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What are the Symptoms of Prostate Cancer?
As with any cancer, very early prostate cancer produces no symptoms, since the "tumor burden" is too small to
cause interference with normal body functioning. It is most commonly detected symptom less ("asymptomatic") by a
screening blood test called "Prostate Specific Antigen" or "PSA" for short. The prostate normally produces
this enzyme and releases it into the bloodstream; it's level increases with BPH, infection, cancer or even vigorous rectal
exam. However, in cancer the PSA is usually markedly increased (when adjusted for the volume of prostate tissue), compared
to smaller increases with other conditions. A PSA reading of over 4.0 milligrams per milliliter of blood starts getting suspicious
for prostate cancer, since 95% of men under age 50 will be below this number. A PSA reading of 30 mg/ml or over almost certainly
indicates cancer (technical note-- In general, the PSA increases by 3 mg/ml for each gram of cancerous tissue). It is possible
to see PSA's in the thousands when the cancer is widespread.
If and when prostate cancer actually produces symptoms, they are most likely to resemble those of BPH-- a swollen prostate
causing urinary frequency, especially at night ("nocturia") along with incomplete emptying of the bladder ("post-void
residual"). Symptoms of more advanced prostate cancer include pain in the pelvis (from the cancer invading nerves), impotence
(ditto), swelling of the legs or genitalia (from blockage of lymphatic flow by tumor) or even complete shutdown of urine output
("uremia") which causing itching ("pruritis") and blurred thinking ("uremic encephalopathy").
The first symptoms noted may even be from cancer spread to other organs, with bone pain, weight loss, fatigue and low blood
counts ("anemia"). The most common area for spread to bone is the pelvis and spine, spread to the finger or toe
areas is rare. Spread to the brain may occur in advanced disease and produce neurological symptoms of poor judgment, partial
paralysis, sensory loss, and seizures. Spread to spinal cord may cause weakness and numbness requiring immediate therapy to
prevent irreversible paralysis. Fortunately, most of the symptoms of prostate cancer can be alleviated.
How is Prostate Cancer Detected and Evaluated?
Today, the most common way of detecting Prostate Cancer is through the PSA test (Hospitals often run free screening programs,
hoping to treat you if they detect cancer). Another common way the disease comes to attention is during an annual physical
exam when the doctor does a "digital rectal examination" and feels a lumpy ("nodular") or diffusely enlarged
prostate gland. The gloved examining finger is then applied to a specially treated card and "developer" placed on
it ("guiac test") to look for occult (too little to be seen with the naked eye) blood in the rectum. If there is
suspicion of prostate cancer, a PSA test will be ordered, and the patient usually sent to a "urologist."
Prostate cancer is the most common organ cancer in men, and is the source of much confusion. While it is the second leading
cause of cancer death in men, only about 5% of men with early stage prostate cancer will die from it! There are many treatment
options, including surgery, radiation therapy, hormones, castration, and even just "watching" it.
It is crucial for a man to understand his options in dealing with a prostate cancer problem. Being knowledgeable may help
him preserve his potency, continence or even his life. It is important to know that one has done everything possible to fight
prostate cancer successfully.
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Special thanks to "Cancer Group Inst."
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