Prostate Cancer

Prostate Cancer: Warning Signs and Symptoms

In the early stages, prostate cancer often shows no symptoms.

As a result, it can go unnoticed for years, with symptoms only occurring when the prostate has grown large enough to put pressure on the urethra.

The prostate is a walnut-sized gland that rests below the bladder and in front of the rectum.

The gland surrounds part of the urethra, the tube in the penis which carries urine from the bladder. 

The function of the prostate is to help make some of the fluid in semen which carries sperm from the testicles when a man ejaculates.

Various problems can affect the prostate gland, and cancer is one of them.

What is prostate cancer and how to recognize the signs and symptoms of this serious disease? Scroll on to find out. 

What is prostate cancer? 

Prostate cancer is a type of cancer that attacks the prostate, and it begins when cells in this gland start to multiply uncontrollably.

Cells in almost any part of the body can become cancer cells and spread to other areas of the human body, and prostate is not an exception. 

At this point, it is not entirely clear what causes prostate cancer, but it usually starts in the glandular cells.

This is known as adenocarcinoma. Tiny changes occur in the shape and size of prostate cells, and they are called prostatic intraepithelial neoplasia (PIN).

These changes tend to develop slowly and do not exhibit symptoms until their progression. 

Figures show that almost 50% of men over 50 have PIN. While low-grade PIN is not a cause for concern high-grade PIN is considered pre-cancerous. 

According to the American Cancer Society, prostate cancer is the most prevalent type of cancer in American men, right behind skin cancer.

The estimates for prostate cancer in the United States for 2019 are about 174,650 new cases of prostate cancer and 31,620 deaths caused by this serious prostate problem.

It is worth noting that prostate cancer treatment can be successful, particularly when the disease is diagnosed before metastasis. However, if it spreads, cancer can become more dangerous. 

Who is most at risk of prostate cancer? 

Millions of men across the globe have various prostate problems that affect their quality of life and overall health. 

Prostate cancer is one of the most common issues that affect the walnut-sized gland. So, how common is prostate cancer?

Figures show that one in nine men will be diagnosed with prostate cancer at some point in his life.

Every man can develop prostate cancer, but some men are at a higher prostate cancer risk than others. The most significant risk factors for prostate cancer are: 

  • Age – the risk of prostate cancer increases with age. About six out of 10 cases of prostate cancer diagnosis account for men ages 65 or older. It’s rare for men younger than 40 to develop prostate cancer. The average age at the time of diagnosis is 66.
     
  • Family history – like many other health problems prostate cancer also has a genetic component. If men in your family had prostate cancer, then you could be at a higher risk of developing it as well. 

  • Obesity – being overweight or obese can enhance the likelihood of many health problems, including prostate cancer. What’s more, obese men are more likely to have aggressive or advanced prostate. 

  • Race – although scientists don’t know why, African-American men have a higher risk of developing prostate cancer compared to men of other races. Moreover, prostate cancer is more likely to be aggressive and advanced in black men.

     

Prostate cancer is the second leading cause of death in American men, right behind lung cancer.

In fact, one in 41 men will die from prostate cancer. Although this is a serious disease, most men do not die from it.

More than 2.9 million men in the US who have been diagnosed with prostate cancer at some point are still alive today.

The five-year survival rate for most men with local or regional prostate cancer is nearly 100%.

For men diagnosed with metastatic prostate cancer, i.e., type of prostate cancer that has spread to other parts of the body, survival is 30%. 

What are the stages of prostate cancer? 

Before we address stages of prostate cancer, it’s useful to mention types of this disease.

As mentioned above, most prostate cancer types are adenocarcinomas, i.e., and they develop from gland cells.

Other types of prostate cancer are sarcomas, small cell carcinomas, neuroendocrine tumors, transitional cell carcinomas.

We can also categorize this disease to recurring prostate cancer, localized prostate cancer, and metastatic prostate cancer

Staging of prostate cancer is done in two ways: clinical and pathologic. Clinical staging is based on the results of prostate-specific antigen, i.e., PSA test, DRE test, and Gleason score.

On the other hand, pathologic staging is based on information found during surgery and laboratory results. 

Let’s take a look at prostate cancer stages breakdown: 

  • Stage I – doctor can’t feel the tumor or see it with some imaging test such as transrectal ultrasound. Cancer hasn’t spread to nearby lymph nodes or elsewhere in the body.
     

  • Stage IIA – cancer is growing in the prostate but hasn’t spread beyond it. The doctor may or may not be able to feel the tumor during DRE or see it during some imaging test. The tumor can touch more than half of one lobe of the prostate.

  • Stage IIB – cancer is growing in the prostate but doesn’t spread to other tissues. The doctor may or may not be able to feel it during DRE testing. The tumor can be present in one or both lobes of the prostate.

     
  • Stage IIC – similar to Stage IIB, but prostate cancer cells appear more abnormal.

     
  • Stage IIIA – cancer hasn’t spread outside the prostate; the doctor may or may not be able to spot it during DRE or imaging test. Cancer hasn’t spread to lymph nodes.

     
  • Stage IIIB – cancer has spread outside the prostate but hasn’t reached lymph nodes and distant sites in the body.

