The prostate is a gland to watch, and especially as one gets longer in the tooth. Prostate cancer is one of the major killers of men. Which is why I always include the prostate specific antigen in my blood tests (“Our Contest,” January 25, 2005). Since my move to Croatia, I have tested it eleven times, but only the last eight tests are of the same kind. The PSA levels in my blood get up and down all the time, but the last test was a bit worrying. It was way above the recommended maximum. And so I started learning about the prostate on the World Wide Web. In particular, what does the PSA test actually show? And what should be done if the recommended maximum is exceeded?

According to quite a few websites I have visited, the PSA levels can go up either because of prostate cancer or benign prostatic hyperplasia, also known as benign prostatic hypertrophy. These are terms for an enlarged prostate gland that is not affected by cancer. The enlargement happens with age. Since the prostate surrounds the urethra, the tube that carries urine from the bladder, BPH can squeeze or partly block the urethra, which causes problems with urinating. Most important, BPH is not cancerous and it usually does not require treatment. About fifty percent of men aged sixty have some symptoms. And so do ninety-five percent of men aged eight-five. Symptoms of BPH include difficulties with starting and stopping the urine stream, often feeling the need to urinate, a weak urine stream, and feeling the need to urinate at night. These symptoms may eventually lead to bladder damage, kidney damage, urinary tract infections, and so on.

Now, the eight PSA readings from as many blood tests over the last five years are always with me in my laptop. When I put them on a chart, they tell me that I am suffering from BPH rather than prostate cancer. The PSA levels have seesawed over the years, but the trend is rising only gradually, which makes sense on account of my age. The rise of the trend line is steady but gentle. In the case of cancer, the levels would show a more pronounced upward trend. Indeed, some symptoms of BPH are already with me on top of the PSA results. The last few years, I am awoken by an urge to pee once or twice a night. In addition, I pee a bit more often during the day than several years ago. So far, the symptoms are not yet bothersome. But I need to learn much more about prostate enlargement and ways to slow it down, or perhaps even stop it. It is a question of diet and exercise, I guess. Fingers crossed.