The Signs and Symptoms of Prostate Cancer

In it's early stages, prostate cancer may not cause and warning signs or symptoms. As it advances unchecked (this is what early screening is so important) prostate cancer may cause such signs and symptoms such as:

  • Trouble urinating, including painful urination
  • Less powerful urine stream
  • Blood in the urine, or
  • Blood in the semen
  • Swelling to the legs
  • Discomfort or pain in the pelvis
  • Bone pain
  • Lower back pain
  • Erectile dysfunction or impotence

Symptoms of Enlarged Prostate: BPH

Benign prostatic hyperplasia (BPH) is an enlarged prostate gland. Symtoms include trouble with urination, a weak urine stream, and not feeling empty after urination. Treatments usually include lifestyle changes, medicine (drugs), and sometimes, surgery.

An enlarged prostate is not a sign of prostate cancer, but is sometimes confused with it. Many men will exhibit little or no symptoms, and the severity of the enlargement of the prostate will not always be related to the severity of the symptoms.

Symptoms of enlarged prostate are:

  • Weak urine stream
  • Trouble with urination
  • Not feeling empty after urination

Is immediate treatment always necessary?

It depends on the case, but men diagnosed with a very early stage of prostate cancer may not have to have treatment right away, some may never need treatment. Instead, we might recommend what is called watchful waiting' where instead of painful and invasive surgery or radiation treatments, our doctors will closely monitor your situation with regular blood tests, rectal exams and possibly biopsies.

If your cancer is progressing treatment such as surgery or radiation might be recommended. Watchful waiting is used for cancer without symptoms, or is expected to grow very slowly and confined to a small area of the prostate. This might also be used for men with another health risk, unrelated to the cancer.

Radiation therapy

Radiation therapy uses focused and high-powered energy (like X-rays) to kill cancer cells. Radiation for prostate cancer is usually delivered in two ways:

  • Outside the body (external beam radiation). When using external beam radiation, you will lie on a table while the machine using the radiation will move around your body, directing its beams at your prostate cancer. This therapy will typically last for five weeks, five days a week.
  • Radiation inside the body (brachytherapy). Brachytherapy involves putting several rice-sized radioactive seeds into your prostate. These deliver a low dose of radiation over a long period of time. The implanted seeds will eventually stop giving off radiation and won't need to be removed.

Side effects can include:

  • Painful urination
  • Loose stools
  • Erectile dysfunction

Hormone therapy

Hormone therapy prevents your body from producing the male hormone testosterone. Testosterone is known to fuel the growth of prostate cancer cells, so by cutting off the supply the hope is the cancer cells, starved by fuel, will die or at least grow more slowly. Hormone therapy is used to shrink the cancer in men with advanced prostate cancer and to slow the growth of tumors.

Hormone therapy includes:

  • Medications stopping testosterone producing. Medications known as luteinizing hormone-releasing hormone (LH-RH) agonists will prevent the testicles receiving messages to produce testosterone. These drugs include triptorelin (Trelstar), histrelin (Vantas), leuprolide (Lupron, Eligard,), goserelin (Zoladex) and degarelix (Firmagon).
  • Medications that block testosterone from reaching cancer cells. Medications known as anti-androgens prevent testosterone from reaching your cancer cells. Examples include bicalutamide (Casodex), flutamide, and nilutamide (Nilandron). These drugs typically are given along with an LH-RH agonist or given before taking an LH-RH agonist.
  • Surgery to remove the testicles (orchiectomy). Removing the testicles reduces testosterone levels in your body. This is something of a last resort operation, but it has been know to reduce hormone levels faster than medication.

Surgery to remove the prostate

Surgery involves removing the prostate gland (radical prostatectomy), a certain amount of surrounding tissue and a few lymph nodes. The procedure can include:

  • Incision in your abdomen. During retropubic surgery, the prostate gland is taken out through the lower abdomen. Retropubic prostate surgery might carry a smaller risk of nerve damage than other surgeries.
  • Incision between anus and scrotum. Perineal surgery. This involves an incision between the anus and scrotum to access the prostate. This approach to may allow for quicker recovery times, but makes removing the nearby lymph nodes, avoiding nerve damage, that much more difficult.
  • Robot to assisted surgery. Not just for science fiction, at least not anymore. During robotic laparoscopic surgery, the instruments are attached to a robot. The surgeon will use hand controls to guide the robot to move the instruments.
  • Laparoscopic prostatectomy. During this surgery, several small incisions are made into the abdomen. Laparoscopic surgery may offer a shorter hospital stay and quicker recovery than traditional surgery. The doctor inserts the surgical tools through this incision, including a small camera that will guide them in the operation.

Each of these procedures has their pros, cons and side effects. Consult with your doctors about which one would be best for your cancer treatment.

Chemotherapy

Chemotherapy uses drugs to kill the rapidly growing cells, including cancer cells. Chemotherapy has long been an accepted treatment, known as safe if administered correctly. Chemotherapy may be an option for men whose prostate cancer that has metastasized to other areas of the body. Chemotherapy might also be used for cancers that don't respond to normal hormone therapy.

Chemotherapy does have side effects and must be monitored by medical professionals.