The Symptoms of Prostate Cancer
According to the American Cancer Society, one in seven men will be diagnosed with prostate cancer in his lifetime. It is the second most common cancer in men, after skin cancer. If detected early, however, it is very treatable.
Unfortunately, early stage prostate cancer often produces no discernible symptoms, which emphasizes the importance of regular screening. However, it is important to know the symptoms, as they may indicate advanced prostate cancer or other health problems that require medical attention.
Prostate Cancer Facts
- According to the American Cancer Society, it is estimated that in 2014 about 233,000 new cases of prostate cancer will be diagnosed, and about 29,480 men will die of prostate cancer. So even though it is the second leading cause of cancer death in men (lung cancer is the number one cause of cancer death in men), it is highly survivable when detected early. One in seven men may be diagnosed with prostate cancer, but only one in 36 will die of prostate cancer.
- Although the reasons for racial and ethnic differences in prostate cancer are not clear, they do exist. According to the American Cancer Society, prostate cancer occurs most often in African-American men and Caribbean men of African ancestry. African-American men are also at higher risk for advanced stages of the disease, and are more than twice as likely to die of prostate cancer as white men. Conversely, Asian-American and Hispanic/Latino men have a lower risk of prostate cancer than caucasian males.
- Prostate cancer is most common in older men. About six out of ten cases are diagnosed in men over the age of 65, and it is rare in men under the age of 40.
- Prostate cancer is typically a very slow growing cancer. Because of this, and the age of the average prostate cancer patient, it is likely that death will occur from other health issues before prostate cancer has advanced to the point of mortality.
- Because of the slow growth rate of prostate cancer, and the adverse side effects (such as impotence and incontinence) of most traditional treatment options, watchful waiting is often the preferred treatment option for very early stage prostate cancer. Watchful waiting involves active surveillance, and usually includes ongoing testing every three to six months to make sure the cancer is not spreading, as well as an annual transrectal ultrasound-guided prostate biopsy. Other common treatments include surgery, radiation and hormone therapy.
- Breakthrough treatments such as advances in targeted radiation therapy and focal laser ablation therapy achieve a level of precision in treating early stage prostate cancer that achieve effective treatment without undesirable side effects of traditional therapies, or the uncertainty of watchful waiting.
- Metastatic prostate cancer is advanced prostate cancer that has spread to other parts of the body, often including the bones. While the five year survival rate for early stage. prostate cancer is nearly 100%, for advanced prostate cancer that has spread to other parts of the body, the survival rate drops to 28%.
The Symptoms of Prostate Cancer
If you are having a regular exam to check for prostate cancer, you may be diagnosed with prostate cancer before you have any symptoms at all. However, if you experience any of the following symptoms, you should see your doctor.
- Weakened Flow of Urine/Burning When Urinating/Blood in Urine: In some advanced cases, the cancer in the prostate may become enlarged enough to place pressure on the urethra. This causes a weakened flow of urine, which makes urination difficult. It may also cause a burning sensation during urination or the presence of blood in the urine. As the tumor grows, it can become increasingly obstructive, resulting in an enlarged and painfully blocked bladder.
- Malaise/Weight Loss/Fatigue: These symptoms tend to occur when prostate cancer has spread to the surrounding tissue, nearby lymph nodes or other parts of the body including the bones, liver and lungs.
- Back and Pelvic Pain: Once advanced prostate cancer begins to invade the body, it often spreads initially to the lower spine or the pelvic bones, resulting in back or pelvic pain.
- Abdominal Pain and Jaundice: Advanced prostate cancer may also travel to the liver and lungs. If it has spread to the liver, you may experience abdominal pain and jaundice (yellow color of the skin).
- Unusual Coughing and Chest Pain: If prostate cancer has spread to the lungs, you may experience unusual coughing and chest pain.
The presence of these symptoms alone does not necessarily mean you have prostate cancer. Often these same symptoms can occur in men who have a non-cancerous enlargement of the prostate, or may indicate other health issues. However, if you experience these symptoms, you should make an appointment with your doctor to confirm that cancer is not the primary cause, and if not, to receive appropriate treatment.
What You Can Do
As stated previously, the best possible practice for men is to get regular screening for prostate cancer to ensure early detection. The age you should start screening depends on your risk factor.
The American Cancer Society makes the following recommendations:
- Very High Risk: If you have had more than one first-degree relative (parent, full sibling or your own child) who was diagnosed with prostate cancer at an early age (younger than 65), you should begin regular prostate cancer screening at the age of 40.
- High Risk: If you are an African-American, or have had a single first-degree relative who was diagnosed with prostate cancer at an early age, you should begin regular prostate cancer screening at the age of 45.
- Average Risk: If you are at average risk, you should begin regular prostate cancer screening at the age of 50.
What kind of screening practices you undergo is a conversation you will need to have with your doctor. The American Cancer Society website still recommends a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE). It should be noted that PSA testing has fallen out of favor in recent years due to a high rate of false positive readings. However, it continues to be a useful tool in prostate cancer detection, so you will want to discuss the pros and cons of PSA testing with your doctor.
 - Oto A, Sethi I, Karczmar G, McNichols R, Ivancevic MK, Stadler WM, Watson S, Eggener S
Radiology. 2013 Jun; 267(3):932-40.
 - http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-survival-rates
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