23 signs that may indicate prostate cancer
Most patients do not have any signs or symptoms of prostate cancer until its advanced stages. Prostate cancer most commonly spreads to the bones; hence, bone pain is often a sign of prostate cancer. Many patients are diagnosed incidentally while being investigated for other conditions.
Furthermore, when present, the following 23 symptoms may indicate the presence of prostate cancer:
- Difficulty or pain while passing urine
- Thin urine stream or interrupted urine flow
- Urine urgency (a sudden urge to pass urine)
- Increased urine frequency particularly at night (nocturia)
- Burning while urinating
- Loss of bladder control
- Blood in the urine (hematuria)
- Blood in semen (hematospermia)
- Erectile dysfunction (inability to keep an erection firm enough for sexual intercourse)
- Painful ejaculation
- Decreased ejaculate volume
- Bone pains
- Unexplained weight loss
- Loss of appetite
- Increased fracture risk
- Back, pelvic, or hip pain that worsens or does not go away
- Swelling in the legs
- Pale appearance
- Shortness of breath
The above signs are not exclusively seen in prostate cancer. They may be seen in many benign or noncancerous conditions, such as benign prostatic hyperplasia (BPH) or urinary tract infection (UTI). Nonetheless, one must not delay consulting a doctor so that timely diagnosis and treatment may be done.
What is prostate cancer?
Prostate cancer is the uncontrolled growth of cells starting in the prostate gland.
- The prostate gland is a part of the male reproductive system.
- This walnut-sized gland surrounds a part of the male urethra (the tube through which urine is voided) with the urinary bladder in front and the rectum behind.
- It has several lobes covered in a tissue layer.
- The gland secretes various substances that form semen.
Prostate cancer is the second most common cancer (first being skin cancer) affecting one in eight men in the United States. It causes about 268,500 cases and 34,500 deaths each year.
Prostate cancer is the second most common cause of cancer death (the first being lung cancer) in males.
4 types of prostate cancer
Prostate cancer is categorized into various types based on the cells from which it arises.
Adenocarcinoma is the most common type of prostate cancer accounting for over 95 percent of all prostate cancer cases. This cancer arises from the gland cells in the prostate lobules that secrete fluid that forms the semen.
Other types of prostate cancer include:
- Small cell carcinomas
- Neuroendocrine tumors (other than small cell carcinomas)
- Transitional cell carcinomas
Knowing the type of prostate cancer helps the doctor plan treatment and predict the outlook or prognosis. Most prostate cancers are slow-growing and rarely cause any life-threatening consequences.
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What causes prostate cancer?
The exact cause of prostate cancer is not known, however, advancing age is the most important risk factor for this cancer.
- It results when there is an abnormal change (called a mutation) in the genetic material (DNA) in a cell in the prostate gland.
- The abnormal cell then starts growing and producing more cells of its kind uncontrollably, forming cancer.
- The consequent abnormal cells (that have no function in the body) have an increased need for nutrients that deprive the healthy cells of nourishment causing metabolic starvation.
Certain conditions may increase the risk of prostate cancer, such as:
- Older age: The risk of prostate cancer is higher in older men and is rarely seen in men younger than 40 years. About 60 percent of prostate cancer cases are diagnosed in men who are 65 years or older.
- Genetics: Certain genetic abnormalities, such as BRCA or BRCA2, CHECK2, RAD15, or ATM gene mutations, may increase prostate cancer risk. Men who have a family history of prostate cancer may be at a higher risk of developing the disease. The risk is higher in men whose brothers may have prostate cancer than those whose fathers had the disease.
- Ethnicity: African American and Caribbean men and men of African ancestry are more likely to get prostate cancer than men of other ethnicities.
- Geography: The prevalence of prostate cancer is more in men in North America, northwestern Europe, Australia, and Caribbean islands, and it is less common in Asia, Africa, Central America, and South America.
- Smoking: Smoking may increase the risk of dying from prostate cancer.
- Obesity: Obese individuals may have a slightly higher risk of getting a more aggressive form of prostate cancer.
- Diet: Although there is no strong evidence, men who consume dairy products and red meats in excess may have a higher risk of prostate cancer.
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How is prostate cancer treated?
The treatment of prostate cancer depends on various factors, such as:
- The age at diagnosis
- The stage of the cancer
- The severity of the symptoms
- Patient preferences
Treatment generally includes:
- Active surveillance: In this approach, no treatment is provided to treat cancer, but the doctor regularly conducts tests to check for the growth of cancer. This may be done when the cancer is localized and slow-growing. Regular monitoring helps initiate timely treatment if cancer turns aggressive. This is because, in some cases, this cancer is extremely slow-growing.
- Watchful waiting: In this approach, only symptomatic treatment is provided without doing any tests. It may be done in men who are expected to live for 10 years or less.
