Ticket 2 Ride

You’ve heard those words, men over 50 may encounter getting up many times during the night. That is just one symptom of prostate issues.

The prostate has a full range of tricks to throw at you. It does, because it can.

The prostate serves a function in the reproductive process to help carry the sperm. The rest of the time, you generally do not notice it is there, until you do. Prostates have a big ego and as you age, they want you to remember they are a big deal. They grow in size and problem, and if angry enough, they try to kill you.

In the last decade, my nemesis, the prostate, has thrown a variety of challenges at me. When I turned 50, I started getting a PSA exam and visiting a urologist. PSA measures the prostate-specific antigen in your blood produced by the prostate. I did so to earn wellness points to get a discount on my health insurance. A few years later they eliminated that incentive because medical science began to question the reliability of the test. Regardless, the test got men to pay attention to their prostate. Undetected, prostate cancer can kill you if it travels beyond the prostate.

When you take a PSA test you get a score, the lower the better. With age, the score tends to inch upward. A number of things including genetics, age and general health can lead to a rising score. Other alarm bells like trouble urinating, more trips to the bathroom, or feeling like you cannot empty your bladder point to your friend, the prostate.

Although my score climbed through the years, thankfully it never got over 10, but staying above 8, which still put it in a suspicious category. Three times I got a biopsy. Long needles inserted into your rectum to take tissue samples of the prostate. A wonderful experience.

There are new tests that can help access your probability of prostate cancer. The 4Kscore test goes beyond the standard PSA blood test to analyze your risk of aggressive cancer. I had about a seven percent chance of cancer based on my 4Kscore test.

Prostate cancer is the second leading cause of cancer death in men.  Caught in the prostate or localized near the prostate, the five-year survival rate is nearly 100 percent.  Cancer that spreads to other parts of the body, the survival rate drops to only 31 percent (American Cancer Society).

Three biopsies in a little over a decade, the last one including an MRI fusion procedure that allowed the doctor to use 3-D imaging to see the hidden part of the prostate that normally is hard to biopsy. The “dark side of the moon” is where cancer likes to hide, usually undetected. Each biopsy was clean, but my prostate issues continued, as it got angrier.

It is unsettling to hear that your prostate is twice the normal size. But, when you take more trips to the bathroom and you settle for a weak stream, you are very aware of the issues. Then, you begin to notice pain and your flow shrinks. Alarm bells go off in your head. Benign prostatic hyperplasia (BPH) is the medical term for a large fucking prostate. Imagine your bladder full and not being able to urinate. Think about. What would you do?

The body is a curious thing when it works against you. Diseases like cancer take over organs or grow to impact other life functions, or the immune system is turned against itself, and other processes of the body are overrun and shutdown.

Your massive prostate begins to exert itself, using its size to seemingly strangle you from the inside. One in four men aged 55 or older suffer from BPH and the number increases sharply with age.

What makes the prostate grow? There are theories involving testosterone and estrogen, and the male hormone dihydrotestosterone. Whatever the cause, if you are a male over 50, watch out.

It is no wonder that BPH has become a new frontier of men’s health. Medications to increase flow, control bladder discomfort and even shrink the prostate are available. You can purchase over the counter supplements at your corner superstore. But do they work? I skipped the supplements and went for the medications, but found no lasting improvement.

Prostrate reduction can be accomplished sometimes with better diet and exercise, in addition to medications, but surgery and other treatments remain the best weapons against the very angry prostate.  It used to be that open surgery, a very invasive method, was commonly used for trimming out the prostate. Then, a rotor-rooter technology came into fashion, which seemed as inviting as leeches. It is difficult to think of the rotor-rooter method without fainting. Other treatments range from impacting the blood supply to the prostate to cause cell damage, enlarging the bladder (yes, really), using microwaves to stunt prostate tissue, inserting stints to push the bladder away from the prostate, injecting water vapor into the prostate, and injecting a solution into the urethra to remove prostate tissue cells.

The method I used was a patented laser technology that vaporized prostate tissue, like hollowing out a pumpkin, or in this case, a peach. Lovely image. For most people with prostates smaller than the peach I was carrying, the procedure was an hour or less, and they walked out with little discomfort. I was lucky to get three hours of surgery, a return trip to the ER and a day in the hospital. The food was very good there, but there are better dining options.

As my body heals, I wonder what my future relationship will be with my prostate. Will it grow back? Most likely in time. Will there be side effects from the laser surgery? Too soon to tell.

The angry prostate has been tamed for the time being. However, it is likely I’ve not heard the last from my nemesis.