Cancer is a disease that can affect almost every major organ in the body – from our skin to our liver. However, prostate cancer affects more men than any other cancer type apart from skin cancer. Based on data between 2010 and 2012, the NIH estimates that an astonishing 14 percent of the male population will be diagnosed with some form of prostate cancer in their lifetime. An estimated 220,800 cases were reported in the USA in 2015, with deaths at 27,540. By 2012, there were almost 3 million men living with prostate cancer in the US. It’s important not to live in fear, but the statistics should concern you enough to be more vigilant regarding your health and the health of your loved ones. Remember, the biggest fight against cancer starts with prevention. [1]
Getting To Know The Prostate
The prostate is part of the male reproductive system that is found just underneath the bladder. Roughly the size of a walnut, this gland produces fluid that supports the sperm used for sexual reproduction. The prostate grows naturally throughout the lifetime in two major “growth spurts”. The first obviously happens during puberty and the other during a man’s thirties. The weight of the gland grows from about 20 grams during adulthood to double its weight by the time a man reaches his 70s. [2] However, the sudden growth of the prostate can put pressure on its surrounding organs and tissues and cause pain and problems with urination and bowel movement. Learn about these warning signs and symptoms of prostate cancer below.
#1: Painful Or Difficult Urination
Dysuria is a term that means painful or difficult urination. With this symptom, you may find it difficult to urinate even if your bladder feels full; or be able to urinate but with mild to severe pain in the pelvic or perineal area (but note that a burning sensation in the urinary tract is usually due to a urinary tract infection). Dysuria is a cause for concern because it can indicate that something may be pressing against your urinary tract (the tract that allows urine to flow out from the bladder) most likely an enlarged prostate, a symptom of prostate cancer. [3]
#2: Frequent Urination
Frequent urination can also be a sign of prostate cancer. When the enlarged prostate or tumor compresses the bladder, it reduces its capacity to hold urine – ergo, more frequent trips to the bathroom to urinate. This can also lead to a feeling that your bladder isn’t fully empty even after repeated urination. [3]
#3: Very Weak Urine Flow
Slow or reduced urine flow usually accompanies the previous symptoms mentioned above. When something is blocking the urinary tract or bladder, the urine flow is greatly reduced, often to a mere dripping or dribbling. This also makes it hard to direct the stream of urine, even with a lot of force being made by the abdominal muscles during urination.
#4: Hematuria
Blood in the urine or hematuria is a cause for worry for anyone – male or female. In the case of prostate cancer, blood in the urine can indicate that the tumor has damaged the urethra or bladder – causing bleeding.
Bear in mind that severe problems with urination are late symptoms of prostate cancer – usually occurs when the prostate gland has already reached a large enough size to disrupt the normal function of the urinary system.
#5: Blood In Semen And Painful Ejaculation
As with hematuria, there should be a concern if blood appears in semen. Vascularized tumors are prone to bleeding, which can be the reason why blood-tinged semen is considered a sign of prostate cancer. The tumor itself can be bleeding or damaging surrounding prostate tissue to cause bleeding and pain.
#6: Swelling Of The Legs And Feet
There are two ways wherein prostate cancer can affect the lymph nodes – the first by compressing them, affecting the flow of lymph fluid in and out of the nodes and the second by metastasis to the lymph system. When the ducts that lead to and from the lymph nodes near the pelvic area become blocked, it causes a build-up of fluid in the lower extremities. This can cause mild to severe edema in the ankles and feet, or even the entire leg. However, lower extremity lymphedema usually happens after surgery and therapy but there is still a risk of it occurring prior to the start of treatment, depending on the stage of the tumor. [4]
#7: Pain In The Hips, Back, Or Chest
When prostate cancer has reached the last state (stage four), it has usually spread or metastasized to other parts of the body. The most common place where prostate cancer metastasizes is bone. This is why pain in the hips (pelvic bone), back (spine), and chest (ribs) are indicative of widespread bone metastasis in cases of prostate cancer. In a study on prostate cancer in 2000, 90 percent of autopsies done on people who died of prostate cancer revealed bone metastasis. [5]
#8: Urinary And Stool Incontinence
When metastasis has spread to the bones in the spinal column, it can start to affect spinal tissue as well. Because the spinal cord is a part of the nervous system and contributes to the control of the muscles of the bladder and the rectum, metastasis can lead to problems with urinary and stool control, manifesting as incontinence. This can start with feeling the urge to urinate and defecate but never making it to the bathroom on time, eventually leading to full incontinence. [6]
#9: Erectile Dysfunction
While many people believe that erectile dysfunction only occurs after treatment for prostate cancer has started, science begs to differ. In a 2015 study on baseline erectile dysfunction and diagnoses of prostate cancer, erectile dysfunction was present in more than half (53 percent) of the total number of subjects, with severe ED occurring in roughly half of that number (24 percent). This demonstrates that baseline erectile dysfunction is a prevalent warning symptom of prostate cancer.[7]
#10: Weight Loss And Fatigue
Unexplained weight loss and fatigue are common among all types of cancer. When any kind of tumor develops, the body basically “feeds” it which causes it to spread and grow. The nutrients sent to the cancer cells starve the healthy cells, leading to weight loss and easy fatiguability. This is actually one of the earliest signs of cancer, with affected people only noting weakness at the beginning stage of the disease to severe fatigue and weight loss as the staging of cancer progresses. [8]
Your Number One Tactic: Prostate Cancer Screening
Here’s the truth: most of these signs and symptoms only occur when prostate cancer has already progressed to later stages. More often than not, men with the early stages of prostate cancer are asymptomatic – meaning they don’t feel any different or don’t manifest any signs and symptoms of the disease. This is where screening comes in. You may not know it but you maybe be at risk for prostate cancer.
