)
To decide whether a PSA test to screen for prostate cancer is right for you, talk with your health care provider about:
Your risk for developing a serious type of prostate cancer. If your risk is high, the possible benefits of finding cancer early may outweigh the possible harms.
Your general health. Are you well enough to have treatment for prostate cancer if it's found?
Your preferences. How do you feel about the possible benefits and harms of screening, diagnosis, and treatment?
PSA testing may also be used to:
Help diagnose the cause of prostate conditions that aren't cancer
Monitor treatment for a prostate condition, including cancer
It's your choice whether to have a PSA test to screen for cancer. You and your prover may consider your risk for developing a serious cancer that could spread if you don't catch it early. Your risk for serious prostate cancer may be higher depending on your:
Age. The risk of prostate cancer increases after age 50.
Your family health history. If members of your family have had prostate cancer, your risk may be higher.
Your race. Prostate cancer is more common in African Americans. They also have a higher risk of developing prostate cancer at a younger age and having more serious disease.
You may also have a PSA test if:
You have symptoms of a prostate condition, such as:
Painful or frequent urination (peeing)
Blood in urine or semen
Pelvic and/or back pain
You have prostate cancer. Your provider may use PSA testing to monitor your condition or to see how well treatment is working.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You will need to avoid having sex or masturbating for 24 hours before your PSA test. That's because releasing semen can increase your PSA levels, which may make your results less accurate. Also, certain medicines may affect your test results, so tell your provider about any medicines you take.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is no specific normal or abnormal level for PSA in blood. In general, the higher your PSA level, the more likely it is that you have cancer. But it's possible to have a high PSA without prostate cancer, or a low PSA with prostate cancer.
If you had a PSA test for a prostate cancer screening or because you have prostate symptoms:
High PSA levels can mean you have prostate cancer or a prostate condition that's not cancer, such as an infection (prostatitis) or an enlarged prostate. If your PSA levels are higher than normal, your provider may talk with you about having more tests to diagnose the cause. These tests may include:
Another PSA test, more commonly if you don't have any symptoms. PSA levels can go up and down, so it helpful to see if your PSA levels change over time.
A digital rectal exam (DRE). For this test, your provider inserts a gloved, lubricated finger into your rectum to feel your prostate for lumps or anything unusual.
A urine test. A sample of your urine is tested for infection.
A prostate biopsy. A biopsy is minor surgery. A doctor removes samples of tissue from your prostate so it can be studied under a microscope to look for cancer cells. A biopsy is the only way to diagnose cancer. It may be recommended if your provider thinks you may have prostate cancer.
If you had a PSA test to monitor prostate cancer or treatment, ask your provider what a high PSA level means. Your provider will usually look at several tests results over time to get a fuller understanding of your condition.
If you have questions about your results, talk with your provider.
Prostate-Specific Antigen (PSA) Test: MedlinePlus Lab Test Information [accessed on Feb 29, 2024]
Prostate-specific antigen (PSA) blood test: MedlinePlus Medical Encyclopedia [accessed on Oct 03, 2018]
Prostate-Specific Antigen (PSA) Test - National Cancer Institute [accessed on Oct 03, 2018]
PSA - Clinical: Prostate-Specific Antigen (PSA) Diagnostic, Serum [accessed on Oct 03, 2018]
PSA. Lab Tests Online. [accessed on Oct 03, 2018]
010322: Prostate-specific Antigen (PSA) | LabCorp [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (29)
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Prostate Gland
Prostate Description Line drawing showing lateral view of the prostate gland, rectum, bladder, penis and testis.
Image by National Cancer Institute
Normal vs enlarged prostate
BPH - Prostate enlargement problems
Image by Akcmdu9
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What Is Prostate Cancer?
Delve into the prostate, understand this complex disease found in men that is challenging to diagnose and witness a cutting edge procedure that may change how prostate cancer is diagnosed in the future.
Video by TheVisualMD
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Prostate Cancer Treatment
Once someone is diagnosed with prostate cancer, the patient and his doctors decide a course of action, and create a treatment plan. Very often with prostate cancer, that means simply keeping an eye on the progression of the disease. Here, top doctors lay out the most common prostate cancer treatment options, explain the tools and methods used as well as the risk factors involved.
Video by TheVisualMD
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Standard Biopsy for Prostate Cancer
National Cancer Institute urologist and surgeon Dr. Peter Pinto explains the process of the standard multi-core or "blind" biopsy of the prostate.
Video by TheVisualMD
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Visualizing the Prostate
Unlike for many other cancers, there are no standardized imaging protocols, apart from the use of transrectal ultrasound (TRUS), for the early detection and diagnosis of prostate cancer. This is a critical need. Prostate cancer is a disease for which it is crucial to detect and diagnose cancers early and accurately, both because early prostate cancer is usually without symptoms and because treatment side effects can be severe. Fortunately, new technologies are currently being developed, and even being used in some medical facilities, with promising results. By providing more specific and accurate detection and diagnosis results, these more sophisticated forms of prostate imaging and analysis will help in detecting early cancers, and in making the decision of whether to treat for prostate cancer when abnormalities are detected.
Video by TheVisualMD
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Moving Forward with Prostate Imaging
Unlike for many other cancers, there are no standardized imaging protocols, apart from the use of transrectal ultrasound (TRUS), for the early detection and diagnosis of prostate cancer. This is a critical need. Prostate cancer is a disease for which it is crucial to detect and diagnose cancers early and accurately, both because early prostate cancer is usually without symptoms and because treatment side effects can be severe. Fortunately, new technologies are currently being developed, and even being used in some medical facilities, with promising results. By providing more specific and accurate detection and diagnosis results, these more sophisticated forms of prostate imaging and analysis will help in detecting early cancers, and in making the decision of whether to treat for prostate cancer when abnormalities are detected.
Video by TheVisualMD
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Prostate Cancer Prognosis
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
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Risks of Overdiagnosis of Prostate Cancer
University of Chicago Hospital radiologist Dr. Aytekin Oto talks about the challenge that doctors face in treating less aggressive forms of prostate cancer.
Video by TheVisualMD
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Risks of Treatment for Prostate Cancer
Prostate cancer patients are likely to have a number of treatment options to choose from. If you have prostate cancer, you may feel pressured to make a decision quickly. But take the time to learn as much as you can about prostate cancer, your prognosis, and the treatments that are appropriate for your case. Talk to your doctor and, preferably, get a second opinion as well. Bear in mind that a surgeon may tend to recommend surgery and a radiation oncologist to recommend radiation therapy. Consider your own feelings about these treatments and their possible side effects.
Video by TheVisualMD
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Treatment Options for Prostate Cancer
Prostate cancer patients are likely to have a number of treatment options to choose from. If you have prostate cancer, you may feel pressured to make a decision quickly. But take the time to learn as much as you can about prostate cancer, your prognosis, and the treatments that are appropriate for your case. Talk to your doctor and, preferably, get a second opinion as well. Bear in mind that a surgeon may tend to recommend surgery and a radiation oncologist to recommend radiation therapy. Consider your own feelings about these treatments and their possible side effects.
Video by TheVisualMD
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MRI for Prostate Cancer
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
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PET/CT for Prostate Cancer
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
Prostate Anatomy by Zones with insets
Prostate cancer usually starts in certain zones of the prostate. Knowledge of these different zones helps the doctor to decide where to biopsy tissue and where to look for cancer spread. In this image, the central zone is shown as orange, the transition zone is shown as green, and the peripheral zone is shown as yellow.
