Prostate problems in older men

The prostate is commonly referred to as the male G-spot (or P-spot) because it is a highly sensitive gland capable of producing intense, full-body pleasure and orgasms when stimulated. Located about two inches inside the rectum, it can be stimulated internally or externally via the perineum.

Key Aspects of the Prostate as a Pleasure Zone:

Location: The prostate is a small, walnut-sized gland located in the pelvis, between the bladder and the rectum.

Stimulation: It can be accessed internally by inserting a finger into the rectum and applying a "come hither" motion toward the front wall (toward the belly button).

Sensation: The area feels firm yet spongy, and stimulation can trigger unique, intense orgasms.

Methods: Common methods for stimulation include using fingers, prostate massagers, or external pressure on the perineum (the area between the scrotum and anus

If your prostate feels lumpy or rough, seek medical advise as it should be smooth.

What is the PSA test?

Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. Both prostate cancer and several benign conditions (particularly benign prostatic hyperplasia, or BPH, and prostatitis) can cause PSA levels in the blood to rise. 

The PSA test measures the level of PSA in the blood. This test is used in several different ways: to monitor the progression of prostate cancer in men who have already been diagnosed with the disease to follow up on prostate symptoms, such as painful or frequent urination, blood in urine or semen, and pelvic and/or back painto screen for prostate cancer in men who do not have symptoms of the disease

Is the PSA test recommended for prostate cancer screening?

The PSA test

is not recommended

for routine prostate cancer screening in the general population.

It was used for this purpose for several decades, beginning in the late 1980s. But by around 2008, as more was learned about both the benefits and harms of prostate cancer screening, many professional medical organizations began to caution against routine population screening with the PSA test. Most organizations now recommend that individuals who are considering PSA screening first discuss the risks and benefits with their doctors before making a decision. 

Some organizations do recommend that men who are at higher risk of prostate cancer have routine PSA testing, beginning at age 40 or 45. Those at higher risk include Black men, men with inherited variants in BRCA2 (and to a lesser extent, in BRCA1), and men whose father or brother had prostate cancer.

The current recommendation of the United States Preventive Serves Task ForceExit Disclaimer (USPSTF), which applies both to the general population and to those at increased risk due to race/ethnicity or family history, is as follows:

For individuals aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one. Before making the decision, a person should discuss the potential benefits and harms of screening with their clinician and consider these in the context of their own values and preferences.

PSA-based screening for prostate cancer is not recommended

for individuals 70 years and older. 

What is a normal PSA test result?

There is no single threshold that distinguishes a normal versus an abnormal PSA result. This is in part because there is no specific PSA level that means that someone has prostate cancer. However, the higher someone’s PSA level, the likelier it is that prostate cancer is present.

In general, a PSA level above 4.0 ng/mL is considered abnormal and may result in a recommendation for prostate biopsy. However, because PSA levels increase with age, some doctors apply a higher cutoff (such as 5 ng/ml) for older men and a lower cutoff ( such as 2.5 ng/mL) for younger men.

In addition, a lower cutoff for abnormal is used in men taking certain drugs, including finasteride and dutasteride, which are used to treat BPH. These drugs lower the PSA level.

Various factors can increase someone’s PSA level temporarily. An infection or inflammation of the prostate or having had a recent prostate biopsy can cause PSA levels to be raised for a month or two. Vigorous exercise (such as cycling) and ejaculation can also increase the PSA level transiently. People are generally recommended to wait until any conditions that can change PSA level resolve before they have testing and to avoid activities that may raise the PSA level for 2 days before testing.

What is done if a screening test shows an elevated PSA level?

If someone who has no symptoms of prostate cancer chooses to undergo prostate cancer screening and is found to have an abnormal PSA level, the doctor may recommend another PSA test in 6 to 8 weeks to confirm the original finding. If the PSA level is still elevated, the doctor may recommend continued observation with repeat PSA tests along with digital rectal exams (DREs) to watch for any changes over time.