The three most common methods for prostate cancer screening are:
1) digital rectal exams (DREs)
2) prostate-specific antigen (PSA) detection in the blood and
3) checking for the presence of the protein Engrailed-2 (EN2) in the urine.
The first method allows the manual palpation of an enlarged prostate, raising the alarm for the performance of other screening tests to fully assess the condition. The second is also able to detect an enlarged prostate through PSA levels in the blood, which is useful if the prostate cannot be palpated through a DRE. While the ability of these tests to actually detect prostate cancer is not 100 percent, they are very valuable in detecting abnormalities with the prostate and have positive effects on mortality rates beyond 7 years. [9][10]
The EN2 test is based on relatively new research and reported to be not yet available. A laboratory test currently identifies EN2 in urine, and a simple home test kit is envisioned which will be similar to a home pregnancy test strip. [11]
But remember this: Not all enlarged prostates are cancerous.
An enlarged prostate is not always a cause for concern. In fact, this condition is very common in older men – occurring in about 90 percent of men in their 70s and 80s. Hyperplasia or the enlargement of the prostate naturally occurs as a man ages. When this growth doesn’t stop, it can develop into BPH – which stands for benign prostatic hyperplasia, which is not at all cancerous and is generally regarded as not requiring any form of treatment – unless there is great difficulty in urination. However, the urinary symptoms of BPH are similar to prostate cancer, which makes adequate screening even more important. [11]
Note: As with the rest of this website, this article is not medical advice nor a substitute for a consultation with a medical professional. We do not advise self-diagnosis or self-treatment. If you believe you have the symptoms mentioned or are concerned about your health, please schedule an appointment with your doctor/healthcare advisor.
References:
[1] National Institutes of Health. SEER Stat Fact Sheets: Prostate Cancer. http://seer.cancer.gov/statfacts/html/prost.html
[2] Department of Health and Human Services (Victoria, Australia). Prostate gland and urinary problems.https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/prostate-gland-and-urinary-problems
[3] National Institutes of Health. Prostate Cancer Prevention and Early Detection.http://www.cancer.org/cancer/prostatecancer/moreinformation/prostatecancerearlydetection/prostate-cancer-early-detection-symptoms-of-prostate-cancer
[4] Rasmusson, E., et. al. (2013). Low rate of lymphedema after extended pelvic lymphadenectomy followed by pelvic irradiation of node-positive prostate cancer. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842657/
[5] Bubendorf, L., et. al. (2000). Metastatic patterns of prostate cancer: An autopsy study of 1,589 patients.http://www.sciencedirect.com/science/article/pii/S0046817700800350
[6] Alizadeh, M. & Alizadeh, S. (2014). Survey of Clinical and Pathological Characteristics and Outcomes of Patients With Prostate Cancer. http://www.ccsenet.org/journal/index.php/gjhs/article/view/38296/22260
[7] Ong, W., McLachlan, H. & Millar, J. (2015). Prevalence of Baseline Erectile Dysfunction (ED) in an Australian Cohort of Men with Localized Prostate Cancer. http://www.ncbi.nlm.nih.gov/pubmed/25847707
[8] Langer, C., Hoffman, J. & Ottery, F. (2001). Clinical significance of weight loss in cancer patients: Rationale for the use of anabolic agents in the treatment of cancer-related cachexia.http://www.sciencedirect.com/science/article/pii/S0899900701800010
[9] Mistry, K. & Cable, G. (2003). Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. http://www.jabfm.org/content/16/2/95.short
[10] National Institutes of Health. Prostate Cancer Screening – for health professionals.http://www.cancer.gov/types/prostate/hp/prostate-screening-pdq
[12] Roehrborn, C. (2005). Benign Prostatic Hyperplasia: An Overview. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477638/
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