Image by TheVisualMD
Prostate Gland Zones
The prostate gland is a small gland that sits below the bladder (the gland lies close to the wall of the rectum, which allows it to be felt in a digital rectal exam). The prostate gland can be divided up in two different ways, by lobes or zones; there are four lobes and five zones. The zone system of classification is used mostly for pathology; the largest zone, the peripheral zone, comprises about three-quarters of the prostate and is where most cancer occurs.
Image by TheVisualMD
Prostate Gland and Seminal Vesicle
Visualization reconstructed from scanned human data of a posterior view of the prostate gland, seminal vesicles, ductus deferens and Cowper's glands. The ductus deferens joins with the seminal vesicles to form the ejaculatory duct. The seminal vesicles act to secrete a thick alkaline fluid that mixes with the sperm as it passes into the ejaculatory ducts and the urethra. The prostate gland secretes a lubricant that helps to prevent infection in the urethra and protects and energizes sperm. The Cowper's gland produces a lubricating fluid which is secreted into the urethra.
Image by TheVisualMD
Male Reproductive System Showing Prostate Cancer
Three-dimensional visualization reconstructed from scanned human data. Lateral cross-section of an enlarged cancerous prostate, as well as bladder, penis, and testicles. Prostate cancer is the leading cause of cancer death in men over the age of 75 and the third leading cause of cancer death in men of all ages. Prostate enlargement in older men is usually benign but can be monitored for malignancy through the use of a blood test for prostate specific antigen (PSA) as well as through more invasive exams such as transrectal ultrasound and tranperineal biospy. Early cancers are sometimes treated with removal of the prostate while late-stage cancers are often treated with hormone and/or radiation therapy in combination with removal of the testicles (orchidectomy) to lower the level of testosterone and decrease cell growth. 2 of 2.
Image by TheVisualMD
Prostate Gland
Visualization of the prostate gland. The prostate gland is the largest accessory gland of the male reproductive system. Two thirds of the prostate is glandular while the remaining third is fibromuscular. Prostatic secretions help to prevent infection in the urethra, energizes sperm and keep the urethral lining moist.
Image by TheVisualMD
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Male Reproductive System
Three-dimensional visualization reconstructed from scanned human data. Lateral cross-section of a healthy, normal prostate, as well as bladder, penis, and testicles. Prostate cancer is the leading cause of cancer death in men over the age of 75 and the third leading cause of cancer death in men of all ages. Prostate enlargement in older men is usually benign (noncancerous) but can be monitored for malignancy through the use of a blood test for prostate specific antigen (PSA) as well as through more invasive exams such as transrectal ultrasound and tranperineal biospy. Early cancers are sometimes treated with removal of the prostate while late-stage cancers are often treated by hormone and/or radiation therapy in combination with removal of the testicles (orchidectomy) to lower the level of testosterone and decrease cell growth. 1 of 2.
Image by TheVisualMD
What Is Prostate Cancer?
Image by TheVisualMD
Prostate Cancer Symptoms
Image by TheVisualMD
Prostate Function
Image by TheVisualMD
Prostate Cancer Grading with Gleason Scale
After biopsy, cancer cells are graded
Image by TheVisualMD
Risk Factors for Prostate Cancer
Some risk factors for prostate cancer are controllable, some aren't. Knowing what the risk factors are can help you to lower your chances of getting prostate cancer and to make decisions about beginning screening. Every man should talk with his general practitioner or urologist and discuss the benefits and shortcomings of PSA screening and whether to have it. Risk factors for prostate cancer include: AGE Risk increases dramatically after age 50. RACE Men of African descent are at higher risk. LIFESTYLE Men in North America and northwestern Europe have an increased risk. FAMILY HISTORY Having a brother or father who has the disease raises risk. GENETICS Some genes have been linked to prostate cancer. DIET High-fat diet increases the chances of getting prostate cancer. HORMONES High levels of testosterone can cause or accelerate the disease.
Image by TheVisualMD
Prostate Cancer Symptoms
Prostate cancer usually causes no symptoms in its early stages. Often there are no symptoms until the disease has spread beyond the prostate gland. Symptoms of advanced prostate cancer can include: 1) blood in the urine or semen, 2) difficulty, pain, or frequency in urinating, 3) pain in the lower back, pelvis, hips, or thigh bones, 4) compression of the spine, 5) pain with ejaculation, and 6) anemia and fatigue.
Image by TheVisualMD
Prostate Gland
Prostate and Seminal Vesicles sagittal and axial slices : Derived from magnetic resonance imaging (MRI) data, the axial and sagittal slices (cross sections) through the prostate reveal the glandular tissue of the prostate as well as the ejaculatory ducts and the urethra. The inner coils of the seminal vesicles are also visible within the slices. Seminal fluid from the seminal vesicles mixes with sperm from the testes, via the ductus deferens, within the ejaculatory duct. The contents of the ejaculatory duct are then deposited into the urethra. There prostatic fluid is added to the mix along with contributions from the bulbourethral glands, forming semen. The prostatic urethra most often carries urine from the bladder and through the prostate.
Image by TheVisualMD
Side Effects of Treatment for Prostate Cancer
The side effects of prostate cancer treatment can be severe and sometimes permanent. They include impotence, incontinence, bleeding, and nerve damage.
Image by TheVisualMD
Prostate Gland
MRI Slices of the Prostate : Radiologists view different cross-sectional slices of the prostate, including the sagittal and axial slices, in order to detect any abnormalities.
Image by TheVisualMD
Decipher Test for Prostate Cancer Recurrence
Range of scores for the Decipher test showing low, intermediate, and high risk of prostate cancer metastasis. By estimating the future risk of prostate cancer spread and death, the Decipher test could help patients and their doctors make treatment decisions.
Image by National Cancer Institute (NCI)
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Prostate Gland
National Cancer Institute
Normal vs enlarged prostate
Akcmdu9
4:26
What Is Prostate Cancer?
TheVisualMD
2:35
Prostate Cancer Treatment
TheVisualMD
0:51
Standard Biopsy for Prostate Cancer
TheVisualMD
1:00
Visualizing the Prostate
TheVisualMD
0:34
Moving Forward with Prostate Imaging
TheVisualMD
0:39
Prostate Cancer Prognosis
TheVisualMD
0:40
Risks of Overdiagnosis of Prostate Cancer
TheVisualMD
0:42
Risks of Treatment for Prostate Cancer
TheVisualMD
0:33
Treatment Options for Prostate Cancer
TheVisualMD
0:27
MRI for Prostate Cancer
TheVisualMD
0:33
PET/CT for Prostate Cancer
TheVisualMD
Prostate Anatomy by Zones with insets
TheVisualMD
Prostate Gland Zones
TheVisualMD
Prostate Gland and Seminal Vesicle
TheVisualMD
Male Reproductive System Showing Prostate Cancer
TheVisualMD
Prostate Gland
TheVisualMD
Sensitive content
This media may include sensitive content
Male Reproductive System
TheVisualMD
What Is Prostate Cancer?
TheVisualMD
Prostate Cancer Symptoms
TheVisualMD
Prostate Function
TheVisualMD
Prostate Cancer Grading with Gleason Scale
TheVisualMD
Risk Factors for Prostate Cancer
TheVisualMD
Prostate Cancer Symptoms
TheVisualMD
Prostate Gland
TheVisualMD
Side Effects of Treatment for Prostate Cancer
TheVisualMD
Prostate Gland
TheVisualMD
Decipher Test for Prostate Cancer Recurrence
National Cancer Institute (NCI)
Prostate Biopsy
Prostate Biopsy
Also called: Biopsy of the Prostate
A prostate biopsy is a procedure in which a small sample of the prostate tissue is taken and then sent to a specialist to see if there are any cancerous cells present in it.
