Comprehensive Lecture: What You Should Know About the Prostate
By Dr. WEMA
Introduction
The prostate is a small gland that is part of the male reproductive system. Although it is normally about the size of a walnut in younger men, it can enlarge with age.
Prostate problems are common, especially in men over 50, but many prostate conditions can be detected and managed effectively when addressed early.
This lecture explains the prostate step by step, including its anatomy, functions, common diseases, symptoms, risk factors, diagnosis, treatment, prevention, and frequently asked
questions.
- What is the prostate?
The prostate is a gland found only in males. It is located below the urinary bladder and surrounds part of the urethra—the tube through which urine and semen leave the body.
Its position is important because an enlarged or diseased prostate can affect urination.
Approximate size
In a young adult, a healthy prostate is often around:
20–30 grams in weight
Similar in size to a walnut
The prostate can become larger with age without necessarily meaning that the man has cancer. - Where is the prostate located?
The prostate is located:
Directly below the bladder
In front of the rectum
Around the upper part of the urethra
Behind the pubic bone
Because the prostate lies next to the rectum, a healthcare professional can examine part of it through a digital rectal examination (DRE). - What does the prostate do?
The prostate has several important functions.
A. It contributes fluid to semen
The prostate produces a fluid that forms part of semen. This fluid contains substances that help support and transport sperm.
B. It helps sperm function
Prostatic secretions contribute to the environment that allows sperm to survive and function.
C. It participates in ejaculation
Prostate muscles contract during ejaculation and help propel semen into the urethra.
D. It surrounds the urethra
This explains why prostate enlargement can interfere with urination.
- What happens to the prostate as a man gets older?
The prostate commonly grows with age.
One of the most common age-related conditions is benign prostatic hyperplasia (BPH).
BPH means that the prostate has become enlarged, but BPH is not prostate cancer.
As the prostate grows, it can compress the urethra and cause urinary symptoms. - Major prostate conditions
The three major prostate problems that men should understand are: - Benign prostatic hyperplasia (BPH)
Non-cancerous enlargement of the prostate. - Prostatitis
Inflammation of the prostate, sometimes caused by infection. - Prostate cancer
Cancer arising from cells of the prostate.
These conditions can have overlapping symptoms, so symptoms alone cannot reliably determine which condition is present. - Understanding BPH
BPH is extremely common as men age.
It can cause:
Difficulty starting urination
Weak urine stream
Urine that starts and stops
Frequent urination
Urgency to urinate
Waking several times at night to urinate
Feeling that the bladder has not emptied completely
Dribbling after urination
Important point
An enlarged prostate does not automatically mean cancer.
A man can have:
An enlarged prostate without cancer
Prostate cancer without significant enlargement
Both BPH and prostate cancer - What is prostatitis?
Prostatitis means inflammation of the prostate.
It can occur because of bacterial infection, but not every form of prostatitis is caused by bacteria.
Possible symptoms include:
Pain or burning during urination
Difficulty urinating
Pelvic or lower abdominal pain
Pain between the scrotum and anus
Pain with ejaculation
Fever and chills in some acute infections
Frequent urination
Acute bacterial prostatitis can become serious and requires prompt medical assessment. - What is prostate cancer?
Prostate cancer occurs when abnormal cells in the prostate grow uncontrollably.
It is one of the most common cancers affecting men.
Early prostate cancer may cause no symptoms at all.
This is one reason discussions about prostate screening and risk assessment are important. - Symptoms that should not be ignored
A man should seek medical evaluation if he develops:
Difficulty urinating
Persistent weak urine flow
Blood in urine
Blood in semen
Painful urination
Repeated urinary infections
Persistent pelvic or back pain
Unexplained weight loss
Significant erectile or sexual problems
Frequent nighttime urination that is new or worsening
These symptoms do not automatically mean cancer, but they deserve proper assessment. - Is frequent urination always a prostate problem?
No.
Frequent urination can result from many conditions, including:
Enlarged prostate
Diabetes
Urinary tract infection
Excessive fluid intake
Caffeine
Certain medications
Bladder problems
Kidney disease
Other medical conditions
Therefore, it is not correct to assume that every urinary problem is caused by the prostate. - Is waking up at night to urinate a prostate problem?
