Prostate Cancer Symptoms

What are the symptoms of prostate cancer?
Prostate cancer often does not cause symptoms for many years. By the time symptoms occur, the disease may have spread beyond the prostate. When symptoms do occur, they may include:

• Frequent urination, especially at night
• Inability to urinate
• Trouble starting or holding back urination
• A weak or interrupted flow of urine
• Painful or burning urination
• Blood in the urine or semen
• Painful ejaculation (The release of semen through the penis during sex activities)
• Frequent pain in the lower back, hips, or upper thighs

These can be symptoms of cancer, but more often they are symptoms of noncancerous conditions. It is important to check with a doctor.

What other prostate conditions can cause symptoms like these?
As men get older, their prostate may grow bigger and block the flow of urine or interfere with sexual function. This common condition, called benign prostatic hyperplasia (BPH), is not cancer, but can cause many of the same symptoms as prostate cancer. Although BPH may not be a threat to life, it may require treatment with medicine or surgery to relieve symptoms. An infection or inflammation of the prostate, called prostatitis, may also cause many of the same symptoms as prostate cancer. Again, it is important to check with a doctor.

Can prostate cancer be found before a man has symptoms?
Yes. Two tests can be used to detect prostate cancer in the absence of any symptoms. One is the digital rectal exam (DRE), in which a doctor feels the prostate through the rectum to find hard or lumpy areas. The other is a blood test used to detect a substance made by the prostate called prostate specific antigen (PSA). Together, these tests can detect many “silent” prostate cancers, those that have not caused symptoms.

Why am I having problems urinating?
Problems with urination may occur because the prostate is enlarged.

The prostate may enlarge as a man ages or it may enlarge due to infection or a tumor. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren't noticed until much later in life. Be sure to tell your doctor if you have any urinary symptoms.

Tell your doctor if you:

• Are passing urine more during the day
• Have an urgent need to pass urine
• Have less urine flow
• Feel burning when you pass urine
• Need to get up many times during the night to pass urine

What prostate changes should you be aware of?
Growing older raises your risk of prostate problems. The three most common prostate problems are:

• Infection, called prostatitis
• Enlarged prostate called benign prostatic hyperplasia (BPH)
• Prostate cancer

One change does not lead to another. For example, having prostatitis or an enlarged prostate does not raise your chance of prostate cancer. It is also possible for you to have more than one condition at the same time.

Most men have prostate changes that are not cancer.

What questions should I ask my physician?
No written information can take the place of talking directly with your health care professionals. If you don't understand the answers to your questions, ask him or his staff to explain further.

Many men find it helpful to write down their questions ahead of time. Below are some of the most common questions. You may have others. Jot them down as you think of them, and take the list with you when you see your physician.

• Could my symptoms be a sign of cancer?
• What tests do you recommend? Why?
• If I don't have cancer, what can I do about my symptoms?
• If I do have cancer, what stage is it? What grade? What is my PSA level?
• Would it be useful to get a second opinion from a second pathologist?
• What is my prognosis? Is recurrence likely?
• Do I need additional tests to look for lymph node involvement or metastases?
• What are my treatment options? What are the benefits?
• What are the possible side effects? How can they be managed?
• Are there clinical trials that would be appropriate for me?
• What other doctors should I talk with-a cancer specialist, a surgeon, a radiation oncologist?
• How much experience does your physician have? How many times a year does your physician perform this procedure? If a surgeon, is he familiar with nervesparing techniques?