Initially, prostate cancer produces no symptoms. In fact, at this stage, prostate cancer is seldom discovered unless revealed by a test. This test, called a PSA (prostate-specific antigen), reveals the presence of a protein generated by the prostate gland that circulates in the bloodstream.
PSA Screening for Prostate Cancer
The PSA blood test, approved by the FDA in 1986, can detect prostate cancer early when properly analyzed in a laboratory. Results are typically reported as nanograms per milliliter (ng/mL). Many doctors still recommend yearly PSA prostate cancer screening for men 50 and older, but newer research into prostate cancer suggests that this may in some cases be counterproductive.
For example, March 2009 trials (published in the New England Journal of Medicine), appeared to arrive at conflicting conclusions regarding PSA prostate cancer evaluations. One trial suggested no prostate cancer survival benefit with PSA testing and digital rectal examination, while another found a 20-percent reduction in prostate cancer deaths. Experts suggest that this result may reflect the fact that screening detects a large number of lower-risk cancers but fails to diagnose more aggressive prostate cancer tumors in their early stages.
As men age, their prostate gland may enlarge. This noncancerous condition is called benign prostatic hyperplasia (BPH). While BPH does not commonly evolve into prostate cancer, an enlarged prostate gland may occasionally contain some areas of cancer cells that require monitoring.
Initially, because prostate cancers usually start in the part of the prostate gland distant from the urethra, there are no symptoms. This is because the growing tumor does not press on the urethra or bladder.
As prostate cancer advances, pressing on the urethra or spreading to other sites in the body, sufferers may notice:
• A frequent need to urinate, particularly at night
• Difficulty initiating or stopping a stream of urine
• A weakened or intermittent urinary stream
• Urine leakage when laughing or coughing
• Difficulty urinating while standing
• Pain or burning during urination
• Blood or semen in the urine
These symptoms are all a result of the growing tumor pressing on or blocking the tube that carries urine and semen. However, it is important to remember that these symptoms can be the result of BPH, a bladder obstruction, a urinary tract infection, or even acute (sudden) kidney failure.
In advanced prostate cancer, patients may experience:
• One-sided pain in the back or hip
• Deep bone pain, most notably in the area nearest the prostate gland
• Bone fracture
• Spinal cord compression, where prostate cancer has spread to the spine
• Weakness in the legs
• Loss of feeling, numbness or tingling in the groin area or legs
Other symptoms that may occur are weight loss, particularly in men over 70, or difficulty getting an erection where none has existed before.
Reference:Kiciński M, Vangronsveld J, Nawrot TS: An epidemiological reappraisal of the familial aggregation of prostate cancer: a meta-analysis. PLoS One 6 (10): e27130, 2011. [PUBMED Abstract]