Prostate Awareness Foundation

Prostate Self Help

Monthly Bulletin

May 2009

The Size of Your Prostate Gland is Important: Many men do not know the size of their prostate but it’s important. A good diagnostic urologist can determine the size of your prostate with a simple ultrasound scan. The prostate gland is measured in grams. Younger men have smaller prostates, usually between 15 grams and 25 grams. As we age and our hormonal balance changes, the prostate begins to grow in size. In many men the prostate will double in size and weight. At PAF, we regularly talk with men whose prostates are over 50 grams and in some men, well over 100 grams. This change in size and weight is varies for all men. For some, the process starts as early as forty, for others it starts in one’s fifties or sixties and in some men – never.

As the gland grows, it squeezes the urethra, the tube coming from the bladder and can create a condition called BPH, a benign enlargement of the prostate which can present problems. The good news is that BPH does not lead to prostate cancer. But for many of us the problem exhibits itself in the more frequent and urgent need to urinate, especially at night. There are a number of prescription drugs and nutritional supplements that provide relief for many men, but no help for others.

As the prostate increases in size, one’s PSA number also increases. This is normal and does not necessarily indicate the presence of prostate cancer. This is one reason that it is important to know the size of your prostate gland.

A study conducted at New York Presbyterian Hospital in 2005 showed that men with prostate cancer that have a small prostate gland had a higher rate of positive surgical margins and non-organ confined tumors. The study on 1,296 patients who underwent robotic radical prostatectomy showed that the positive surgical margin rate was 10.9% for men with glands weighing 50 grams or less vs. 7.2% for prostates larger than 50 grams. This is considered significant. Another study at Cornell University showed that men with smaller prostates had more high-grade cancers and are more likely to have advanced disease.

So, as you can see, the size of your prostate gland is important. This is especially true in men with diagnosed prostate cancer who are trying to choose a treatment path. Ask your urologist to tell you the size of your prostate gland the next time you see him!

Chondroitin Sulfate Alert: Many of us use supplements for relief of arthritis and joint pain. We’ve recently read that a common ingredient in many of these supplements called chondroitin sulfate, may present problems for men with prostate cancer.

Charles Myers, MD the editor of the popular publication The Prostate Forum has raised concerns that chondroitin sulfate has been seen in higher concentrations in prostate tissue in men with prostate cancer Dr Myers feels that these higher concentrations predict a higher rate of recurrence after radical prostatectomy. No studies to date have been done to determine if taking chondroitin supplements promotes or leads to prostate cancer. However, we have a great deal of respect for Dr Myers and his work. Until more studies can be done, we would suggest that men take a joint support supplement that does not contain chondroitin.

Did You Know Women Have a PSA: If you thought PSA was confusing, here’s some more food for thought! PSA is also found in women. A recent study in Italy showed that PSA is not organ or sex specific, but rather a steroid hormone-mediated response. A study was conducted on 50 healthy female volunteers between the ages of 25-39 years of age and detected PSA in voided urine in all of them. The researchers felt that the source of this urinary PSA is probably the Skene’s gland.

The Skene’s gland is in some respects the female prostate. It is located in the upper wall of the vagina around the lower end of the urethra. Experts think that this gland starts out as a prostate in the fetus, but shrinks in females and grows in males as sexual differences develop in the womb. The Skene’s gland is in the same area as the female “G-Spot” that is activated during orgasm. The gland varies in size from woman to woman.

Mark Scholz, MD, the executive director of the Prostate Cancer Research Institute (PCRI) recently reported in a Wall Street Journal article that in rare cases, the Skene’s gland can become cancerous and these tumors show elevated PSA levels. An article in the Journal of Gynecological Pathology in 2004 reported on an 88 year old woman with a large tumor on her Skene’s gland that was treated with external beam radiation and became cancer free.

Agent Orange Prostate Cancer & Disease Recurrence: A study of 1,495 veterans at the VA Medical Center in Augusta, GA showed some alarming results. Veterans exposed to Agent Orange during the Vietnam War have an increased risk of aggressive recurrence of prostate cancer after a radical prostatectomy surgery. These men had a 50% higher recurrence rate even when their initial cancers appeared to be non-aggressive before the procedure. The PSA doubling time after surgery in these men was eight months compared with eighteen months in those non-exposed veterans.

Margaret Terris, MD, Chief of Urology at the Charlie Norwood VA Medical Center in Augusta, GA who led the study says “There is something about the biology of these cancers that are associated with prior Agent Orange exposure that is causing them to be more aggressive. More research needs to be conducted to look at the impact on patients who undergo other types of treatment including radiation and brachytherapy. In addition to whether the degree of Agent Orange exposure has on impact on cancer severity.”

Please help us get the word out to our Vietnam veteran friends, especially those exposed to Agent Orange: Get a prostate checkup at your local VA hospital.

Prostate Awareness Foundation
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, San Francisco, CA 94116 / 415-675-5661 /