It can be, but not always.
Waking during the night to urinate is called nocturia.
Possible causes include:
BPH
Diabetes
Excessive evening fluid intake
Sleep disorders
Certain medications
Heart or kidney conditions
Bladder problems
A medical evaluation can help determine the cause. - What is PSA?
PSA means prostate-specific antigen.
It is a protein produced by prostate cells.
A blood test can measure PSA levels.
An elevated PSA does not automatically mean prostate cancer.
PSA can increase because of:
Prostate cancer
BPH
Prostatitis
Urinary infection
Recent prostate manipulation
Sometimes other factors
Therefore, PSA must be interpreted in the context of the individual’s age, symptoms, examination, medical history and other findings. - What is a digital rectal examination?
A digital rectal examination (DRE) is a physical examination in which a trained healthcare professional gently inserts a lubricated, gloved finger into the rectum to feel the prostate.
The clinician may assess:
Size
Shape
Symmetry
Hard areas
Nodules
Other abnormalities
A DRE is only one part of prostate assessment. - Can a PSA test alone diagnose prostate cancer?
No.
PSA is a useful tool, but it is not a definitive cancer diagnosis.
If cancer is suspected, the doctor may recommend additional tests such as:
Repeat PSA
Urine tests
DRE
Prostate MRI
Other blood or biomarker tests
Biopsy when appropriate
A prostate biopsy is generally what confirms cancer by examining prostate tissue under a microscope. - What is a prostate biopsy?
A biopsy involves taking small samples of prostate tissue for laboratory examination.
It may be recommended when the overall assessment suggests a significant possibility of prostate cancer.
A biopsy can determine whether cancer is present and, when cancer is found, provide information about its characteristics and aggressiveness. - What is prostate MRI?
Magnetic resonance imaging (MRI) can provide detailed images of the prostate.
It can help doctors:
Identify suspicious areas
Determine whether a biopsy may be useful
Help target a biopsy
Assess the extent of known disease in appropriate circumstances
MRI does not replace professional medical assessment. - Risk factors for prostate cancer
Important risk factors include:
Age
Risk increases significantly as men get older.
Family history
Having a close relative with prostate cancer can increase risk.
Genetics
Certain inherited genetic changes can increase risk.
Ancestry
Some populations have higher rates of prostate cancer or develop clinically significant disease at younger ages.
Lifestyle and metabolic factors
Obesity and some lifestyle factors may be associated with prostate cancer risk and outcomes. - Can sexual activity cause prostate cancer?
There is no good evidence that ordinary sexual activity causes prostate cancer.
Sexual activity, ejaculation, masturbation and abstinence should not be presented as direct causes of prostate cancer.
Research has investigated whether ejaculation frequency may be associated with prostate cancer risk, but this does not mean that ejaculation is a proven treatment or prevention method. - Can masturbation damage the prostate?
Normal masturbation does not generally damage the prostate.
However, persistent pelvic pain, pain with ejaculation, blood in semen or urinary symptoms should be evaluated rather than automatically attributed to masturbation. - Prostate and erectile dysfunction
Prostate disease and erectile dysfunction can sometimes occur together, but they are not the same condition.
Erectile dysfunction may be related to:
Diabetes
High blood pressure
Cardiovascular disease
Nerve problems
Hormonal problems
Psychological factors
Medications
Prostate cancer treatment
Some prostate treatments can also affect sexual function. - Can prostate problems cause infertility?
Some prostate conditions can affect reproductive function, particularly conditions involving inflammation or infection.
However, infertility has many possible causes involving:
Sperm production
Testicles
Hormones
Sperm transport
Ejaculatory function
Sexual function
A fertility evaluation may therefore require examination of both partners. - Foods that support general prostate health
There is no single food that can prevent or cure prostate disease.
A generally healthy dietary pattern includes:
Vegetables
Fruits
Whole grains
Beans and legumes
Fish
Nuts and seeds
Adequate water
Moderate amounts of healthy fats
It is also wise to limit excessive:
Processed foods
Highly processed meats
Excessive saturated fat
Excessive sugar
Heavy alcohol consumption - Tomatoes and prostate health
Tomatoes contain lycopene, an antioxidant that has been studied in relation to prostate health.
