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Prostate Cancer: Signs and Symptoms

Behind skin cancer, prostate cancer is the second most common cancer among men in the US. Approximately 1 out of 8 men will be diagnosed with this disease in their lifetime, and 1 out of 41 of them will die as a result of it. Due to the advancement of technology and screening measures, the percentage of men diagnosed with prostate cancer that live beyond 5 years has increased over the last few decades. Studies show that this percentage went from 69% in the 1970s, to 76% in the 1980s, to 100% in today’s time for men in the local and regional stages of the disease.

Early detection can influence the prognosis, so keep reading to learn more about the signs, symptoms, and risk factors.

Prostate Cancer: Signs and Symptoms

What is Prostate Cancer?

Prostate cancer is cancer that develops in the prostate, which is a male reproductive organ that produces seminal fluid. Seminal fluid nourishes and protects sperm, which originates from the testes. The prostate is not a vital organ (meaning it is not necessary for survival), however, it is essential for reproduction.

Although prostate cancer is the fourth most commonly diagnosed cancer in the world, mortality rates have dropped significantly since the late 1900s. Most prostate cancers progress slowly and can be monitored for years with little to no treatment, although this depends on how far the cancer has already spread when it’s been detected. Metastatic prostate cancer has the lowest chance of successful treatment.

Signs and Symptoms

Prostate cancer in its early stages often presents no symptoms and is usually detected through regular screening that starts between the ages of 45 and 50. When symptoms do occur, they may be mistaken for BPH (benign prostatic hyperplasia) - or prostate gland enlargement. It’s best to consult with a primary care provider if these prostate cancer symptoms occur:

  • Difficulty urinating
  • Pain or burning sensation when urinating (dysuria)
  • Blood in urine (hematuria)
  • Blood in semen (hematospermia)
  • Loss of bladder control (urinary incontinence)
  • Excessive urination (polyuria)
  • Unexplained weight loss
  • Erectile dysfunction

Advanced (metastatic) prostate cancer symptoms may include:

  • Pain and numbness in the lower extremities
  • Bone pain
  • Swelling in the pelvic region
Prostate Cancer: Signs and Symptoms

Causes

It is unknown exactly what causes prostate cancer. Scientists know that DNA mutation that causes uncontrolled prostatic cell division gives rise to prostate cancer, but it is unclear what starts those mutations.

DNA (deoxyribonucleic acid) is a molecule that carries the genetic code for the development and function of cells that form organs, which then form an organism. Some of the genes within DNA control cell growth, division, and death. When a mutation in these genes occurs, it can cause cells to divide uncontrollably. Typically the immune system will target and attack these cells, but sometimes it fails and the cells continue to divide rampantly, creating a tumor.

There are several risk factors associated with prostate cancer, and understanding them can better prepare men to take preventative measures against it.

Risk Factors

  • Age: Prostate cancer seldom develops in men younger than 40, but those chances increase significantly after age 50. According to the American Cancer Society, approximately 6 out of 10 prostate cancer cases are among men aged 65 and older.
  • Family History: A man’s risk for developing prostate cancer is doubled if he has a father, brother, or uncle who’s been diagnosed with it. That likelihood continues to increase with the more relatives that have had it, especially if they were diagnosed under 50 years of age.
  • Race: African Americans and Caribbean men of African descent are far more likely to develop prostate cancer than any other race. Not only is the disease more prevalent among them, but it is more likely to onset at an earlier age and progress faster. The reason for this is unknown, though some speculate that genetics may be a cause.
  • Smoking: Researchers found that smoking increases the risk of prostate cancer progressing after diagnosis, and the risk of dying from aggressive forms of the disease.
  • Diet: Obesity hasn’t been shown to increase the overall likelihood of being diagnosed with prostate cancer, but obese men are at a higher risk for developing an aggressive form of the disease rather than a low-grade one.
Prostate Cancer: Signs and Symptoms

Diagnosis

To screen for prostate cancer, a primary care provider will likely first inquire about the family medical history of the patient, for reasons discussed above. Next, they will examine the patient and perform a DRE (digital rectal exam). This is a simple and quick procedure in which a healthcare provider inserts a gloved finger into the patient’s rectum to feel for any abnormalities on the prostate. After this exam, the provider may also order a PSA (prostate-specific antigen) blood test, which checks for the amount of PSA protein in the blood. A high amount of PSA may indicate the presence of cancerous cells, though it may also indicate other benign conditions.

If the results are abnormal, the provider will perform a prostate ultrasound and biopsy. The ultrasound involves a small probe that gets inserted into the rectum and allows the provider to get a clear image of the prostate for the biopsy. A biopsy is the removal of tissue for the purpose of being examined for the presence of disease. They’ll take a few tissue samples and send them off to a lab to be tested for cancer.

The biopsy results will be assigned a Gleason score and will aid the provider in deciding on a treatment plan.

Treatment

The recommended treatment will depend on how far the cancer has spread, how aggressively it grows, and if the patient has any other complications (i.e. significantly old age). For prostate cancer that hasn’t spread, a prostatectomy (surgical removal of the prostate) or radiation therapy may be an option. If the tumor is small enough, the provider may choose not to treat it at all just yet, but rather wait and see.

For advanced prostate cancer that has spread to the surrounding tissues, treatments such as chemotherapy, hormone therapy, and immunotherapy (Provenge cancer vaccine) may be used after surgery or radiation therapy have failed. Medications (as well as radiation) are necessary for prostate cancer that has metastasized to the bones.

Prostate Cancer: Signs and Symptoms

Prevention

Some risk factors for prostate cancer can’t be controlled, but some can. Maintaining a healthy diet, exercising regularly, and avoiding smoking are all steps that can be taken to lessen the risk of developing this disease. Additionally, making one’s doctor aware of a family history of prostate cancer is important because they may recommend screenings at an earlier age.

Wrapping up…

Prostate cancer is a very real risk that men have to keep in mind as they get older. Despite it being so common, it’s not as frightening of a disease today as it was 40 years ago. Screening measures continue to improve and treatment options are abundant. It’s no wonder why over 3 million men who have been diagnosed with it are still living - carrying on with their lives for years to come.

References

Brawley O. W. (2012). Trends in prostate cancer in the United States. Journal of the National Cancer Institute. Monographs, 2012(45), 152–156. https://doi.org/10.1093/jncimonographs/lgs035

Key Statistics for Prostate Cancer | Prostate Cancer Facts. (2022, January 12). American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html

Mulumba, P. (2021, February 27). Why Are Black Men More At Risk For Prostate Cancer? Longevity LIVE. https://longevitylive.com/medical-research/why-are-black-men-more-at-risk-for-prostate-cancer/

NCI Dictionary of Cancer Terms. (n.d.). National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/gleason-score

Prostate Cancer - Statistics. (2022, April 14). Cancer.Net. https://www.cancer.net/cancer-types/prostate-cancer/statistics

Prostate Cancer Foundation. (2019, January 10). The Connection Between Smoking and Prostate Cancer. https://www.pcf.org/c/the-connection-between-smoking-and-prostate-cancer/

Prostate Cancer Risk Factors. (2020, June 9). American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/causes-risks-prevention/risk-factors.html

Staff, R. (2021, June 15). Tips For a Healthy Daily Routine For Men. RX Sleeve. https://www.rxsleeve.com/tips-for-a-healthy-daily-routine-for-men/

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