If the PSA level continues to rise—especially if it rises quickly—or if a lump is detected during a DRE, the doctor may recommend additional tests. These may include additional blood- or urine-based tests, or imaging tests, such as magnetic resonance imaging (MRI) or high-resolution micro-ultrasound.

Alternatively, the doctor may recommend a prostate biopsy without further testing. During this procedure, multiple samples of prostate tissue are collected by inserting hollow needles into the prostate and then withdrawing them. The biopsy needle may be inserted through the wall of the rectum (transrectal biopsy) or through the perineum (transperineal biopsy). A pathologist then examines the collected tissue under a microscope. Although both biopsy techniques are guided by ultrasound imaging so the doctor can view the prostate during the biopsy procedure, ultrasound cannot be used alone to diagnose prostate cancer. An MRI-guided biopsy may be performed for patients with suspicious areas seen on MRI.

What are some of the potential benefits and harms of the PSA test for prostate cancer screening?

The potential benefit of the PSA test for prostate cancer screening is that it may help detect prostate cancer earlier, before it spreads and when it may be easier to treat, possibly reducing someone’s risk of dying from prostate cancer. 

A systematic review and meta-analysis of all randomized controlled trials comparing PSA screening with usual care in men without a diagnosis of prostate cancer concluded that PSA screening for prostate cancer leads to a small reduction in prostate cancer mortality over 10 years (2).

However, this potential benefit needs to be balanced against several potential harms:

Some cancers detected through PSA screening grow so slowly that they would never cause symptoms or become life threatening. However, treating them can cause harms. Detecting tumors that would not have caused problems during someone’s lifetime is called “overdiagnosis,” and treating them is called “overtreatment.”

Overtreatment exposes a person unnecessarily to potential complications. These include urinary, bowel, and sexual side effects, such as leaking of urine following surgery; increased frequency and urgency of urination following radiation; loose stools or, less commonly, rectal bleeding, following radiation; and loss of erections or decreased erections, following both surgery and radiation.

Detecting prostate cancer earlier does not always result in cure. While the PSA test can help detect small tumors, some of these tumors, regardless of size, may have already spread beyond the prostate before being detected and may not be curable.

The PSA test may give false-positive results. A false-positive test result occurs when the PSA level is elevated but no cancer is present. A false-positive test result may create anxiety and lead to additional medical procedures, such as a prostate biopsy, that can be harmful. Possible side effects of biopsies include serious infections, pain, and bleeding.

False-positive test results are common with PSA screening. About 6%–7% of men have a false-positive PSA test on any given screening round, and only about 25% of men who have a biopsy due to an elevated PSA level are found to have prostate cancer.

WARNING: If and when you have PSA test, be aware that the results can mean many things.

My test results some years ago was 19 and 3 months later was 4.... and it was only 19 because I had been ill and it was high because my body was fighting infection and was an artificial reading. he announced I had cancer of the prostate because of this artificial reading and I have had 3 monthly blood teats ever since, and all have been around the 4 mark - except one other time when I was again ill and it gave a higher reading...

Your PSA can go up and down according to stress, a hard days work, coffee and all sorts of things affect your PSA, so do not panic if and when.

IT IS SUGGESTED you have your PSA levels checked yearly at your doctor ( blood test ) - especially as you get older.

Prostate-Specific Antigen (PSA) Test

Priapus is an ancient Greek and Roman ithyphallic minor deity of fertility, gardens, livestock, and male genitalia. Often depicted with a grotesque, enormous phallus, he served as a protector of gardens and vineyards, frequently portrayed in art with fruits, vegetables, and a Phrygian cap. As a rustic god, he was believed to ward off the evil eye, though he was often treated with comedic, ribald humor.

So the God of the Cock is also the God of Gardens and live stock.... Ok ? that makes a lot of sence...NOT.

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