Tomatoes can be part of a healthy diet, but lycopene should not be presented as a cure for prostate cancer or BPH. - Does drinking water help the prostate?
Adequate hydration is important for general health and urinary function.
However, drinking excessive amounts of water does not “flush out” an enlarged prostate.
If a man has severe nighttime urination, he may need to discuss the timing and amount of evening fluids with his healthcare professional rather than simply drinking more water. - Exercise and prostate health
Regular physical activity supports general health and may contribute to healthier body weight and cardiovascular health.
Examples include:
Walking
Swimming
Cycling
Strength training
Jogging, when appropriate
Men should choose exercise appropriate to their age and physical condition. - Smoking and prostate health
Smoking is harmful to overall health and is associated with increased risks of several cancers and cardiovascular diseases.
Stopping smoking is therefore an important part of maintaining long-term health. - Alcohol and prostate health
Excessive alcohol consumption can negatively affect general health and may worsen some urinary symptoms in some individuals.
Moderation or avoiding alcohol is preferable for people who experience symptoms after drinking. - What treatments are available for BPH?
Treatment depends on the severity of symptoms and the individual’s health.
A. Lifestyle measures
For mild symptoms, a doctor may recommend measures such as:
Reducing evening fluids
Limiting caffeine
Reviewing medications
Avoiding prolonged holding of urine
Managing constipation
Monitoring symptoms
B. Medicines
Doctors may prescribe medicines such as:
Alpha-blockers
5-alpha-reductase inhibitors
Other medicines depending on symptoms
C. Procedures or surgery
For severe symptoms or complications, procedures may be considered.
These can include various minimally invasive treatments or surgical techniques.
- Treatment of prostatitis
Treatment depends on the type.
If bacterial infection is confirmed or strongly suspected, antibiotics may be required.
Other treatments may address:
Pain
Urinary symptoms
Pelvic muscle problems
Inflammation
Chronic pelvic pain
It is important not to repeatedly take antibiotics without appropriate medical evaluation. - Treatment of prostate cancer
Treatment depends heavily on the cancer’s stage, grade, overall health and personal circumstances.
Possible approaches include:
Active surveillance
Surgery
Radiation therapy
Hormone therapy
Chemotherapy
Other systemic treatments
Combination treatments
Not every prostate cancer requires immediate surgery.
Some slow-growing cancers can be safely monitored under a structured active surveillance program. - Can prostate cancer be cured?
Yes, prostate cancer can be curable, particularly when detected while it is still localized to the prostate.
The chance of successful treatment depends on factors such as:
Stage
Grade
PSA level
Cancer characteristics
Overall health
Response to treatment
Advanced prostate cancer may not be curable in the same way, but modern treatments can often control it for substantial periods. - What happens if prostate cancer spreads?
Prostate cancer can spread to other parts of the body.
Common sites include:
Bones
Lymph nodes
Other organs
Advanced disease may cause:
Bone pain
Weakness
Weight loss
Urinary problems
Fatigue
Severe back pain accompanied by leg weakness, numbness or loss of bladder/bowel control is an emergency because spinal cord compression can occur in advanced cancer. - Can herbal medicine cure prostate cancer?
Be very careful with this claim.
There is no reliable evidence that an herbal preparation can be used as a substitute for proven prostate cancer treatment.
Some herbs may interact with medicines or cause liver, kidney or other problems.
A person taking herbal products should tell their healthcare professional exactly what they are taking. - Common myths about the prostate
Myth 1: “Every enlarged prostate is cancer.”
False. BPH is non-cancerous.
Myth 2: “If you have no symptoms, you cannot have prostate cancer.”
False. Early prostate cancer may have no symptoms.
Myth 3: “A high PSA proves cancer.”
False. Many non-cancerous conditions can raise PSA.
Myth 4: “Prostate cancer only affects elderly men.”
False. Risk increases with age, but younger men can develop it.
Myth 5: “Urinary problems always mean prostate disease.”
False. Diabetes, infections, bladder conditions and other problems can cause similar symptoms.
- When should a man see a doctor?