Prostate Biopsy
Also called: Biopsy of the Prostate
A prostate biopsy is a procedure in which a small sample of the prostate tissue is taken and then sent to a specialist to see if there are any cancerous cells present in it.
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Use the slider below to see how your results affect your
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score
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8
Your result is Low risk.
Gleason score of 6 or less = Grade Group 1
Related conditions
Low-risk prostate cancer
The prostate is a small gland that can be found deep inside the groin, located between the rectum and the base of the penis. This gland forms part of the male reproductive system, and it’s in charge of producing seminal fluid, which is of utmost importance for sperm survival.
A prostate biopsy is a test in which a small piece of the prostate is taken and then sent to a pathologist for evaluation.
There are two main approaches to take the prostate sample, which are by performing a transrectal biopsy (through the rectum) or a template biopsy (through the perineum, which is the portion of skin between the anus and the penis).
The prostate biopsy is usually performed under ultrasound guidance. However, under certain circumstances, you might have a special type of magnetic resonance imaging (MRI) scan before having the prostate biopsy. The MRI images provide more detailed information of the prostate than is possible with ultrasound, and it helps to pinpoint specific areas that may require further evaluation.
Your doctor may want to order this test to diagnose prostate cancer in the following situations:
If you have a nodule or other prostate abnormality that was found during your digital rectal examination (DRE), which is a common prostate cancer screening test.
If you have elevated levels of prostate-specific antigen (PSA) in the blood.
The MRI-guided prostate biopsy may be useful in men who have a rising PSA level along with a normal ultrasound-guided biopsy
This test can also be used to differentiate between cancer and a common condition in elderly men that is called benign prostatic hyperplasia.
First, the physician will perform a DRE. Then, for an ultrasound-guided transrectal biopsy, you will be asked to lie down and onto your left side with your legs bent towards your chest. At this point, a finger-sized ultrasound probe (which has been previously lubricated and covered with a condom) will be carefully inserted into your rectum. The images that appear on the ultrasound machine screen are used to guide a very fine needle into your prostate so a biopsy sample can be taken
For an MRI-guided transrectal biopsy, you will be asked to lie down on your stomach on a cushioned table and the biopsy guide will be gently inserted into your rectum, the biopsy needle will be guided with the help of the MRI images, and the biopsy sample will be taken.
For an MRI-guided transperineal biopsy, you will be asked to lie down on your back and a guidance grid will be placed against your peritoneum, between your legs. The biopsy needle will be guided with the help of the MRI images, and the biopsy sample will be taken.
In either method, the biopsy sampling is repeated to ensure coverage of all the possible affected areas of the prostate, and to ensure that there are no areas left behind where cancer could be hiding. Therefore, during the biopsy procedure, up to 14 individual samples will be taken and then sent to a laboratory for analysis by the pathologist.
You will be asked to fast, or to eat light meals for at least 8 to 12 hours before the procedure. In most cases, you will be given antibiotic pills for a day or two before the biopsy to help prevent infection.
Inform your healthcare practitioner if you are taking any over-the-counter or prescription medications.
For the MRI-guided biopsy, you must remove any chains, rings, watches, dentures, or other metals, and wear comfortable clothing for the test.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, and infection. You may also present a bad reaction to the anesthesia.
During the transrectal biopsy, you will feel pressure and discomfort in the rectal area, which can last for a day or two after the biopsy, especially when you are seated.
After the biopsy, is common for small amounts of blood to appear in the urine, sperm, and feces. This usually goes away within one or two weeks.
The prostate biopsy results are expressed by using the Gleason score, which is obtained by adding the two most common cancerous grades that were found in the prostate tissue.
This happens because prostate tumors are often made up of cancerous cells that have different grades of malignancy. Then, the first grade describes the most common cells that were found in the tumor; and the second grade describes the second most common cells.
For example, if the Gleason score is written as 4+5=9, it means that the most common grade in all the tumor samples is 4 and the next common grade of the tumor is 5, when added together these grades make up the total Gleason score, which would be 9.
The higher your Gleason score, the more aggressive the cancer and the more likely it is to metastasize (grow and spread outside the prostate to surrounding tissue).
Nevertheless, besides taking your Gleason score into consideration, your doctor will also consider other factors such as your age, overall health, and PSA (prostate-specific antigen) levels to determine the prostate cancer stage, risk level, and prognosis (outcome).
A biopsy can only show if there are cancerous cells in the samples taken; therefore, it is possible that cancer in unsampled areas of the prostate might be missed.
How Is Prostate Cancer Diagnosed? [accessed on Nov 24, 2018]
Understanding Your Pathology Report: Prostate Cancer [accessed on Nov 24, 2018]
https://www.prostateconditions.org/about-prostate-conditions/prostate-cancer/newly-diagnosed/gleason-score [accessed on Nov 24, 2018]
Understanding Prostate Cancer: The Gleason Scale [accessed on Nov 24, 2018]
Prostate biopsy | Prostate Cancer UK [accessed on Nov 24, 2018]
Ultrasound- and MRI-Guided Prostate Biopsy [accessed on Nov 24, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Transrectal ultrasound with prostate biopsy
Drawing of a transrectal ultrasound with prostate biopsy, showing a needle and needle guide inserted in the rectum. The bladder, transducer, and needle guide are labeled. Inset of enlarged view of prostate with needle inserted.
Image by NIDDK Image Library
Cross-section diagram of transrectal prostate biopsy with ultrasound probe guiding the needle to the prostate. An inset shows a close-up of a needle entering the prostate
Transrectal ultrasound and prostate biopsy
Image by NIDDK Image Library
Drawing of a transrectal ultrasound with prostate biopsy, showing a needle and needle guide inserted in the rectum. The bladder, transducer, and needle guide are labeled. Inset of enlarged view of prostate with needle inserted. The prostate and needle are labeled
Transrectal ultrasound with prostate biopsy.
Image by NIDDK Image Library
Cross-section diagram of a transrectal prostate biopsy with an untrasound probe guiding the needle to the prostate
Tranrectal ultrasound and prostate biopsy
Image by NIDDK Image Library
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Transperineal Prostate biopsy - Image 2
Diagram showing a transperineal prostate biopsy
Image by Cancer Research UK uploader
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transperineal prostate biopsy - Image 1
Diagram showing a transperineal prostate biopsy
Image by Cancer Research UK uploader
Deeper Dive on PSA Screening
Video by DocMikeEvans/YouTube
What is prostate cancer? | Cancer Research UK
Video by Cancer Research UK/YouTube
Prostate Cancer Treatment | Cancer Research UK
Video by Cancer Research UK/YouTube
What are the Signs and Symptoms of Prostate Cancer? | Cancer Research UK
Video by Cancer Research UK/YouTube
NHS Prostate Cancer Screening Module 2
Video by AS&K Communications - Visual Science/YouTube
Video by AS&K Communications - Visual Science/YouTube
NHS Prostate Cancer Screening Module 1
Video by AS&K Communications - Visual Science/YouTube
NHS Prostate Cancer Screening Module 3
Video by AS&K Communications - Visual Science/YouTube
PSA Test: Prostate Cancer Screening Harmful to Men?
Video by ABC News/YouTube
Stage 1: Cancer is confined to a small area of the prostate.
Stage 2: Cancer is confined to the prostate but has spread within it, patient had a high Gleason score, had a high PSA level, or can be felt.
