Prostate Cancer Symptoms

Prostate cancer is slow-growing and often asymptomatic. For this reason symptoms are not usually evident until the cancer has spread from the prostate to other areas of the body. In many cases prostate cancer is discovered when a physician performs routine screening tests such as a digital rectal examination (DRE) or a prostate-specific antigen (PSA) – both tests that are usually included in an older (>50 yrs of age) man’s yearly physical examination. If these tests raise concerns, the physician can order additional testing such as a transrectal ultrasound or a prostate biopsy to confirm or rule out the disease.

There are a number of signs and symptoms of prostate cancer, many having to do with urine flow. This is due to the fact that the prostate surrounds the urethra, the tube that carries urine from the bladder to the penis. The prostate gland is about the size of a small walnut, and is located just below the bladder and in front of the rectum. A cancerous prostate can become enlarged, and a tumor may exert pressure on the bladder or the urethra. The primary urinary symptoms include an inability to urinate, incontinence, frequent nighttime urination, a weak urine stream, starting and stopping while urinating, pain or burning during urination or ejaculation, and blood in the urine or semen. These symptoms are not from the cancer itself, but are related to the blockage caused by the cancerous growth within the prostate gland. Still, urinary symptoms are the initial symptom in less than 5% of all prostate cancer cases.

Advanced prostate cancer (ie, cancer that has spread from the gland to adjacent areas of the body), often causes symptoms in the back, pelvis, hips and legs. Persistent pain in the pelvic area, lower back or upper thighs should be evaluated, as well as chronic bone pain. Prostate cancer can cause bone fractures, too. Other symptoms of prostate cancer in the advanced stages include weight loss, loss of appetite and nausea and vomiting.

It is crucial to note that any of the above symptoms could be caused by other diseases or infections. Benign prostate hyperplasia (BPH), for instance, is a condition wherein the prostate gland becomes enlarged. The symptoms of BPH closely mimic those of prostate cancer, particularly the difficulties in urination, although this condition is not life-threatening. Prostatitis is an infection or swelling of the prostate gland, which is often painful. There are several types of prostatitis and it is sometimes (but not always) caused by bacteria. Some symptoms of prostatitis which are similar to prostate cancer are: difficulty in passing urine, burning when urinating, urine flow that is weaker than normal, waking many times during the night to urinate, lower back pain, and pain during or after ejaculation.

Because prostate cancer can be life threatening and its symptoms mimic those of other diseases and conditions, The American Cancer Society recommends that men undergo yearly screening tests (ie, PSA and DRE) for prostate cancer beginning at age 50. African-American men and those who have a family history of the disease (ie, a brother or father with prostate cancer) should beginning screening earlier. When prostate cancer is detected in its early stages, it is easier to treat and the patient’s prognosis is much improved.

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