     
  • Stage IIIC – cancer may or may not spread to other tissues such as seminal vesicles, but didn’t reach lymph nodes.

     
  • Stage IVA – cancer may or may not have spread to tissues near the prostate, has reached lymph nodes, but didn’t spread to distant sites.

  • Stage IVB – cancer may or may not have spread to tissues or lymph nodes near the prostate. The disease has spread to remote sites in the body including lymph nodes, bones, and organs. 

What are the symptoms/ warning signs of prostate cancer? 

In the early stages, this common cancer may not cause any noticeable symptoms at all.

Sometimes men can experience some problems that they do not attribute to prostate cancer, which explains why many cases are not diagnosed in early stages.

Below, you can take a look at prostate cancer signs and symptoms. 

Early warning signs 

Due to the proximity of prostate gland to the bladder and urethra, prostate cancer may manifest itself through urinary symptoms, particularly in the early stages.

Depending on the size and location of the tumor, it can press on and constrict the urethra, thereby limiting the flow of urine and impairing the proper function of the urinary tract.

Some early symptoms of prostate cancer include: 

  • Painful ejaculation. 

  • Burning or pain during urination. 

  • Difficulty urinating or trouble to start and stopping while urinating. 

  • Blood in semen. 

  • Urinary problems/ Loss of bladder control. 

  • Blood in the urine (hematuria). 

  • The reduced flow of urine stream. 

Advanced warning signs 

As prostate cancer progresses, the symptoms become more noticeable and have a serious impact on a patient’s quality of life.

In the advanced stages of prostate cancer symptoms affecting urinary tract such as frequent urination become more pronounced.

Besides bladder and urinary troubles, advanced warning signs of prostate cancer include: 

  • Loss of bowel control in cases when the disease spreads to the bowel. In this case, men experience stomach pain, constipation, and blood in their stool. 

  • Soreness in the groin. 

  • Leg swelling or weakness. 

  • Hip or back pain. 

  • Coughing or feeling out of breath. 

  • Unexplained weight loss. 

  • Bone pain that doesn’t go away. 

How is prostate cancer diagnosed and treated? 

Men should go to regular doctor checkups to get their prostate gland examined.

In case you experience signs and symptoms that worry you (especially if they are mentioned above), you should schedule an appointment and see the doctor.

Prostate cancer screening involves: 

  • Digital rectal exam (DRE) – the doctor inserts a gloved, lubricated finger into the rectum to examine the prostate. If abnormalities in shape, texture, or size of the prostate are found further testing is needed.

If the tests mentioned above show abnormalities, then further tests are ordered.

They may include ultrasound, prostate biopsy, and MRI fusion. (magnetic resonance imaging ) 

Once the prostate cancer is diagnosed doctor determines the stage to recommend adequate treatment.

Some specific therapy may not be necessary right away for patients diagnosed with low-risk prostate cancer. In these cases, active surveillance is recommended.

What does it involve? The active surveillance involves regular follow-up blood tests, rectal exams, and biopsy to monitor cancer progression.

In other words, this is watchful waiting that gives the doctor an in-depth insight into the way cancer behaves.

When changes occur, the doctor can recommend the right treatment route, which is usually radiation or surgery

Surgery for prostatic cancer is prostatectomy or radical prostatectomy, which involves removal of the prostate. But, the doctor may also recommend brachytherapy where radioactive seeds are implanted in the prostate to deliver targeted radiation treatment. 

For advanced prostate cancer, the most common treatment measures are chemotherapy and androgen deprivation therapy (ADT), also known as metastatic castration-resistant prostate cancer, to reduce the effect of androgen.

Men receive abiraterone acetate to block the production of testosterone to stop the spread and growth of prostate cancer cells. Many clinical trials are still ongoing to find new treatment routes for prostate cancer. 

How can you prevent prostate cancer? 

In order to reduce the risk of prostate cancer, it is necessary to make some lifestyle adjustments. For example: 

  • Exercise regularly and stay physically active.

  • Maintain weight in a healthy range.

  • Avoid smoking.

Conclusion 

Prostate cancer is a common health problem for men across the globe.

Some early signs are similar to those of benign prostatic hyperplasia (BPH), but it’s important to consult a doctor because early detection is the best thing to successfully treat prostate cancer.

If you notice signs and symptoms listed in this post, you should consult your doctor to get them checked out. 

Sources

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  5. Campos C, Sotomayor P, Jerez D, González J3, Schmidt CB, Schmidt K, Banzer W, Godoy AS. (2018). Exercise and prostate cancer: From basic science to clinical applications.. Wiley. 78 (9), p639-64
  6. Gathirua-Mwangi WG, Zhang J. Dietary factors and risk for advanced prostate cancer. Eur J Cancer Prev. 2014;23(2):96–109. doi:10.1097/CEJ.0b013e3283647394
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About Our Author Dr. Ahmed Zayed

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Dr. Ahmed Zayed holds a baccalaureate of Medicine and Surgery. He has completed his degree at the University of Alexandria, Egypt. Founder of ZayedMD, Dr. Ahmed believes in making the knowledge as accessible as possible to patients. He had his work featured in reputable publications such as The Huffington Post. Other than his passion for writing, Dr. Ahmed spends​ his time outside the hospital at the gym or with a good book.

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