What are prostate nodules?

A man who goes to the doctor for a prostate exam and is told he has prostate nodules, is this cause for concern and does it indicate prostate cancer? 

The finding of a prostate nodule can be determined by the doctor palpating the prostate gland, which is about the size and shape of a walnut.  The prostate gland is part of the male reproductive system and sits just below the bladder and in front of the rectum.  A man’s prostate has the job of producing semen which carries sperm from the testicles through the penis during ejaculation.

When a doctor palpates the prostate gland by examining the prostate through a digital rectal exam, a prostate nodule will feel like a firm lump or area of hardness under the surface of the prostate.  The area is raised and will feel similar to the knuckle on a hand.  Prostate nodules are considered an abnormal growth.   

The terms “nodules” and “tumors” may be used interchangeable and basically both mean the same thing – an abnormal growth of cells found on the prostate. 

Causes of prostate nodules

The discovery of a nodule found on the prostate can mean many different things other than cancer with several different reasons why a man might develop one.  Here are some possible reasons for what a prostate nodule may indicate:

·      Prostate cancer

All prostate cancers will start out as nodule or abnormal growth but not all nodules or abnormal growths found on the prostate are automatically prostate cancer. 

When cells in the prostate gland start to grow uncontrollably and can spread into nearby tissue and organs is when the growth is malignant or cancerous.  Nodules that are found and determined to be benign or noncancerous, do not spread. 

Prostate cancer is the most common form of cancer in men in the United States and it is estimated in 2017, more than 161,000 new cases of prostate cancer 26,730 deaths will be attributable to this disease.

·      Prostatitis

 

A benign or noncancerous nodule may be a sign of prostatitis.  Prostatitis is an inflammation of the prostate gland and is often caused by a bacterial infection.  Around half of all men are affected by prostatitis at some point in their lives but it does not increase the risk of other prostate diseases. 

·      Prostate stones

Sometimes a nodule can actually be what is called a prostate stone, similar to a kidney stone that can be felt under the surface.  What seems like a nodule is actually a tiny formation of calcified minerals with the prostate stone being harmless.  It is believed these stones are formed either by secretions from the prostate thickening or when pus and other debris fuse together during an infection. 

A man with prostate stones may have similar symptoms of chronic prostatitis.  Having the presence of prostate stones can lead to inflammation of the prostate which can stop urine from exiting the body and can lead to a bacterial infection. 

·      Benign prostatic hyperplasia or BPH

Men with an enlarged prostate, also known as benign prostatic hyperplasia or BPH, can have nodules on their prostate which often lead to the symptoms of this condition.  BPH is a condition in which the prostate grows larger than usual but does not increase a man’s risk for prostate cancer. 

·      Other causes of prostate nodules

Other possible causes of nodules found on the prostate can include an infarct, which is an area of dead tissue caused by a loss in blood supply.  Also abnormalities found in the rectum, such as a hemorrhoid, could lead to prostate nodules.

Diagnosing a prostate nodule

Many men will often not be aware of having a prostate nodule as they are not likely to cause symptoms in the beginning.  But if they enlarge, then there can be signs and symptoms of a prostate issue.  Since prostate cancer can be present without symptoms, it is strongly advisable for all men to get regular prostate exams. 

There are several ways to diagnose a prostate nodule which include the following:

·      Prostate specific antigen (PSA) test

If a doctor discovers a nodule, they will order a PSA test.  PSA is a type of protein made by prostate cells.  A simple blood test can measure the PSA in the bloodstream.  Even though elevated levels may indicate prostate cancer, PSA levels can be high for several reasons such as BPH. 

·      Biopsy

A biopsy may be ordered if a doctor finds the nodule to be suspicious. During a biopsy, several tiny samples of prostate tissue will be removed which are then studied in a lab for signs of cancer cells.

Depending on what is found and if the nodule is cancerous or benign, will determine how it is treated.  If it is cancerous, then it will be treated using prostate cancer treatments with might surgery, radiation, or active surveillance. 

If the nodule is benign but is cause by prostatitis or a prostate stone, it will often be treated using antibiotics or other medications.