The prostate gland is a walnut shaped organ that is an integral part of the male reproductive system. It lies just beneath the urinary bladder and the urethra (the tube through which urine passes to the outside from the bladder) passes through the prostate gland. The prostate gland adds volume to the semen and secretes an important enzyme called as acid phosphatase.

The prostate gland is easily felt by inserting a lubricated and gloved finger 3 cms into the anal canal and can be appreciated as a firm nodule. Digital exam of the prostate is an important part of male health check-ups. The size of a pea at birth the prostate gland grows to the size of a walnut in the male adult, that's about one inch by three quarters of an inch by one and a half inches (2.5 cm by 1.9 cm by 3.75 cm).

Though not fully understood, the prostate gland is purported to:

1. Secrete fluids that make up 30-40% of the semen volume.
2. Secretes important nutrients like zinc, amino acids, vitamins and sugars to nourish the sperms.
3. Helps to direct the semen outwards during ejaculation so that the semen does not reflux back to the bladder.
4. Secretes enzymes like acid phosphatase and prostate specific antigen that keep the semen fluid and enable sperms in their mobility.
5. Secretes hormone like substances called Prostaglandins that have important effects in the female genital tract like making the cervix pout and also enabling the female genital tract muscles to contract and suck the sperm towards the egg.

The prostate gland is liable to get into problems ranging from the trivial and irritating to the more sinister.

Infection of the prostate gland is called as Prostatitis. Prostatitis can be acute or chronic. They cause fever, burning while passing urine and a deep-seated pain in chronic cases. The prostate however gets into bad books for the more severe problems like the ones mentioned below.

Benign Prostatic Hypertrophy: BPH is one of the most common causes for men above the age of 50 to visit their physician or Urologist. In this condition the prostate gland enlarges and results in causing obstruction to the flow of urine from the bladder. (Remember the urethra? It passes through the prostate gland).

Prostate cancer: A more serious disease that affects the prostate gland is cancer. This is one of the leading killers in men above the age of 50 years. What's more surprising is the fact is that it is a very easily identifiable form of cancer and yet so many men fall prey to it!

Benign Prostatic Hypertrophy or BPH is enlargement of the prostate gland associated with its range of symptoms.

Causes of BPH: Normally the prostate gland develops under the influence of the male hormone Testosterone. In BPH the Testosterone is converted into Di-Hydro-Testosterone (DHT) under the influence of the enzyme 5-Alpha-Reductase. DHT stimulates the prostate gland to a great extent resulting in enlargement of the prostate.

Symptoms of BPH: BPH and its symptoms occurs in 50% of men above the age of 50, 60% of men above the age of 60, 70% of men above the age of 70 and 80% of men above the age of 80 years. However not all men who have BPH experience the symptoms. Tha symptoms of BPH include:

• Increased frequency of urination.
• Feeling of inability to empty the bladder completely.
• Dribbling of urine.
• Inability to start a flow of urine.
• A weak stream of urine.
• Increased night-time visits to the bathroom.
• In some cases burning while passing urine (especially if there is co-existant bladder or prostate infection).
• Rarely blood in the urine.

Management of BPH: BPH can be classified into mild, moderate and severe according to the severity of symptoms. Investigations like a urine analysis, ultrasound of the prostate, a Digital Rectal Examination, blood test (detects the level of PSA), and a micturating Cystourethrogram (MSU) can be performed by the physician or Urologist to aid in diagnosis and grading of the stage of the disease.

The treatment options range from "wait and watch" policy to medical to surgical management. Medical management includes using drugs like 5-Alpha-Reductase inhibitors (Finasteride) or newer agents like Alfuzosin or Tamsulocin. The attending doctor will be able to decide which option is best for you. In more advanced cases where the symptoms are more than just inconvenient the doctor might advice surgery. Prostate surgery has come a long way and very refined procedures like Trans-Urethral Resection of Prostate (TURP) or Cryoablation of the prostate now offer the patient the chance of getting the prostate removed as a day-care procedure.

Does BPH lead to prostate cancer? The answer remains still elusive and at this point in time anyone diagnosed with BPH should undergo frequent medical checks to detect cancer at an early stage.

Whilst BPH is an innoccous condition what men should guard themselves against is the more deadly prostate cancer. Prostate cancer kills more men and only lung cancer and heart attacks are ahead of prostate cancer in death toll amongst men.

Prostate cancer is a highly uncontrolled and bizzarre multiplication of the prostate glandular cells under the directive of Di-Hydro-Testosterone and possibly genetic and environmental toxins. The risk factors for prostate cancer are more or less same as for any other forms of cancer. Smoking is a risk factor which to many people might be surprising. The prostate gland in its actions to add volume to the semen concentrates nutrients and at the same time environmental toxins to over 600 times the levels in blood within itself. This leads to an abundance of carcinogenic chemicals in the prostate.

Prostate cancer is characterized by local and systemic symptoms. Among the local symptoms include bleeding while passing urine, most of the symptoms of BPH, and severe pain in the prostate gland appreciated by the patient as situated in the perineum (the area below the scrotum and before the anal opening). The more scary part of prostate cancer is its ability to spread to distant organs even before it is diagnosed. In fact many men present with very severe low back pain and upon investigating the cause is metastatic spine lesions. Regional spread to the lymph nodes is common.

The hallmark of diagnosing prostate cancer includes two simple tests. One, a Digital Rectal Examination, done by the doctor where the gland is appreciated as being much more firm than usual (sometimes as hard as a stone) and measurement of the blood levels of Prostate Specific Antigen. PSA is a substance secreted by the prostate gland alone and its elevation is a sign of prostate cancer. Normally the levels should be below 4 and in prostate cancer values are often above 11. Values between 4 to 11 should raise suspicion. PSA is also a very useful diagnostic test to follow up patients of prostate cancer who have been operated upon. Ideally if the disease is localized PSA levels should fall to baseline when the entire gland is removed. If the levels are still elevated after surgery it is a strong indicator of metastatic lesions.

Management of prostate cancer: The first approach to management is to stage or grade the cancer. Many doctors follow the Gleason's index to grade and the Tumor/Node/Metastasis (TNM) classification to stage the disease. Depending on the various stages and grades treatment options are considered. In a vast majority of the cases the prostate gland is removed alongwith the surrounding lymph nodes (radical prostatectomy). In those with more advanced disease the prostate bed and surrounding lymph nodes are subjected to radiotherapy. Chemotherapy is also a viable option in the management. Rarely very advanced cases need bilateral removal of the testes and administration of feminizing hormonal medications.

Despite advances in medicine, Prostate cancer continues to be a leading killer in menespecially in developing countries and public awareness is a potent weapon in the fight against this deadly disease.

Good food habits and taking the right supplements matters a lot for the health of the prostate. Here are some essential foodstuffs and nutrients that you cannot ignore if you are aiming for better prostate health:

1. Selenium: 100 to 200 microgram per day.
2. Saw Palmetto: 160 mg twice daily.
3. Tomatoes (boiled)/Lycopenes: 30 mg from diet.
4. Green and black tea: 4 - 10 cups per day.
5. Avoid sodas.
6. Aspirin: 81 to 325 mg per day.
7. A healthy diet low in saturated fat with lots of greens, whole grains, 30 g of nuts per day, fresh fruits and salad vegetables.
8. Zyflamend: Olive oil based herbal supplement that promises much in the battle against many cancers.
9. Regular exercise on top of good nutrition.