Andrew Siegel MD 3/23/2019
Thank you Wikipedia for image above
One would think that the mammary glands and prostate gland are worlds apart—separated by gender, geographical locale on the body, external vs. internal—but in reality, they have many more similarities than differences.
The female breasts and the male prostate are both sources of fascination, curiosity, and fear. Surprisingly, they have much in common. The breasts—with an aura of mystique and power—are situated in the chest superficial to the pectorals, contributing to the alluring female form and allowing ready access for the hungry infant, oddly an erogenous zone as well as a feeding zone. On the other hand, hidden deep in the pelvis at the crossroads of the male urinary and reproductive systems, the prostate is arguably man’s center of gravity.
The breasts and prostate both serve important “nutritional” roles. Each function to manufacture a milky white fluid; in the case of the breasts, the milk serving as nourishment for infants, and in the case of the prostate, the “milk” serving as sustenance for sperm cells.
Breasts are composed of glandular tissue that produces milk and ducts that transport the milk to the nipple. The remainder of the breast consists of fatty tissue. The glandular tissue is sustained by the sex hormone estrogen and after menopause, when estrogen levels decline, the glandular tissue withers, with the fatty tissue predominating.
The prostate is made up of glandular tissue that produces prostate “milk” and ducts that empty into the urethra. At the time of ejaculation, the prostate fluid mixes with other reproductive secretions and sperm to form semen. The remainder of the prostate consists of fibro-muscular tissue. The glandular tissue is sustained by the sex hormone testosterone and after age 40 there is a slow and gradual increase in the size of the prostate gland because of glandular and fibro-muscular cell growth.
Access to the breasts as mammary feeding zones is via stimulation of the erect nipples through the act of nursing. Access to prostate fluid is via stimulation of the erect penis, with the release of semen and its prostate fluid component at the time of ejaculation.
The breasts and prostate can be considered reproductive organs since they are vital to the nourishment of infants and sperm, respectively. At the same time, they are sexual organs. The breasts have a dual role that not only provide milk to infants, but also function as erogenous zones that attract the interest of the opposite sex and contribute positively to the sexual and thus, reproductive process. Similarly, the prostate is both a reproductive and sexual organ, since sexual stimulation resulting in ejaculation is the means of accessing the prostate’s reproductive function.
Both breast and prostate are susceptible to similar disease processes including infection, inflammation and cancer. Congestion of the breast and prostate glands can result in a painful mastitis and prostatitis, respectively. Excluding skin cancer, breast cancer is the most common cancer in women and prostate cancer is the most common cancer in men. Breast and prostate tissue are dependent upon the sex hormones estrogen and testosterone, respectively, and one mode of treatment for both breast cancer and prostate cancer is suppression of these hormones with medications. Both breast and prostate cancer incidence increase with aging. The median age of breast cancer at diagnosis is the early 60s and breast cancer is the second most common form of cancer death, after lung cancer. There are about 3 million breast cancer survivors in the USA. The median age of prostate cancer at diagnosis is the mid-late 60s and prostate cancer is the second most common form of cancer death, after lung cancer. There are about 3 million prostate cancer survivors in the USA.
Both breast and prostate cancer are often detected during screening examinations before symptoms have developed. Breast cancer is often picked up via screening mammography, whereas prostate cancer is often identified via an elevated or accelerated PSA blood test. Alternatively, breast and prostate cancer are detected when an abnormal lump is found on breast exam or digital rectal exam of the prostate, respectively.
Both breast and prostate cells may develop a non-invasive form of cancer known as carcinoma-in-situ—ductal carcinoma-in-situ (DCIS) and high-grade prostate intraepithelial neoplasia (HGPIN), respectively—non-invasive forms in which the abnormal cells have not grown beyond the layer of cells where they originated, often predating invasive cancer by years.
Family history is relevant to both breast and prostate cancer since there can be a genetic predisposition to both types and having a first degree relative with the disease will typically increase one’s risk. Both women and men can inherit abnormal BRCA1 and BRCA2 tumor suppressor genes. Women who inherit BRCA1 and BRCA2 abnormal genes have about a 60% and 45% chance of developing breast cancer by age 70, respectively. Men who inherit the BRCA1 abnormal gene have a slightly increased risk for prostate cancer; men who inherit the BRCA2 abnormal gene have about a seven-fold increased risk. BRCA1 mutations double the risk of metastatic prostate cancer and BRCA2 mutations increase the risk of metastatic prostate cancer by 4-6 times, with earlier onset and higher grade at diagnosis.
Imaging tests used in the diagnosis and evaluation of both breast and prostate cancers are similar with ultrasonography and MRI commonly used. Treatment modalities for both breast and prostate cancer share much in common with important roles for surgery, radiation, chemotherapy and hormone therapy.
….On the subjects of breasts, next week’s entry will cover “When men develop breasts.”
Wishing you the best of health,
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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery. He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.
The content of this entry is excerpted from his new book, PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families
Preview of Prostate Cancer 20/20
Video trailer for Prostate Cancer 20/20
Dr. Siegel is the author of 4 other books:
PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food
MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health
THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health
Andrew Siegel MD Amazon author page
Prostate Cancer 20/20 on Apple iBooks
Tags: Andrew Siegel MD, breast cancer, Breasts, mammary glands, prostate cancer, Prostate Cancer 20/20, prostate gland, reproductive organs, sexual organs
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