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Prostate cancer usually develops quietly early on. Oftentimes, if a man experiences symptoms of prostate cancer, his disease has reached a more advanced stage.
Compounding the problem is that these prostate cancer symptoms can mimic those of other, noncancerous problems, so it’s important to visit your physician and find the root cause.
“Lower urinary tract symptoms may indicate the presence of many different conditions, ranging from infection and inflammation to prostate enlargement or cancer,” says urologist Stacy Loeb, MD, a prostate cancer expert with NYU Langone Medical Center. “Men should be evaluated to determine the cause of these symptoms, and to determine the appropriate management.”
And regardless of whether you have symptoms of prostate cancer, Dr. Loeb says, ask your doctor about your odds of developing the disease and discuss prostate cancer screening.
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Heed the Warning Signs
Day and night, it seems like you’re constantly trekking to the bathroom, and once you get there, you may have problems urinating. It’s easy to disregard these warning signs. After all, if you’ve watched your father or grandfather make frequent trips to the bathroom or routinely get up in the middle of the night to urinate, you’re probably not too surprised or worried when the same thing happens to you.
However, you should never ignore these potential symptoms of prostate cancer:
- Trouble starting to urinate or an inability to urinate
- Increased urinary frequency
- Burning or painful urination
- Blood in the urine or semen
- Painful ejaculation
- Erectile dysfunction
- Frequent pain in the lower back, hips, or upper thighs
“Advanced prostate cancer may present with symptoms such as bone pain from spread of the disease to bone or urinary symptoms from locally advanced disease,” Dr. Loeb explains.
Most of the time, however, these symptoms and complications result from a medical condition other than prostate cancer. For men, increased urinary urgency and frequency or difficulty starting to urinate are more commonly associated with benign prostatic hyperplasia (BPH, or enlarged prostate). These symptoms, as well as burning or painful urination and pain in the lower back, pelvis, and lower abdomen, also may be signs of prostatitis, a noncancerous inflammation of the prostate.
The only way to know for sure what’s causing your symptoms is to seek a medical evaluation from your physician.
Finding the Cause
Your doctor will review your medical history and ask about your symptoms and how long you’ve had them. He or she also may ask about your family medical history and whether prostate cancer runs in your immediate family. According to the American Cancer Society, your personal risk of prostate cancer doubles if your father or brother had the disease, and it’s even greater if several of your relatives had it, particularly if they were young when they were diagnosed.
Your physician will perform a physical examination, including a digital rectal exam, in which the doctor inserts a lubricated, gloved finger into your rectum to feel through the rectal wall for any abnormalities in the prostate that might indicate cancer, and to determine whether the prostate is enlarged.
You should undergo a urinalysis to check for infection as a cause of your urinary symptoms. Your doctor also will order a blood test for prostate-specific antigen (PSA), a liquid protein that your prostate normally secretes in small amounts into the bloodstream. Prostate cancer can cause your PSA to rise, and, generally speaking, as your PSA level climbs, so does the likelihood that you have prostate cancer. However, benign conditions like BPH, prostatitis, and urinary tract infections also cause PSA elevations. So, a PSA test should be done in conjunction with a digital rectal exam. Additionally, your doctor may order other tests that fine-tune PSA or measure other biomarkers that may signal prostate cancer.
Based on your PSA and other test results, as well as other factors—such as the results of your digital rectal exam, age, race, and findings from any previous biopsies—your physician may recommend a prostate biopsy to confirm a diagnosis of prostate cancer. In this procedure, an ultrasound probe is inserted into the rectum to visualize the prostate. The probe fires a fine needle through the rectal wall to retrieve tissue samples from several areas of the prostate. Then, a pathologist examines those samples for cancer.
Ask About Screening
Before you experience symptoms of prostate cancer, talk to your doctor about screening for the disease. Prostate cancer screening is highly controversial. Critics point to the fact that prostate cancer tends to grow slowly, and that screening can lead to complications from invasive biopsies and treatment of cancers that may never become life-threatening. In light of these concerns, the U.S. Preventive Services Task Force, a government advisory panel, recommends against screening for men without symptoms of prostate cancer.
Proponents counter that screening saves lives because it detects prostate cancer at an early, more curable stage. Many medical organizations recommend that asymptomatic men have informed discussions with their physicians and carefully weigh the pros and cons of screening.
“Most prostate cancer is currently identified through screening of asymptomatic men,” Dr. Loeb says. “Prostate cancer typically has no symptoms until it is advanced. This is why screening is so important to identify prostate cancer at an early stage within the window of curability.”