Stage 3: Cancer has spread outside the prostate and may have spread to the seminal vesicles, but has not spread anywhere else.
Stage 4: Cancer has spread to nearby tissues (other than the seminal vesicles), or to the lymph nodes, or to distant sites in the body.
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Prostate Cancer Summary Staging
Cancer staging helps in estimating the patient's prognosis and in deciding on treatment. If tests show the cancer is likely to have spread, imaging and other tests are done to see the extent of the cancer and to assign it a stage.
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Pelvis, Prostate and Tumor
Prostate and Tumor
Prostate Only
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Prostate Cancer
About 80-95% of all cases of prostate cancer are carcinomas that develop in the glandular tissue of the prostate.Most cases of prostatic adenocarcinoma grow more slowly than most other types of cancer. In fact, some prostate tumors grow so slowly that they never require treatment.
Interactive by TheVisualMD
Central zone
Transition zone
Peripheral zone
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1) Central Zone 2) Transition Zone 3) Peripheral Zone
The interactive shows prostate gland zones in several layers: (1) central zone, (2) transition zone and (3) peripheral zone. Prostate cancer usually starts in certain zones of the prostate. Knowing these different zones helps the doctor to decide where to biopsy tissue and where to look for cancer spread. Percentage of cancer origin in prostate zones: peripheral zone 70-75%, transition zone 10-15%, central zone 15-20%.
Interactive by TheVisualMD
CT
PET/CT
PET
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Prostate Cancer PET/CT 1) CT Scan 2) CT/Pet Scan 3) Pet Scan
Positron emission tomography (PET) scans produce pictures of the body's metabolic functions, such as where glucose is concentrated in cancerous tumors. Computed tomography (CT) scans use X-rays to create images of the body's anatomical structures. PET/CT scans combine PET with CT to show both metabolic functions and anatomical structures. PET/CT is the best imaging technology for detecting cancer recurrence.
Interactive by TheVisualMD
Transrectal ultrasound with prostate biopsy
NIDDK Image Library
Cross-section diagram of transrectal prostate biopsy with ultrasound probe guiding the needle to the prostate. An inset shows a close-up of a needle entering the prostate
NIDDK Image Library
Drawing of a transrectal ultrasound with prostate biopsy, showing a needle and needle guide inserted in the rectum. The bladder, transducer, and needle guide are labeled. Inset of enlarged view of prostate with needle inserted. The prostate and needle are labeled
NIDDK Image Library
Cross-section diagram of a transrectal prostate biopsy with an untrasound probe guiding the needle to the prostate
NIDDK Image Library
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Transperineal Prostate biopsy - Image 2
Cancer Research UK uploader
Sensitive content
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transperineal prostate biopsy - Image 1
Cancer Research UK uploader
1:57
Deeper Dive on PSA Screening
DocMikeEvans/YouTube
2:35
What is prostate cancer? | Cancer Research UK
Cancer Research UK/YouTube
2:35
Prostate Cancer Treatment | Cancer Research UK
Cancer Research UK/YouTube
2:34
What are the Signs and Symptoms of Prostate Cancer? | Cancer Research UK
PSA Test: Prostate Cancer Screening Harmful to Men?
ABC News/YouTube
Prostate Cancer Summary Staging
TheVisualMD
Prostate Cancer
TheVisualMD
1) Central Zone 2) Transition Zone 3) Peripheral Zone
TheVisualMD
Prostate Cancer PET/CT 1) CT Scan 2) CT/Pet Scan 3) Pet Scan
TheVisualMD
Prostate Cancer Antigen 3 Test
Prostate Cancer Antigen 3 Test
Also called: PCA3, PCA3 mRNA, Prostate Cancer Gene 3, Differential Display Code 3, DD3
The prostate cancer antigen 3 (PCA3) is a test that is used to determine the need of repeat biopsy in men who remain under suspicion of having prostate cancer, even though previous biopsies have come back negative. This test measures the amount of PCA3 in the urine after a digital rectal exam (DRE).
Prostate Cancer Antigen 3 Test
Also called: PCA3, PCA3 mRNA, Prostate Cancer Gene 3, Differential Display Code 3, DD3
The prostate cancer antigen 3 (PCA3) is a test that is used to determine the need of repeat biopsy in men who remain under suspicion of having prostate cancer, even though previous biopsies have come back negative. This test measures the amount of PCA3 in the urine after a digital rectal exam (DRE).
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Use the slider below to see how your results affect your
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score
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Your result is 14% risk.
You have approximately a 14% probability of your prostate biopsy to be positive for cancer. Lower PCA3 scores are associated with a lower risk of prostate cancer. However, a low PCA3 score doesn’t completely rule out the possibility of prostate cancer, as other factors such as PSA levels and DRE findings also contribute to the overall risk assessment.
Related conditions
Prostate cancer
The prostate is a small gland that can be found deep inside the groin, located between the rectum and the base of the penis. This gland forms part of the male reproductive system, and it’s in charge of producing seminal fluid, which is of utmost importance for sperm survival.
The prostate cancer antigen 3 (PCA3) is a protein that can be found only in the prostate gland and it’s normally present in low levels. Overexpression (increased amounts) of this protein happens in about 90% of prostate cancers.
Therefore, this test can be used to detect the presence of the genetic material (RNA) of PCA3 in a sample of your urine after your prostate has been manipulated.
Your doctor may want to order this test to help determine whether you need to have a prostate biopsy, in the following situations:
If you continue to have a high PSA (prostate-specific antigen) level, or abnormalities during your digital rectal exam (DRE), even though a previous prostate biopsy did not show any sign of cancer.
To help determine if a repeat prostate biopsy would likely be positive, in order to avoid performing an unnecessary biopsy.
Since a sample of urine that contains prostate cells is needed, you will be asked to provide a urine sample right after a healthcare practitioner performs a DRE to manipulate your prostate.
No fasting or other preparations are needed.
There are no known risks associated with the test. You may feel discomfort during the digital rectal exam.
A numerical score is obtained, which correlates with the probability of the prostate biopsy to be positive. The higher the score, the more likely it is that you have prostate cancer.
Approximately 90% of prostate cancers will over-express PCA3. However, PCA3 should not be used as a stand-alone test and by any means can be used to confirm or rule out a prostate cancer diagnosis.
Your doctor will take into consideration this test result, along with the results of other tests (including your PSA levels), and your clinical findings to decide whether to perform another prostate biopsy.
Both PSA and PCA3 are over-expressed as a result of prostate cancer; however, unlike PSA, PCA3 is not affected by other conditions that affect the prostate gland (such as prostatitis or benign prostatic hyperplasia).
There is also a urine test called T2:ERG that detects genetic abnormalities that are found in approximately 50% of advanced prostate cancers. Nevertheless, this test is currently available at a few cancer research facilities.
Prostate Cancer Screening (PDQ®)—Patient Version - National Cancer Institute [accessed on Nov 25, 2018]
Biomarkers in Urine Could Reduce Unnecessary Prostate Biopsies - National Cancer Institute [accessed on Nov 25, 2018]
Association Between Combined TMPRSS2:ERG and PCA3 RNA Urinary Testing and Detection of Aggressive Prostate Cancer. | Cancer Biomarkers | JAMA Oncology | JAMA Network [accessed on Nov 25, 2018]
The PCA3 test for prostate cancer | Prostate cancer | Cancer Research UK [accessed on Nov 25, 2018]
PCA3 score [accessed on Nov 25, 2018]
PCA3 | Lab Tests Online [accessed on Nov 25, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Digital Rectal Examination
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
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Use the slider below to see how your results affect your
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Your result is Normal.
