Prostate Cancer Slideshow Pictures Medical Illustrations of the Prostate Image Collection Screening Tests Every Man Needs Slideshow Pictures

Medical Author:

Kevin C. Zorn, MD, FRCSC, FACS

Coauthor:

Gagan Gautam, MD, MCh (Urology)

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Prostate Cancer Symptoms

Most men with prostate cancer have no symptoms. This is particularly true of early prostate cancer.

• Currently, most prostate cancers are discovered when a prostate biopsy is performed after a raised serum prostate specific antigen (S. PSA) blood test is noted. This test is frequently performed as a part of a health screening program.



• Sometimes, prostate cancers are discovered incidentally when a digital rectal exam is performed.



• A digital rectal exam is part of a thorough regular health examination. Digital refers to finger.



• During the digital rectal exam, the examiner inserts a gloved and lubricated finger in the rectum to feel the prostate for abnormalities. If there are some hard or irregular areas in the prostate, the physician may request for a prostate biopsy to confirm or rule out the presence of prostate cancer. (Details regarding S. PSA and prostate biopsy are available in subsequent sections.)

Symptoms usually appear when the tumor causes some degree of urinary blockage at the bladder neck or the urethra.

• The usual symptoms include difficulty in starting and stopping the urinary stream, increase in frequency of urination, and pain while urinating.



• The urinary stream may be diminished (urinary retention), or it may simply dribble out.



• Even after urination, there is a sense of bladder fullness because the bladder has not been fully emptied.

Less common symptoms are blood in the urine (hematuria), painful ejaculation, or impotence (inability to have an erection).

• These three symptoms are uncommon in early stages of the disease. They usually occur when the cancer is advanced.



• As the cancer advances to cause a greater blockage, bladder function may deteriorate further.



• Men with such advanced cancers sometimes experience recurring urinary tract infections.

These symptoms, by themselves, do not confirm the presence of prostate cancer in any single individual. Indeed, most, if not all, of these can occur in men with non-cancerous (benign) enlargement of the prostate, which is the more common form of prostate enlargement as compared to cancer. However, the occurrence of these symptoms should prompt an evaluation by the physician to rule out cancer and provide appropriate treatment.

Despite these symptoms, many men do not seek medical care until the cancer has spread. Symptoms of metastatic disease include fatigue, malaise, and weight loss. Spread to the bones causes deep bone pain, especially in the hips and back, and bone fractures from weakening of the bone.