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Hardly a month goes by before I’m reading another story of the changing options for the
diagnosis and treatment of prostate disorders.
Yesterday, reading my morning KingstonWhig Standard
newspaper, I came across an article entitled, “New laser
treatment a green light for prostate patients.” It described
the recent acquisition of a special laser unit for the
Department of Urology at the Kingston General Hospital
which will be used in the treatment of enlargement of the
prostate gland,
benign prostatic hyperplasia
or BPH. The
current routine screening blood test for prostatic cancer, the
prostatic specific antigen (PSA) was declared in May 2012 to
be inappropriate for screening on a widespread basis by a
prestigious American group of experts, The U.S. Preventive
Services Task Force (USPSTF). As most of us in the senior
male population are at significant risk for development of
one or more prostate problems in our lifetime, it is timely
to review these potential problems and the choices which
we will face in their diagnosis and treatment at this point in
The prostate gland, about the size of a walnut, is located
in front of the rectum and below the bladder and is part of
the male reproductive system. Because it surrounds part
of the urethra (the tube through which urine passes), any
enlargement or disorder in the gland can result in urinary
symptoms. The three main afflictions can be infection
(prostatitis), benign enlargement (BPH) and prostate cancer.
is most commonly caused by bacterial infection
in the gland and is characterized by urgent and frequent
urination. Painful urination, fever and chills may also be
present. Early treatment with antibiotics cures most cases,
but careful assessment of the patient is necessary to rule out
any other problem.
Benign prostatic hyperplasia
(BPH) involves an increase in
the number of cells in the gland, resulting in enlargement
and pressure on the urethra and the bladder. It is estimated
that almost half of Canadian males will have some
enlargement of their prostate by age 50, and more than
80% of males over the age of 80. Symptoms may include
increased frequency of urination, having to get up during
the night to urinate, a weaker stream, and difficulty starting
and stopping urination. BPH is not a precursor of prostate
cancer, although symptoms may be similar, thereby
The Changing Management of
Prostate Disorders
by Robert MacMillan MD
Prostate cancer is the
most common cancer
among Canadian
men, excluding non-
melanoma skin cancer.
The Canadian Cancer
Society reports that one
in seven men will develop
prostate cancer during
his lifetime and one in 28
will die from it.