Prostate cancer is the most common cancer in men and is known as the second most prevalent cause of death after lung cancer. The prostate is a small walnut-sized gland in the lower abdomen of males, located in front of the rectum. The urethra passes through the center of the gland from the bladder to the penis. The prostate helps in producing semen that passes through the urethra during the process of ejaculation.
Prostate cancer is notorious for the fact that it shows very few symptoms in the early stages of the disease. Prostate cancer can be easily detected by prostate-specific antigen level. It can be further diagnosed by digital rectal examination and ultrasound-guided transrectal prostate biopsy. It is common in old age, so doctors prefer to evaluate biopsy of the prostate of suspicious patients under a microscope before devising the treatment. Prostate cancer develops slowly over time, but debilitating symptoms generally start after few years of the silent disease. If you are having any problems while urinating at the age above 55, it is highly advised to visit your doctor and get yourself screened for prostate cancer.
» Now, let’s discuss signs & symptoms of prostate cancer.
1) Painful or burning urination
Prostate cancer causes the gland to enlarge in size, affecting the normal flow of urine. Impedance to urine flow is the reason for painful micturition. It is also possible that painful urination occurs due to cancer spreading to surrounding structures. Prostate cancer is notorious for its nature of local invasion of surrounding structures like the urethra, bladder, and rectum. Burning during urination can be due to suppurative infection or side effects of the treatment of prostate cancer. The enlargement of the gland causes urinary obstruction and retention. Undue retention of urine inside the bladder can lead to infection of urethra and bladder leading to burning during urination.
Antibiotics can relieve the situation for a while, but the doctor needs to start treating prostate cancer to avoid further risks and complications. Discussing this problem with your doctor is the best possible choice to ward off the complications of undiagnosed prostate cancer. Family history and genetics are major risk factors of prostate cancer, but lifestyle changes and diet can make these warning signs more conspicuous as obesity can worsen your condition of painful micturition.
2) Frequent urination and nocturia
Frequent urination and nocturia are dangerous warning signs if you are suspecting prostate cancer. Nocturia is the condition in which the person has to wake up during the night in order to urinate. Sleep issues can further deteriorate the patient’s health condition. Nocturia can make the person feel tired in the morning due to frequent bathroom visits in the night. You should seek the advice of the doctor immediately if you are troubled by the number of times you have to wake up during the night to empty your bladder. Bladder diary is considered an important tool for the evaluation of the magnitude of the issue. Bladder or fluid diary requires proper documentation of urine excreted by the patient in 24 hours.
3) Blood in the urine and semen
Blood in the urine is called hematuria. It is only noticeable in an advanced and aggressive stage of prostate cancer. Two types of hematuria are likely to appear in prostate cancer. Microscopic hematuria is the one in which red blood cells are present in the urine but can only be observed through the microscope. In macroscopic hematuria, red blood cells can be seen with the naked eye in the urine of the patient.
3-5 percent of the prostate cancer can present with blood in the urine. In this case, the urine changes to red or pinkish color. It is due to the invasion of other parts of the urinary tract by the prostate cancer. The most common areas of invasion are the kidneys, ureters and urinary bladder. Regular checkup of urine is required to reach the proper diagnosis. Doctors normally ask for urinalysis, urine cytology, genital exam, rectal exam, urine culture, and ultrasound to find the right cause of hematuria.
4) Raised prostate-specific antigen level
Raised prostate antigen level can occur in prostate cancer. Prostate antigen is normally secreted substance by the gland as normal value of this protein is four (ng/mL) in the blood. It is also raised in some other diseases such as prostatitis and other urinary tract infection. Proper checkup by the doctor is necessary to find out the correct diagnosis. PSA screening can detect small tumors of the prostate that are still symptomless. Through monitoring of the PSA, mortality and morbidity rates due to prostate cancer can be mitigated to great extent. PSA level is considered very important in diagnosing prostate cancer as its level can provide major clues in narrowing down our diagnosis.
Patients having PSA level lower than four (ng/mL) in the blood have 15% chance of developing prostate cancer. Patients having PSA level higher than four (ng/mL) but lower than 10(ng/mL) in the blood have 25% chance of developing prostate cancer. Patients having PSA level higher than 10(ng/mL) in the blood have more than 50% chance of developing prostate cancer. Routine screening for PSA antigen is generally recommended between 45-55 years of age as the risk of prostate cancer is maximum in this age group.
5) Stiffness and pain in the lower back, hips, thighs
Prostate cancer can cause massive pain in thighs, hips and lower back. It is due to metastatic spread of prostate cancer to the bones of the regions as mentioned above. Prostate cancer that metastasizes to the bones affects new bone cells. A research was done on men who presented with the complaint of back, neck and pelvic pain. A strong connection was established between back pain and prostate cancer as men with back pain had 50 percent more chance of being diagnosed with prostate cancer than normal men. Apart from this, weakness and numbness of the limbs are also reported by patients with prostate cancer in an advanced stage of the disease. Consulting your doctor is mandatory if you are suspecting lower back, pelvic or thigh pain due to an unknown cause.
