Prostate Cancer (cont.)
What are Symptoms of Prostate Cancer?
Most men with prostate cancer have no symptoms. This is particularly true of early prostate cancer. 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. These symptoms are commonly referred to as “irritative” or “storage” urinary symptoms.
- The urinary stream may be diminished (urinary retention), or it may simply dribble out and a feeling of bladder fullness after urination can appear as well. These symptoms are commonly referred to as “voiding” or “obstructive” urinary symptoms.
- It is noteworthy that these symptoms, by themselves, do not confirm or necessarily reflect the presence of prostate cancer in any single individual. Indeed, most, if not all of these can occur in men with noncancerous (benign) enlargement of the prostate (BPH), which is the more common form of prostate enlargement. However, the occurrence of these symptoms should prompt an evaluation by a physician to rule out cancer and provide appropriate treatment.
If the cancer causes a chronic (long-term) or more advanced obstruction, the bladder may be affected and be more prone to recurring urinary tract infections(UTI).
Rare symptoms that may manifest occasionally when the cancer is advanced may include blood in the urine (hematuria), painful ejaculation, and impotence (inability to have an erection).
If the cancer has spread to remote organs (metastasis) symptoms may include fatigue, malaise, and weight loss. Metastasis to the bones can cause deep bone pain, particularly in the hips and back or even bone fractures from weakening of the bone.
When Should I Call the Doctor about Prostate Cancer?
One should consult a health care professional if any of the following symptoms are present:
- Difficulty initiating and/or stopping a urine stream
- Frequent urination
- Pain on urination
- Pain on ejaculation
- Decreasing speed of urine flow or a urine stream that stops and starts
- A sensation of incomplete emptying of the bladder even after passing urine
- Erectile dysfunction
- Bone pain and/or fractures
One should go to the nearest hospital emergency department without delay if any of the following symptoms occur:
- Urinary tract infection (UTI): Burning pain on urination, urgency, or frequent urination, especially with fever.
- Bladder obstruction: Not urinating or urinating very little despite drinking enough fluid; producing little urine despite straining; pain due to a full bladder.
- Acute kidney failure: Not urinating or urinating little, with little discomfort, despite drinking enough fluid.
- Deep bone pain, especially in the back, hips, or thighs, or bone fracture: Possible sign of advanced prostate cancer that has spread to the bone.
- Spinal cord compression: This occurs when the cancer has spread to vertebrae of the spine and tailbone region. The weakened vertebrae can collapse on the spinal cord. Typical symptoms that might signal acute spinal cord compression include weakness in the legs and difficulty walking, increased difficulty urinating, difficulty controlling the bladder or bowels, and decreased sensation, numbness, or tingling in the groin or legs. These are often preceded by a persistent new central pain in the back lasting a few days or weeks. This condition is a true emergency and requires immediate evaluation in the nearest hospital emergency department. Failure to be treated immediately can result in permanent spinal cord damage with paralysis.
Last Reviewed 11/21/2017
Pierre-Alain Hueber, MD, PhD
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