Prostate Health > Prostate Health Programme

Because prostate problems are such a major cause of ill-health and impaired quality of daily life and poor sleep in middle-aged and older men, the Men’s Health Centre has in conjunction with a leading Consultant Urologist specializing in this area, established a ‘Prostate Health Programme’. Here, the emphasis is placed on prevention of prostate problems through diet, lifestyle and nutritional supplements. Advice and treatment of benign enlargement of the prostate, prostatitis and prostate cancer are also offered.

The Men’s Health Centre has initiated a Prostate Health Programme that aims not only to provide a detailed prostate screen, but also to introduce a range of measures that may help prevent further benign enlargement or malignant changes in the gland. Complete urological assessment and laboratory tests are carried out for the early detection of prostatic disorders, and assessed by a Consultant Urologist specializing in this area.

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Investigations for prostate cancer include a digital rectal examination of the prostate, PSA (prostate-specific antigen) blood test and urinary PCA-3 when necessary. For benign enlargement, bladder emptying can be assessed by abdominal ultrasound, and prostate size by transrectal ultrasound, both undertaken at the Centre. Further investigations and treatment with medications or prostatic surgery can be recommended when necessary (see treatments)

A group of dietary supplements that various studies suggest may be of benefit to the prostate can be provided when appropriate. These supplements may be combined with advice on other dietary measures and life-style modifications designed to enhance sexual performance and orgasm where necessary, and to improve general well-being and resistance to disease.

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Treatment of Benign Prostatic Enlargement and Prostate Cancer

Urinary symptoms associated with benign (i.e. non-cancerous) prostatic enlargement (benign prostatic hyperplasia, BPH) can often be managed by adjusting toilet habits, fluid intake and exercising the muscles that control bladder function, following a urological assessment.

Herbal products are widely used, particularly in Europe, for treating benign prostatic conditions. They are probably not as potent as prescribed medication, but again can be beneficial provided there are no signs of other urological conditions, complications or other medical contraindications.

Prescription medications are frequently used to improve urinary symptoms and quality of life, particularly when surgery is not necessary.  There are two principle classes of medications: 5-alpha-reductase inhibitors and alpha-blockers.

5-alpha-reductase inhibitors block the conversion of testosterone to dihydrotestosterone, a more active male hormone in the prostate. This class of drug may be sued to reduce prostate size with symptom improvement. It is also used to treat male pattern baldness, can cause side effects including reduction of ejaculate, erectile dysfunction, and sometimes reduced libido.

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Alpha-blockers act by relaxing the muscle of the prostate and bladder neck, but can occasionally cause side effects that include dizziness, reduction in blood pressure (beneficial if previously elevated), runny nose, headache and sometimes retrograde ejaculation.

Prostate surgery may be recommended for men who are unable to pass urine (urinary retention), or for men with complications of benign enlargement, including moderate or severe urinary symptoms, recurrent infection, recurrent bleeding in the urine or signs of progressive bladder deterioration. Surgery aims to restore or improve the urinary flow and bladder emptying, as well as other symptoms and effects of prostatic obstruction.

Conventional surgery for benign prostatic enlargement includes transurethral resection of the prostate, (also called TURP), or abdominal surgery. Both aim to remove the central part of the prostate that causes the obstruction, leaving the  peripheral capsule of the prostate intact. Side effects include the likelihood of retrograde ejaculation and sometimes erectile dysfunction.

A new development in the armamentarium of surgical treatments includes greenlight photoselective vapourisation ™ of the prostate or laser prostatectomy that  makes this treatment feasible as a day-case procedure with a quick return to everyday activities, avoids the stress (and bleeding) associated with conventional surgery, avoids the risk of erectile dysfunction, and usually also avoids post-operative catheterisation.

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Operations for benign prostate enlargement differ from the surgery used to treat early stage prostate cancer. Prostate cancer in its early stages can be treated either by radical prostatectomy (removing the entire prostate gland), or by radiotherapy, with long-term follow-up indicating cure in many cases. The surgical technique is highly specialised to preserve the nerves for erectile function, so called nerve-sparing radical prostatectomy.

There are a growing number of alternative treatments for early prostate cancer, some in experimental use or under development. Controversies in the field include the difficulty in distinguishing life-threatening  cancers at their very early stage, from tumours that would remain latent for many years and not impose any immediate threat to quality of life or life itself. Very careful monitoring of low-risk tumours may therefore be considered in selected patients under the care of a specialist.

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