6) Unexplained weight loss
All cancers are linked to weight loss and so is prostate cancer. Loss of appetite, nausea, and vomiting are major causes of weight loss. The scientific reason for these symptoms is still a matter of debate. Prostate cancer patients also report a change in taste of different food along with loss of appetite. If you are suffering from unexplained weight loss, you should consult your doctor as soon as possible to find out the cause. Doctors recommend high-calorie intake in such circumstances to curb massive weight loss. Nausea and vomiting can also be controlled with proper medication. Ignorance of these symptoms can increase the risk of complications.
7) Pressure or pain in the rectum
Pain in the rectum can occur due to the spread of prostate cancer to rectal region. Constipation, fecal urgency, fecal incontinence, flatulence, subtotal bowel obstruction, diarrhea, and other bowel abnormalities can arise due to the invasion of the tumor to the rectum. You need to speak to your doctor immediately in order to manage these symptoms properly along with finding their exact cause. Digital rectal examination, ultrasound and PSA screening can help the doctor find out the right etiology of the disease.
8) Painful ejaculation
Painful ejaculation can really harm the person sexual relationship along with his self-esteem. Prostate cancer can cause painful ejaculation in around 2-3 percent of men. Pain after ejaculation can last for more than 24 hours. Sometimes, patients have reported with the pain before ejaculation, but pain after ejaculation is more common. Seeking help from the specialist doctor can be a great choice in this situation.
9) Bone pain that leads to fractures
Prostate cancer can easily metastasize to bone and cause pain and fractures. 60 percent of prostate cancer can develop bone metastasis. Spine, ribs, pelvis, and thigh are major regions of bone metastasis in prostate cancer. The spread of cancer can occur through blood or lymphatic system. After spreading to the bone, massive bone loss, increased risk of fractures and excruciating pain have been reported by patients. High calcium level in the blood and spinal cord compression can also occur due to the spread of cancer to the bones. It is very important to consult the doctor in these circumstances as things can worsen further.
10) Discomfort while sitting
Patients may feel extreme discomfort while sitting due to an enlarged prostate gland. Prostates cancer patients present with the pain and numbness in the perineal region while sitting on a hard surface. Prostate adenocarcinoma is a type of prostate cancer that is most commonly associated with pain while sitting. If you are feeling pain in your pelvis while sitting, this can be considered as a warning sign of the prostate cancer. Seek the help of the doctor as soon as possible to start the treatment as soon as possible.
11) Inability to urinate or difficulty starting urinate
Those suffering from prostate cancer may be unable to urinate due to urinary retention in the bladder. Local invasion of the tumor and enlarged prostate gland are the major causes of the person facing trouble emptying his bladder. If you are having trouble while urinating, it is highly advisable to consult urologist as early as possible so that a proper treatment plan can be devised to manage the situation.
12) Loss of bladder control
Loss of bladder control can be another warning symptom. In medical terms, this condition is widely known as urinary incontinence. Different types of urinary incontinence can occur in prostate cancer. Stress incontinence and urge incontinence are the two major types reported by the patients. Loss of bladder control can occur as a part of the disease process, but mostly radiation therapy and prostatectomy are the major causes of loss of bladder control.
Prostate also helps in controlling the flow of urine through the urethra from the bladder. After prostatectomy to control the spread of prostate cancer, bladder fails to hold the urine resulting in dribbling and nocturia. Surgery of the prostate can cause damage to nerves that supply the bladder resulting in urinary incontinence. External beam of radiation can also cause damage to bladder and urethra to worsen the condition further. 25 percent of men suffer from loss of bladder control due to prostate cancer and its treatment options. You should seek the advice of the doctor as soon as possible if you are suspecting these warning signs.
13) Swelling in legs
Swelling of legs, also called lymphedema, can also be considered a warning symptom of prostate cancer. This occurs when the tumor invades the lymphatic system of the body. Lymphatic fluid builds up in different regions of the body causing swelling or edema. Lymphedema can compromise the daily movement of the patient. Consultation with the doctor is necessary for proper management of the swelling in legs and arms due to prostate cancer.
14) Neurological deficits
Prostate cancer can cause neurological deficit in an advanced stage of the disease. 15-30 percent of the prostate cancer spread to the spinal cord through the venous route. When the tumor spreads to the spinal cord, it causes its compression. Due to compression of the spine, several neurological signs start appearing. Numbness and tingling sensation in upper and lower limbs are earliest warning signs of this invasion. Pain and unsteadiness of the feet can also occur during the process. Partial or complete paralysis of the limbs is possible as an end-stage outcome of the disease.
Consult your doctor immediately if your having numbness or tingling sensation in your limbs as early detection of the tumor can prevent permanent damage to the spinal nerves. Radiographs and CT-scan can provide great visual image of the extent of the disease. Proper treatment plan also depends upon the extent of invasion of the tumor.
Conclusion
Prostate cancer is highly common tumor among men. There are few early symptoms of prostate cancer but an advanced stage of the disease present with debilitating symptoms like weight loss, numbness of legs and feet, hematuria, painful ejaculation, painful urination, lymphedema, and bone pain. PSA level in the blood is essential for screening of prostate cancer which is most common among men of age between 45-55. Digital rectal examination and ultrasound-guided transrectal prostate biopsy are also important to diagnose the condition among men presenting with the warning signs of the disease.