- Surgery: The prostate gland may be removed with or without the removal of the surrounding tissues.
- Radiation therapy: High-energy radiation may be administered to destroy cancer cells.
- Chemotherapy: The cancer cells may be killed via drugs.
- Hormone therapy: It involves administering medications that block the effect of hormones (androgens) that cause cancer growth.
- Biological therapy: It involves using the body’s immunity to kill cancer cells.
- High-intensity focused ultrasound: It involves using high-energy sound waves to kill cancer cells.
Health Solutions From Our Sponsors
Centers for Disease Control and Prevention. What Are the Symptoms of Prostate Cancer? https://www.cdc.gov/cancer/prostate/basic_info/symptoms.htm
Taplin M-A, Smith JA. Clinical presentation and diagnosis of prostate cancer. UpToDate. https://www.uptodate.com/contents/clinical-presentation-and-diagnosis-of-prostate-cancer#H2335184355
Tracy CR. Prostate Cancer Clinical Presentation. Medscape. https://emedicine.medscape.com/article/1967731-clinical
National Institutes of Health. Prostate Cancer Treatment (PDQ®)–Patient Version. https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq
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How Is Prostate Cancer Diagnosed?
Prostate cancer is largely a disease of men over 40, so it’s around this age doctors recommend the first prostate screening. The first exam is a blood test to determine if there are abnormal prostate specific antigen (PSA) levels in your blood – PSA is produced by the prostate. If the PSA is high, your doctor will perform a digital rectal exam, during which the doctor feels your prostate from inside your rectum with a gloved finger. Other diagnostic tests include an endoscopic biopsy of tumor tissue for analysis in a lab.
How Painful Is a Prostate Biopsy?A prostate biopsy is a simple surgical procedure that takes just 10 minutes. It involves inserting the biopsy needle through the wall of your rectum to reach your prostate to cut and remove around 10-12 small samples of tissue from the prostate. The idea of the procedure makes a prostate biopsy appear as an extremely painful procedure.
Prostate cancer is the most common cancer in men after skin cancer.
- Risk factors include age, family history, ethnicity, and diet.
- Prostate cancer is diagnosed by a digital rectal exam, prostate-specific antigen (PSA) test, and prostate biopsy.
- Symptoms may include
- frequent need to urinate,
- incontinence, pain,
- blood in the urine,
- fatigue, and more.
- Prognosis and treatment depend on cancer staging.
- Watchful waiting,
- cryotherapy, and
- other management strategies are available.
- Research and clinical trials strive to find new and better treatments for prostate cancer.
Prostate Cancer QuizIs prostate cancer the most common cancer in men? Take this prostate cancer quiz to find out and learn the causes, symptoms, and treatments of this disease.
Prostate Cancer Facts
Prostate cancer is a leading cause of cancer and cancer death in males; in some men, identifying it early may prevent or delay metastasis and death from prostate cancer.
- The prostate is a walnut-shaped gland that is a part of the male reproductive system that wraps around the male urethra at it exits the bladder.
- Prostate cancer is common in men over 50 years of age, with the risk of developing prostate cancer increases with aging.
Prostate Cancer Staging and Survival Rates
The prognosis for prostate cancer, as with any cancer, depends on how advanced the cancer has become, according to established stage designations. The patient's PSA score at diagnosis, as well as their Gleason score (the grading system used to determine the aggressiveness of prostate cancer) determines the prognosis and final stage designation. Prostate cancer has a high survival rate in general, but your chances depend on the stage of the cancer.
Illustrations of ProstateSide View of the Prostate. The prostate is a walnut-sized gland located between the bladder and the penis. See a picture of the Prostate and learn more about the health topic.
PSA Test (Prostate Specific Antigen)Prostate specific antigen (PSA) is a protein found in semen. PSA levels are used to detect prostate cancer and monitor the progression of the disease. Learn about test uses, results, and accuracy.
How Long Does It Take to Recover From a Prostate Biopsy?A patient may take about four to six weeks or even more to recover after a prostate biopsy. The recovery process after biopsy usually depends on the patient's health and age. Doctors may recommend only light activities for 24-48 hours after a prostate biopsy.
What Are the 5 Warning Signs of Prostate Cancer?Prostate cancer rarely produces symptoms in the early stage; however, few signs can help in detecting prostate cancer.
What Are the Five Stages of Prostate Cancer?The Gleason grading system grades prostate cancer from 1 to 5. According to cells’ appearances under a microscope, this system grades the most common (primary) and second most common (secondary) patterns of cells in a tissue sample collected via biopsy.
What Happens If You Don't Treat Prostate Cancer?If prostate cancer is left untreated, it may grow and possibly spread out of the prostate gland to the local tissues or distant sites such as liver and lungs.