Editor’s Note :
AHMC Healthcare and National Yang Ming Chiao Tung University Hospital presented seven expert lectures on screening, treatment, and prevention. This article covers the first lecture.
Trouble urinating—could it be cancer? Can cold medicine make it worse?
In “Men’s Health Warning Signs After 50,” Dr. William Huang of National Yang Ming Chiao Tung University Hospital explored prostate and sexual health, emphasizing: normal urination doesn’t rule out prostate cancer, and nighttime urination isn’t always due to prostate enlargement.
Prostate Enlargement, Not Cancer
A Taiwanese saying captures aging men’s frustration: a once-powerful urine stream becomes a dribble. But Dr. Huang warned against blaming every urinary change on age—or confusing an enlarged prostate with cancer.
Benign enlargement does not turn cancerous, even if treatment is delayed. Both conditions can coexist and need separate evaluation.
Located below the bladder, the prostate surrounds the urethra and contributes fluid to semen. As it enlarges, it can restrict urine flow, causing a weak or interrupted stream, difficulty starting, dribbling, and incomplete emptying.
Delaying care can lead to urinary retention, recurrent infections, and bladder or kidney damage.
Choose Wisely, Prevent Retention
Cold medicines are not universally off-limits—the ingredients matter.
Some decongestants tighten the prostate and bladder outlet; some antihistamines impair bladder contraction. Either can worsen urination or trigger retention.
Tell your doctor or pharmacist about your prostate condition before choosing medication.
If you cannot urinate and have lower abdominal pain or swelling, seek immediate care.
Nighttime bathroom trips may also signal sleep apnea, especially with loud snoring, breathing pauses, or daytime sleepiness.
Track fluid intake, bathroom visits, and urine volume to help your doctor identify the cause.
Silent Cancer, Informed Screening
Early prostate cancer can be symptom-free. A strong urine stream offers no guarantee. Men with an affected father or brother should discuss their risk and testing options early.
An elevated prostate-specific antigen (PSA) level is not a cancer diagnosis. PSA helps liquefy semen, and levels can rise with benign enlargement, inflammation, or cancer.
Doctors assess age, history, and PSA trends before recommending further tests, which may include a rectal exam, MRI, or biopsy.
Because screening can cause false positives and overdiagnosis, decisions should be individualized.
Tailored Treatment, Sexual Function
Treatment does not always mean surgery.
Options include medication, transurethral resection, laser enucleation, prostatic urethral lift, and water vapor therapy. Prostate size, overall health, and personal priorities guide the choice—not how new a procedure is.
Erections and ejaculation are different functions. Some treatments for benign enlargement alter ejaculation without necessarily impairing erections. Prostate cancer surgery carries different risks.
Before treatment, ask about expected urinary improvement and effects on bladder control, erections, and ejaculation.
Dr. Huang’s message to men over 50: speak up about changes in urination, sleep, and sexual health. Embarrassment should never delay care.(Part 1 of 7)
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