- The prostate gland is located below the bladder, by the rectum.
- Prostate conditions are common as men get older.
- Prostate cancer can be detected early through screening.
- Ezra’s prostate screening MRI scan is painless, non-invasive, doesn’t use gadolinium contrast, and lasts only 20 minutes.
The word “prostate” is derived from the Greek word “prostates,” meaning frontal (pro) and standing (states), which points to the prostate’s position in front of the bladder. When someone asks you, “Where is the prostate?” just remember this etymology.
The prostate is a relatively small organ (about the size of a large walnut) that has a key role in the reproductive system. Prostate cancer is particularly dangerous, so prostate scans are key to early detection and, thus, treatment.
In this article, we’ll discuss details about where the prostate gland is, what it does, its potential issues, and how to get ahead of prostate cancer.
Where is the prostate gland?
The prostate gland is located in male reproductive systems — it’s a little organ about the size of a walnut. It is located below the bladder, where it surrounds the urethra (urinary tract) and rests in front of the rectum.
The prostate gland is mainly composed of soft tissue and is branched with multiple ducts. Its cells are located inside the ducts, which secrete seminal fluid.
Four important zones divide the organ:
- The anterior fibromuscular zone is only made of muscular and fibrous tissue — there are no ducts in this area.
- The peripheral zone contains a majority of the ducts. It is the closest side of the prostate to the rectum. It can be felt during a digital rectal exam (DRE), in which a doctor will insert a finger in the anus to enable palpation of the prostate gland.
- The central zone is the portion of the prostate which surrounds the urethra (prostatic urethra). It contains ejaculatory ducts that emanate from the seminal vesicles.
- The transition zone is located around the prostatic urethra. It is the primary area that expands with age and causes prostate problems, such as benign prostatic hyperplasia or benign prostatic hypertrophy(BPH).
What is the role of the prostate?
The prostate is a non-vital but important part of the male reproductive system. Its primary function is related to ejaculation. It provides spermatozoids an environment they can survive in during their journey to the ovule. Prostate fluid accounts for 20-30% of the semen volume, while seminal vesicles produce 65%. Interestingly, semen contains only 2-3% of sperms produced by the testicles.
Other components of the semen include:
- Prostate-specific antigen (PSA), an enzyme that disaggregates the semen to help spermatozoids swim freely. A blood test for prostate cancer includes a PSA measurement, but this has been shown to have low accuracy in determining whether a man has prostate cancer. Studies have shown that 70% to 80% of men with elevated PSA who do a prostate biopsy do not have cancer.
- Zinc, a mineral that plays an important role in sperm motility and sperm DNA stabilization.
- Citrate, which provides energy for the sperm.
- Various antibacterial substances like lysozyme and lactoferrin to maintain a sterile environment.
How does your prostate work?
When you reach the stage of ejaculation, the muscle cells from the anterior zone contract and squeeze your prostate to release the prostatic and seminal fluids mixed with sperms via the urethra. The contraction of the prostate gland also prevents any urination during ejaculation.
As you age, your prostate enters an enlargement process. An enlarged prostate causes issues. This is why your risk of developing BPH and other problems like prostate cancer increases as you age. An estimated 50% of men over 50 years-old have BPH. This number reached 90% of older men more than 80 years old. Other pathologies are related to an inflammation of the prostate:
- Chronic prostatitis
- Chronic pelvic pain syndrome
Prostate cancer is a dysregulation of prostate cell proliferation. It causes an anarchist multiplication of the cells resulting in abnormal mass.
If the tumor keeps growing, it will first put pressure on surrounding tissues. For instance, the push on the bladder will cause a constant call for urination.
During the development of the tumor, malignant cells can enter the bloodstream and land on other organs like the liver and lungs. They are called metastases and are usually a synonym for an advanced stage of cancer.
According to the American Cancer Society, prostate cancer is the second deadliest cancer for men (the top deadliest is skin cancer). About 33,330 men, or one in 41, will die from prostate cancer in 2020. The good news is that, when detected at an early stage, your five-year survival rate is nearly 100%.
- Age: The older you get, the higher the risk.
- Ethnicity: African-American and Caribbean men with African ancestry are at a higher risk.
- Geography: Populations in North America are at a higher risk than in Asia.
- Family history: Some risk can be inherited.
- Obesity: Your risk of prostate cancer increases if you are obese.
Prostate cancer symptoms.
Prostate cancer symptoms occur generally at an advanced stage of the disease. The symptoms listed below will raise suspicions of prostate cancer but can be similar to other pathologies.
- Urology issues like difficulty urinating, disturbed urine flow
- Blood in the urine or semen
- Erectile dysfunction
- Pain in the abdomen area
- Loss of bladder control
Don’t wait until symptoms appear to take action. When detected at an early stage, the odds of surviving prostate cancer are nearly 100%.
Indeed, prostate cancer treatments exist but carry side effects. Ask your doctor if you are eligible for a prostate MRI scan, or take our five-minute questionnaire to evaluate your general risk of cancer.
Prostate cancer screening.
The CDC and the U.S. Preventive Services Task Force (USPSF) published recommendations for screening for 55-69 years-old men with average or increased risk for prostate cancer. However, the American Cancer Society‘s recommendations are slightly different. Talk to your healthcare provider to make an informed decision.
Let’s say you are eligible and willing to be screened for prostate cancer. Several tests are available:
- A PSA blood test is the most standard test prescribed. When you have a normal prostate, your PSA level in the blood is shallow (0.6 to 0.7 ng/ml for men between the ages of 40-50). A concentration of 2.5ng/ml is abnormal.
- A digital rectal exam is also standard in this situation. Your doctor will palp your prostate via your rectum with a well-lubricated gloved finger. It is painless but can be uncomfortable, especially if you have hemorrhoids. The DRE is less efficient than the PSA test at detecting prostate cancer but could be complementary if the PSA level is normal.
- As mentioned above, recent studies have shown to have low accuracy in determining whether a man has prostate cancer. 70% to 80% of men with elevated PSA who do a prostate biopsy do not have cancer.
- Prostate MRI is also an excellent screening option. When DRE and/or PSA detects only 50% of cancer, MRI showed 95% accuracy.
Your results for both a PSA blood test as well as a prostate MRI will be ready within 2-3 days. If you have abnormalities on your non-contrast screening prostate MRI scan, your doctor will ask you to do a follow-up diagnostic scan MRI with contrast, followed by a prostate biopsy to confirm the diagnosis and establish what stage of cancer you are in. You’ll then explore treatment options together with your urologist.
Be prepared with Ezra.
At Ezra, your prostate health is our priority. We have the capability of prostate imaging using a 20-minute non-contrast prostate MRI.
Ezra has also just received FDA clearance for prostate cancer artificial intelligence, the first lesion segmentation ever to be approved by the FDA.
With this technology, we are definitely ready to give you the best preventive approach to potential prostate cancer. You can read more here about how we compare with other techniques.
Unfortunately in our current health system, most of the time men have to first get a prostate biopsy before their health insurance will cover a Prostate MRI with IV contrast. This is backwards because a prostate biopsy has notable risks (infection, bleeding and sometimes, erectile dysfunction). Conversely, a prostate MRI is non-invasive and therefore, less risky. That’s why Ezra physicians at our New York locations now offer a prostate MRI with IV contrast to men with elevated PSA levels or urinary symptoms. With our prostate MRI, you can get a head start on prostate cancer — sign up for a consultation today.