A normal result means that your doctor didn't feel any abnormalities during the exam, such as a growth or an organ enlargement.
Related conditions
Digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to search for certain abnormalities in the pelvic organs. This test is usually performed in men to check for abnormalities in their prostate gland, but it can also be used to evaluate a woman's uterus or ovaries.
Many doctors perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.
Your doctor may want to perform this test in the following situations:
If you are bleeding through your rectum
If you have pelvic pain
If you have recently had an unexplained change in your bowel habits
To collect a stool sample to check for occult (hidden) blood; this is usually done as part of the screening for rectal or colon cancer
If you are a man who has symptoms of enlarged prostate or prostate infection
Routinely to check for the size of the prostate and to look for bumps or other prostate abnormalities in men over 50 years old
First, you will need to undress below the waist; then, your doctor will ask you to lie on your side with your knees bent towards your chest, as this is the easiest and comfortable position for the test to be done. In some cases, men can also be examined while bending over the exam table; and women can also be examined during a pelvic exam, with their feet raised and placed on stirrups.
Then, the doctor will slide a lubricated, gloved finger in your rectum. At this point, he or she may want to press your abdomen with their free hand to help them feel any masses or abnormalities. You may also be asked to squeeze your rectum around their finger, so they can evaluate how well your muscles are working.
If an infection is suspected, your doctor might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first.
No special preparations are needed for a DRE. But you should tell your doctor if you have hemorrhoids or anal fissures. The DRE may make them worse.
Most people can feel a little bit uncomfortable, but the test shouldn't be painful.
Some men can feel the urge to pee when their prostate is being examined.
In very rare cases, a vasovagal response can occur. If this happens, you can have symptoms like lightheadedness, dizziness, blurred vision, nausea, sweating, and sometimes fainting.
A normal result means that your doctor did not find any abnormalities during the exam; however, this doesn’t mean that you don’t have a problem. Your doctor may want to order further testing.
If your result was abnormal, it means that your doctor found something during the test. This may happen for several reasons, such as:
Bleeding in the digestive tract
Anal fissure (small tear in the lining of the anus)
Abscess (pus collection) in the rectum or anus
Hemorrhoids (swollen veins in the rectum or anus)
Cancer of the colon or rectum
Enlargement or abnormal growths of an organ, such as the rectum, bladder, prostate in men, or cervix, uterus, or ovaries in women.
If the DRE test indicates a problem may exist, your doctor may order additional tests.
Digital rectal exam: MedlinePlus Medical Encyclopedia [accessed on Dec 21, 2018]
Prostate Tests | NIDDK [accessed on Dec 21, 2018]
https://www.nhs.uk/conditions/rectal-examination/ [accessed on Apr 17, 2019]
https://www.webmd.com/colorectal-cancer/digital-rectal-examination [accessed on Apr 17, 2019]
https://www.verywellhealth.com/the-digital-rectal-exam-2782260 [accessed on Apr 17, 2019]
https://www.verywellhealth.com/vasovagal-reflex-1945072 [accessed on Apr 17, 2019]
https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/digital-rectal-exam-dre [accessed on Sep 16, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
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Digital Rectal Exam
The prostate gland is a small gland that sits below the bladder and encircles the urethra; the gland lies close to the wall of the rectum, which allows it to be felt in a digital rectal exam, or DRE, which is performed to determine the gland is enlarged.
Image by TheVisualMD
Active Surveillance & Watchful Waiting
Not all prostate cancer treatment is radical. Active surveillance and watchful waiting are two approaches to treatment that seek to avoid the often severe side effects of curative prostate treatment. They do this by actively monitoring signs and symptoms and taking action only when necessary. Active surveillance is for men with early prostate cancer who don't have symptoms. It monitors progression of cancer through PSA and DRE testing, and includes curative treatment, such as radiation therapy, if PSA levels rise rapidly. Watchful waiting is for older men who have slow-growing cancers or men with health problems that prevent them from having surgery. This approach includes regular PSA and DRE testing, and may include hormone therapy or other palliative treatment if symptoms, such as urinary retention or pain, become acute.
Image by TheVisualMD
Cross-section diagram of a digital rectal examination showing the physician's index finger inserted into the patient's rectum to feel the size and shape of the prostate
Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate.
Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal.
Image by National Cancer Institute / National Cancer Institute
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Digital Rectal Exam
TheVisualMD
Active Surveillance & Watchful Waiting
TheVisualMD
Cross-section diagram of a digital rectal examination showing the physician's index finger inserted into the patient's rectum to feel the size and shape of the prostate
National Cancer Institute / National Cancer Institute
Pelvic Ultrasound - Male
Pelvic Ultrasound - Male
Also called: Male Pelvic Scan, Male Pelvic Sonography, Transabdominal Male Pelvic Ultrasound, Transrectal Ultrasound, Endorectal Ultrasound, TRUS, Ultrasound - Pelvic (Male)
A male pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a man’s pelvis, including the seminal vesicles, ejaculatory ducts, prostate, and bladder.
Pelvic Ultrasound - Male
Also called: Male Pelvic Scan, Male Pelvic Sonography, Transabdominal Male Pelvic Ultrasound, Transrectal Ultrasound, Endorectal Ultrasound, TRUS, Ultrasound - Pelvic (Male)
A male pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a man’s pelvis, including the seminal vesicles, ejaculatory ducts, prostate, and bladder.
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Use the slider below to see how your results affect your
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Your result is Normal.
This means that your prostate, seminal vesicles, ejaculatory ducts, and bladder are of a normal shape and size, without any abnormal masses or tissues.
Related conditions
A male pelvic ultrasound is a test that uses an ultrasound machine to examine the organs and tissues inside your pelvis, including your prostate gland, seminal vesicles, ejaculatory ducts, and bladder.
Your doctor may want to order a male pelvic ultrasound to diagnose and assist in the treatment of a wide variety of conditions, such as:
Enlarged prostate gland
Tumors of the prostate gland
Difficulties to start passing the urine
Sensation of incomplete urination
Urgency to urinate
Decreased bladder control
Painful ejaculation
Recurrent hematospermia (bloody semen)
Growths such as tumors or cysts within the pelvis
As part of the work-up for infertility
There are two ways to perform a male pelvic ultrasound, which are transabdominal (external, through the abdominal wall) and transrectal (internal, through the rectum walls - it’s the most common).
Transabdominal pelvic ultrasound
For the transabdominal pelvic ultrasound, you will be asked to unzip your pants, uncover your abdomen, and lie on your back on the medical exam table. Then, a healthcare practitioner will apply a water-based gel on the skin of your lower abdominal area and then place a small probe to visualize your pelvic organs on a screen.
Transrectal pelvic ultrasound
For the transrectal pelvic ultrasound, you will be asked to lie down and onto your left side with your legs bent towards your chest. At this point, a finger-sized ultrasound probe (which has been previously lubricated and covered with a plastic/latex sheath) will be carefully inserted into your rectum. During the procedure, the healthcare practitioner will move the probe a little bit to examine your organs properly.
Either of these procedures usually takes no more than 20 minutes, and there is no need for an anesthetic because they’re painless.
Usually, you must have a full bladder; therefore, you will be asked to drink about 32 ounces of liquid at least 1 hour before the exam. Follow the instructions provided by your healthcare practitioner.
There are no risks related to a male pelvic ultrasound test.
A normal result means that your prostate, seminal vesicles, ejaculatory ducts, and bladder are of a normal shape and size, without any abnormal masses or tissues.