A man should arrange medical evaluation if he has persistent:
Difficulty urinating
Weak urine stream
Frequent urination
Urgency
Nighttime urination
Blood in urine or semen
Pelvic pain
Pain during urination
Pain during ejaculation
Unexplained weight loss
Persistent bone or back pain
Seek urgent medical attention if:
You cannot pass urine at all
You have fever and severe urinary symptoms
You have severe blood loss in the urine
You develop severe back pain with leg weakness/numbness or loss of bladder/bowel control - A step-by-step prostate health assessment
A practical assessment can follow this sequence:
Step 1: Ask about symptoms
Find out about urinary, sexual and pelvic symptoms.
Step 2: Review medical history
Consider age, family history, medications, previous urinary problems and other medical conditions.
Step 3: Physical examination
A clinician may perform an abdominal examination and, when appropriate, a DRE.
Step 4: Laboratory tests
Depending on the situation, tests may include:
Urinalysis
PSA
Kidney function tests
Other tests based on symptoms
Step 5: Imaging
Ultrasound or MRI may be recommended depending on the clinical question.
Step 6: Specialist assessment
A urologist may be involved when symptoms are significant or cancer is suspected.
Step 7: Biopsy when indicated
If cancer remains sufficiently suspicious, prostate tissue may be sampled.
Step 8: Treatment or monitoring
The management plan depends on the diagnosis.
Questions and Answers
Q1. What is the prostate?
Answer: The prostate is a male reproductive gland located below the bladder and surrounding part of the urethra.
Q2. What is the main function of the prostate?
Answer: It produces fluid that contributes to semen and helps support sperm function.
Q3. Does every man have a prostate?
Answer: The prostate is a male reproductive organ.
Q4. Does the prostate grow with age?
Answer: Yes. Prostate enlargement becomes increasingly common as men age.
Q5. Is an enlarged prostate cancer?
Answer: No. BPH is a non-cancerous enlargement of the prostate.
Q6. Can prostate cancer occur without symptoms?
Answer: Yes. Early prostate cancer may produce no symptoms.
Q7. What is PSA?
Answer: PSA is prostate-specific antigen, a protein produced by prostate cells that can be measured in blood.
Q8. Does high PSA mean cancer?
Answer: No. PSA can rise for several reasons, including BPH, prostatitis and other prostate conditions.
Q9. What test confirms prostate cancer?
Answer: When cancer is suspected, a biopsy is generally used to confirm the diagnosis by examining prostate tissue.
Q10. Can prostate cancer be treated?
Answer: Yes. Treatment may include surveillance, surgery, radiation, hormone therapy and other treatments depending on the cancer.
Q11. Can BPH be treated?
Answer: Yes. Treatment ranges from lifestyle measures and medicines to procedures or surgery when necessary.
Q12. Can prostate problems affect sex?
Answer: They can. Some prostate diseases and their treatments may affect ejaculation, erections or sexual comfort.
Q13. Can prostate disease cause infertility?
Answer: Some prostate conditions can contribute to fertility problems, but infertility has many possible causes.
Q14. Does drinking water cure an enlarged prostate?
Answer: No. Adequate hydration is healthy, but water does not reverse prostate enlargement.
Q15. Can herbs cure prostate cancer?
Answer: There is no reliable evidence that herbal products can replace proven cancer treatment.
Q16. Can a young man have prostate cancer?
Answer: Yes, although the risk generally increases substantially with age.
Q17. Is frequent urination always caused by the prostate?
Answer: No. Diabetes, urinary infections, bladder problems and other conditions can also cause frequent urination.
Q18. What is the best way to protect prostate health?
Answer: Maintain a healthy lifestyle, exercise regularly, maintain a healthy weight, avoid smoking, eat a balanced diet, and discuss appropriate prostate evaluation with a healthcare professional based on age and individual risk.
Final Take-Home Message
The most important lesson is this:
Prostate health is not just about cancer.
A man can have BPH, prostatitis, prostate cancer, or another urinary condition, and these conditions can produce similar symptoms.
Therefore, men particularly as they get older or if they have a family history should not rely on symptoms, herbal remedies, or PSA alone to determine their prostate health.
Early evaluation, proper diagnosis and appropriate treatment are the keys to good prostate health.
Delivered by:
His Most Valuable
Dr. Wema Samuel
(Founder Dr. Wema Foundation)