An abnormal result indicates that a problem was detected, including but not limited to:
Intraprostatic cysts
Mullerian duct cysts
Ejaculatory duct diverticula
Dilated seminal vesicles
Dilated urethra
Pelvic masses
Undescended testes in the groin
Inguinal hernia
Free liquid in the pelvic cavity
This test can provide information about the location, size, and structure of pelvic masses, but cannot provide a definite diagnosis of cancer or several other conditions.
Another imaging technique known as magnetic resonance (MR) is supplanting transrectal ultrasound for evaluation of the prostate and seminal vesicles.
Pelvic Ultrasound: Purpose, Procedure, Risks, Results [accessed on Dec 27, 2018]
Pelvic Ultrasound [accessed on Dec 27, 2018]
Pelvic Ultrasound - StatPearls - NCBI Bookshelf [accessed on Dec 27, 2018]
DIAGNOSTIC PROCEDURES | Stony Brook Medicine [accessed on Dec 27, 2018]
Male Pelvic Ultrasound | Thornhill | Accurate Imaging Diagnostics [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Acid Phosphatase Test
Acid Phosphatase Test
Acid phosphatase is an enzyme that is highly concentrated in the prostate, but it can also be found in several other tissues such as bone, kidney, liver, and semen, among others. An acid phosphatase test can be used to diagnose prostate disorders and bone disorders, as well as aid in rape investigations.
Acid Phosphatase Test
Acid phosphatase is an enzyme that is highly concentrated in the prostate, but it can also be found in several other tissues such as bone, kidney, liver, and semen, among others. An acid phosphatase test can be used to diagnose prostate disorders and bone disorders, as well as aid in rape investigations.
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Use the slider below to see how your results affect your
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U/L
5.5
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
Acid phosphatase is an enzyme that can be found in several tissues including red blood cells, white blood cells, platelets, liver, spleen, kidney, bone, semen, and especially in the prostate.
An acid phosphatase test measures the amount of this enzyme in a person’s blood.
Your doctor may want to order this test in the following situations:
To help diagnose some bone disorders.
Acid phosphatase can be used along with prostatic acid phosphatase to aid in the diagnosis and monitoring of prostate cancer (prostatic adenocarcinoma).
Since acid phosphatase can be found in the semen, this test can be used to detect this enzyme in vaginal fluid as an aid in rape investigations.
A needle will be used to extract a small quantity of blood from a vein in your arm.
For rape investigations, a swab will be used to collect a sample of vaginal fluids. In this case, you lie on a special table and place your feet in stirrups; then, your healthcare provider will carefully insert a sterile swab in your vagina. In some cases, it will be necessary to insert an instrument called speculum into your vagina to be able to see inside.
No fasting or special preparations are needed; however, you should inform your healthcare provider about any medicines or supplements that you are taking.
In a blood test you may feel a little sting when the needle is inserted and extracted but otherwise is a quick procedure. You may also experience bruising as well as mild soreness for a short amount of time after the blood extraction.
During a vaginal swab, you may feel a little pressure or discomfort, but this is usually a painless and quick procedure.
Normal acid phosphatase levels are less than 5.5 U/L. However, reference ranges can vary depending on the laboratory and method used for testing.
High levels of acid phosphatase can be found in prostatic adenocarcinoma, especially when it has metastasized (spread to other tissues), and in certain bone diseases.
Conditions in which acid phosphatase can also be elevated include:
Niemann-Pick disease
Gaucher’s disease
Prostatitis
Benign prostatic hyperplasia (BPH)
Urinary retention
Cancer that has metastasized to the bones
Myeloid leukemia
Multiple myelomas
Paget disease
Sickle cell anemia
Renal diseases
Liver diseases
Cirrhosis
Thrombocytosis
Hyperparathyroidism
This test results should not be interchanged with the results of the prostatic acid phosphatase test.
Fontanarosa, P., & Christiansen, S. (2009, April 01). Laboratory Values. AMA Manual of Style. Ed. [accessed on Sep 29, 2018]
Acid Phosphatase (AP), Total and Prostatic A. Phosphatase | Labpedia.net [accessed on Sep 29, 2018]
Beaumont Laboratory - Lab Test Details [accessed on Sep 29, 2018]
Acid phosphatase test | definition of acid phosphatase test by Medical dictionary [accessed on Sep 29, 2018]
http://www.ilexmedical.com/files/PDF/ACIDPOHS_ARC_CHEM.pdf [accessed on Sep 29, 2018]
Acid Phosphatase Blood Test [accessed on Sep 29, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (13)
Prostate Cancer Extracapsular Extension in MRI
Extracapsular extension is the spreading of prostate cancer out of the prostatic capsule. Cancer begins when cells start to multiply out of control. Usually they form tumors (masses of tissue). Most cancers of the prostate are adenocarcinomas, cancers that arise in the glandular tissue of the prostate. Unlike most other cancers, however, the majority of prostate cancers grow slowly, doubling in size about once every 4 years. Many never metastasize to other parts of the body and may never need to be treated. Some tumors, however, are aggressive and can spread rapidly.
Image by TheVisualMD
Transrectal Ultrasound Showing Prostate Cancer
Prostate cancer screening is commonly performed for men over the age of 50 by measuring blood levels of PSA (a substance produced by the prostate) and by digital rectal exam. Transrectal ultrasound (TRUS) exams may be given as well. Ultrasound can also be used to guide biopsy of the prostate.
Image by TheVisualMD
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Prostate Gland
Prostate Description Line drawing showing lateral view of the prostate gland, rectum, bladder, penis and testis.
Image by National Cancer Institute
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Side Effects of Prostate Cancer Treatment
The side effects of prostate cancer treatment can be severe and sometimes permanent. They include impotence, incontinence, bleeding, and nerve damage. Impotence may be caused by damage to the nerves surrounding the prostate that control erection. Incontinence can be caused by damage to the muscles around the urethra or to their associated nerves.
Image by TheVisualMD
Prostate cancer that has spread to the bones
Diagram showing prostate cancer that has spread to the bones.
Image by Cancer Research UK / Wikimedia Commons
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What Is Prostate Cancer?
Delve into the prostate, understand this complex disease found in men that is challenging to diagnose and witness a cutting edge procedure that may change how prostate cancer is diagnosed in the future.
Video by TheVisualMD
Prostate and Urethra with Rectum and Bladder Surrounded by Nerves
\"The side effects of prostate cancer treatment can be severe and sometimes permanent. They include impotence, incontinence, bleeding, and nerve damage.
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Prostate Cancer
Illustration of early prostate cancer tumors in the prostate. T1 means that the cancer is so small it can't be felt during a DRE. T1a and T1b cancer is most often found by accident, when men have surgery to relieve symptoms of BPH (which stands for benign prostatic hyperplasia).
Image by National Cancer Institute (NCI) Creator: NIH Medical Arts
Prostate Cancer - urinary catheter in a man who has had his prostate removed
Diagram showing a urinary catheter in a man who has had his prostate removed.
Image by Cancer Research UK / Wikimedia Commons
Prostate Cancer - T1-3 stages
Diagram showing T1-3 stages of prostate cancer.
Image by Cancer Research UK / Wikimedia Commons
Prostate Cancer - T4 stage
Diagram showing stage T4 prostate cancer
Image by Cancer Research UK uploader
Prostate Cancer
Image by BruceBlaus
Differences between a healthy prostate and a prostate with a tumour
Differences between a healthy prostate and a prostate with a tumour
Image by BQmUB2012102
Prostate Cancer Extracapsular Extension in MRI
TheVisualMD
Transrectal Ultrasound Showing Prostate Cancer
TheVisualMD
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Prostate Gland
National Cancer Institute
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Side Effects of Prostate Cancer Treatment
TheVisualMD
Prostate cancer that has spread to the bones
Cancer Research UK / Wikimedia Commons
4:26
What Is Prostate Cancer?
TheVisualMD
Prostate and Urethra with Rectum and Bladder Surrounded by Nerves
TheVisualMD
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Prostate Cancer
National Cancer Institute (NCI) Creator: NIH Medical Arts
Prostate Cancer - urinary catheter in a man who has had his prostate removed
Cancer Research UK / Wikimedia Commons
Prostate Cancer - T1-3 stages
Cancer Research UK / Wikimedia Commons
Prostate Cancer - T4 stage
Cancer Research UK uploader
Prostate Cancer
BruceBlaus
Differences between a healthy prostate and a prostate with a tumour
BQmUB2012102
Who Should Get Tested
Pelvis, Prostate and Tumor
Prostate and Tumor
Prostate Only
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2
3
Prostate Cancer
Interactive by TheVisualMD
Pelvis, Prostate and Tumor
Prostate and Tumor
Prostate Only
1
2
3
Prostate Cancer
About 80-95% of all cases of prostate cancer are carcinomas that develop in the glandular tissue of the prostate.Most cases of prostatic adenocarcinoma grow more slowly than most other types of cancer. In fact, some prostate tumors grow so slowly that they never require treatment.
Interactive by TheVisualMD
Should I Get Screened for Prostate Cancer?
In 2018, the U.S. Preventive Services Task Force (USPSTF) made the following recommendations about prostate cancer screening—
Men who are 55 to 69 years old should make individual decisions about being screened for prostate cancer with a prostate specific antigen (PSA) test.
Before making a decision, men should talk to their doctor about the benefits and harms of screening for prostate cancer, including the benefits and harms of other tests and treatment.
Men who are 70 years old and older should not be screened for prostate cancer routinely.
This recommendation applies to men who—
Are at average risk for prostate cancer.
Are at increased risk for prostate cancer.
Do not have symptoms of prostate cancer.
Have never been diagnosed with prostate cancer.
Other organizations, like the American Urological Association, the American Cancer Society, and the American College of Physicians may have other recommendations.
Talk to Your Doctor
If you are thinking about being screened, you and your doctor should consider—
If you have a family history of prostate cancer.
If you are African-American.
If you have other medical conditions that may make it difficult for you to be treated for prostate cancer if it is found, or that may make you less likely to benefit from screening.
How you value the potential benefits and harms of screening, diagnosis, and treatment.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (7)
Central zone
Transition zone
Peripheral zone
1
2
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1) Central Zone 2) Transition Zone 3) Peripheral Zone
The interactive shows prostate gland zones in several layers: (1) central zone, (2) transition zone and (3) peripheral zone. Prostate cancer usually starts in certain zones of the prostate. Knowing these different zones helps the doctor to decide where to biopsy tissue and where to look for cancer spread. Percentage of cancer origin in prostate zones: peripheral zone 70-75%, transition zone 10-15%, central zone 15-20%.
Interactive by TheVisualMD
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Risks of Overdiagnosis of Prostate Cancer
University of Chicago Hospital radiologist Dr. Aytekin Oto talks about the challenge that doctors face in treating less aggressive forms of prostate cancer.
Video by TheVisualMD
Prostate Cancer Screening and Detection
Prostate Cancer Screening and Detection
Image by TheVisualMD
Risks of Prostate Cancer Screening
Risks of Prostate Cancer Screening
Image by TheVisualMD
Should I Get Tested for Prostate Cancer?
Video by Centers for Disease Control and Prevention (CDC)/YouTube
I'm over 50. Should I get screened for prostate cancer?
Video by SA Health/YouTube
Prostate Cancer, Should You Get Screened?
Video by YurView Virginia/YouTube
1) Central Zone 2) Transition Zone 3) Peripheral Zone
TheVisualMD
0:40
Risks of Overdiagnosis of Prostate Cancer
TheVisualMD
Prostate Cancer Screening and Detection
TheVisualMD
Risks of Prostate Cancer Screening
TheVisualMD
2:30
Should I Get Tested for Prostate Cancer?
Centers for Disease Control and Prevention (CDC)/YouTube
1:27
I'm over 50. Should I get screened for prostate cancer?
SA Health/YouTube
24:31
Prostate Cancer, Should You Get Screened?
YurView Virginia/YouTube
When to See a Doctor
Male Urinary System
Image by TheVisualMD
Male Urinary System
Male Urinary System
Image by TheVisualMD
Prostate Predicaments: When Bladder Problems Are Pressing
Many men develop urinary problems as they get older. They might find it hard to urinate, have a strong and sudden urge to “go,” be unable to hold it in, or wake up often at night to urinate. These symptoms may signal a bladder issue. But they can also be signs of a prostate problem. Identifying the right condition is key for treatment and symptom control.
The prostate gland tends to get larger as men get older. This walnut-shaped gland sits just below the bladder and surrounds the urethra, the tube that carries urine out of the bladder. If the prostate gets too large, it can narrow or even block the urethra and make it hard to pass urine.
Three prostate issues that can cause urinary symptoms are an enlarged prostate (called BPH, or benign prostatic hyperplasia), inflammation (called prostatitis), and prostate cancer. Some of the symptoms can be similar. A thorough medical exam and testing are key to diagnosing and treating the problem.
For men older than 50, BPH is the most common prostate issue. “Nearly half of men over 50 have lower urinary tract symptoms related to BPH,” says Dr. Ziya Kirkali, a prostate disorder specialist at NIH. “This number gets to about 90% in men aged 80 years or older.” Some men eventually find their symptoms troubling enough to need treatment. Drugs or surgery can often relieve symptoms associated with BPH. In extreme cases, BPH can lead to urinary tract infections, bladder stones, or kidney failure if left untreated.
Prostatitis is the most common prostate problem for men under age 50. It’s sometimes caused by bacterial infections and can be treated with antibiotics. Symptoms of bacterial prostatitis can include fever, chills, or body aches along with pain and urinary symptoms such as the inability to urinate, going to the bathroom frequently, and leaking or dribbling urine. Seek immediate medical care if you have a sudden onset of these symptoms, or if you cannot urinate at all.
Most often, the cause of prostatitis is unknown—a condition called chronic prostatitis. “Chronic prostatitis, or chronic pelvic pain syndrome, is seen in about 10–15% of the U.S. population,” explains Kirkali. “It’s very bothersome, and it’s a chronic condition that comes and goes.” Chronic prostatitis can cause pain or discomfort in the groin or lower back. Treatment may require a combination of medicine, surgery, and lifestyle changes.
Few men have symptoms of prostate cancer, although some precancerous or cancer cells may be present. “Prostate cancer may not cause any symptoms at all,” Kirkali explains. “If it does, the urinary symptoms are similar to BPH.”
In fact, more than half of all American men have some cancer cells in their prostate glands by the age of 80. It may take 10, 20, or even 30 years before a prostate tumor gets big enough to cause symptoms. Most of these cancers never pose a problem or become a serious threat to health. Your doctor can help you determine whether treatment is right for you.
Don’t let prostate issues take over your life. Talk with your doctor if you have problems urinating or feel discomfort in your pelvic area. Getting the right treatment can help improve your quality of life.
See your doctor if you have any of these symptoms:
Urinate 8 or more times a day
Blood in your urine
Dribbling at the end of urination
Trouble emptying your bladder completely
Unable to delay urination
Wake up often to urinate at night
Trouble starting or keeping a urine stream
A weak urine stream
Can’t urinate
Urine with unusual color or odor
Pain in your belly or groin area when urinating
If you can’t urinate at all, seek medical care right away.
Source: NIH News in Health
Additional Materials (6)
Don't Urinate or Difficulty urinating
Official sign in Berlin, Germany: don't piss here
Image by Gerbil/Wikimedia
The Pathway of Urine
From the kidneys, urine flows into the bladder through the ureters. The internal sphincter muscle controls the flow of urine out of the bladder and into the urethra. The prostatic urethra carries urine through the prostate. Urine flows out of the prostate, into the penis, and out of the body.
Image by TheVisualMD
The Pathway of Urine
From the kidneys, urine flows into the bladder through the ureters. The internal sphincter muscle controls the flow of urine out of the bladder and into the urethra. The prostatic urethra carries urine through the prostate. Urine flows out of the prostate, into the penis, and out of the body.
Image by TheVisualMD
The Pathway of Urine
From the kidneys, urine flows into the bladder through the ureters. The internal sphincter muscle controls the flow of urine out of the bladder and into the urethra. The prostatic urethra carries urine through the prostate. Urine flows out of the prostate, into the penis, and out of the body.
Image by TheVisualMD
Prostate health: Mayo Clinic Radio
Video by Mayo Clinic/YouTube
Illustration of bathroom toilet and sink lit up by a nightlight
Illustration of bathroom toilet and sink lit up by a nightlight.
Urinary problems in older men may signal a bladder issue or a prostate problem. Identifying the right condition is key for treatment.
Image by NIH News in Health
Don't Urinate or Difficulty urinating
Gerbil/Wikimedia
The Pathway of Urine
TheVisualMD
The Pathway of Urine
TheVisualMD
The Pathway of Urine
TheVisualMD
19:58
Prostate health: Mayo Clinic Radio
Mayo Clinic/YouTube
Illustration of bathroom toilet and sink lit up by a nightlight
NIH News in Health
Questions to Ask
Urologist examining Prostate - active surveillance
Image by TheVisualMD / mohamed Hassan
Urologist examining Prostate - active surveillance
doctor, patient, medical, Waiting, Watchful Expectant Management Management, Expectant Active Surveillance Surveillance, Active, Outcome and Process Assessment, Health Care Outcome Assessment, Health Care Watchful Waiting
Image by TheVisualMD / mohamed Hassan
Talking With Your Doctor About Prostate Health
Different kinds of doctors and other health care professionals manage prostate health. They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:
Family doctors and internists
Physician assistants (PAs) and nurse practitioners (NPs)
Urologists, who are experts in diseases of the urinary tract system and the male reproductive system
Urologic oncologists, who are experts in treating cancers of the urinary system and the male reproductive system
Radiation oncologists, who use radiation therapy to treat cancer
Medical oncologists, who treat cancer with medications such as hormone treatments and chemotherapy
Pathologists, who identify diseases by studying cells and tissues under a microscope
View these professionals as your partners—expert advisors and helpers in your health care. Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect.
Questions you may want to consider asking your doctor include:
What type of prostate problem do I have?
Is more testing needed and what will it tell me?
If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
What type of treatment do you recommend for my prostate problem?
For men like me, has this treatment worked?
How soon would I need to start treatment and how long would it last?
Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
What are the side effects of the medicine?
Are there other medicines that could interfere with this medication?
If I need surgery, what are the benefits and risks?
Would I have any side effects from surgery that could affect my quality of life?
Are these side effects temporary or permanent?
How long is recovery time after surgery?
Will I be able to fully return to normal?
How will this affect my sex life?
How often should I visit the doctor to monitor my condition?
Source: National Cancer Institute (NCI)
Additional Materials (1)
Testicular and Prostate Health: Things You're Too Embarrassed To Ask A Doctor
Video by UChicago Medicine/YouTube
16:09
Testicular and Prostate Health: Things You're Too Embarrassed To Ask A Doctor
UChicago Medicine/YouTube
Protect Your Prostate
Cruciferous vegetables (cabbage)
Image by Bluesnap/Pixabay
Cruciferous vegetables (cabbage)
Image by Bluesnap/Pixabay
Five Foods to Protect Your Prostate
Good news if you’re worried about your prostate health: What you eat can make a difference. “There is plenty of strong evidence that good nutrition and an active lifestyle can reduce the likelihood of prostate cancer and slow its progression,” says Mitchell Sokoloff M.D., Chair of the Department of Urology and Professor at the University of Massachusetts Medical School.
There are a few categorical changes you can make to your diet that make a big difference in overall health, as well as prostate health. The Science of Living Well, Beyond Cancer recommends a diet that is high in colorful vegetables, low in sugar and processed carbohydrates and moderate in animal-based protein (taking advantage of the health benefits of beans, nuts, soy and certain fish).
Here are the top five foods you can eat for a healthy prostate:
Cruciferous Vegetables -This class of vegetables includes things like cabbage, bok choy, kale, cauliflower and Brussels sprouts. Cruciferous vegetables are high in antioxidants, vitamins, minerals and phytochemicals.
Berries - Antioxidants help to neutralize and remove free radicals from the body. Berries are a great source, particularly strawberries, blackberries, blueberries and raspberries. These fruits offer up powerful antioxidants known as anthocyanins.
Fish - Certain fish (especially cold-water fish like salmon, sardines and trout) provide “good fats” that don’t trigger inflammation the same way as saturated animal fats (e.g., beef fat).
Cooked tomatoes - Tomatoes are one food that’s been on prostate cancer researchers’ radar for a long time and here’s why. Lycopene is another powerful antioxidant and is found in the cell walls of tomatoes.
Coffee & Tea - You might have heard about green tea as a source of antioxidants such as catechins (the most important are two called EGCG, for epigallocatechin-3-gallate and epicatechin), which are believed to be anti-carcinogenic and anti-mutagenic (preventing healthy cells from mutating). “Coffee is looking more and more promising,” says Dr. Mucci, “There are now a number of studies that suggest drinking coffee regularly, one to two cups a day, can help prevent prostate cancer.”
Source: U.S. Illinois Department of Central Management Services
Additional Materials (4)
8 Herbs For Prostate Health - Foods That Help Prostate Health
Video by Foods4Health/YouTube
Foods To Help Prevent Prostate Cancer - Anti Prostate Cancer Diet
Video by Dr. DAVID B. SAMADI/YouTube
Top 5 Foods to Prevent Prostate Cancer
Video by Prostate Cancer Foundation/YouTube
Warning: Avoid These 7 Foods to Prevent Enlarged Prostate
Video by Health with Morgan/YouTube
2:03
8 Herbs For Prostate Health - Foods That Help Prostate Health
Foods4Health/YouTube
1:12
Foods To Help Prevent Prostate Cancer - Anti Prostate Cancer Diet
Dr. DAVID B. SAMADI/YouTube
0:44
Top 5 Foods to Prevent Prostate Cancer
Prostate Cancer Foundation/YouTube
4:57
Warning: Avoid These 7 Foods to Prevent Enlarged Prostate
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Understanding Prostate Changes
The prostate gland is about the size of a walnut when a man is in his 20s. By the time he is 40, it may have grown to the size of an apricot. Learn about the main causes of prostate change, including prostatitis, enlarged prostate, and prostate cancer, and know what to ask the doctor about prostate cancer screening tests.