Signs of prostrate cancer
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Summary
7 papers analyzed
These studies suggest that signs of prostate cancer include urinary symptoms, bladder neck obstruction, hematuria, back and hip pain, and elevated PSA values, with early detection being crucial for reducing cancer-related deaths.
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Signs of Prostate Cancer
Urinary Symptoms: Frequency, Urgency, and Hesitancy
One of the most common signs of prostate cancer is urinary tract obstruction, which can lead to symptoms such as urgency, nocturia (frequent urination at night), frequency, and hesitancy. These symptoms are often due to the enlarged prostate gland obstructing the bladder neck. However, these symptoms can also be caused by benign prostatic hyperplasia (BPH), making it challenging to differentiate between benign and malignant conditions based solely on these signs .
Erectile Dysfunction and Impotence
New onset of impotence or less firm penile erections can also be a sign of prostate cancer. This symptom is often overlooked or mistakenly attributed to normal aging. It may indicate that the cancer is involving periprostatic tissue, which is crucial for erectile function.
Hematuria and Haemospermia
Patients with prostate cancer may also present with hematuria (blood in the urine) or haemospermia (blood in the semen). Hematuria typically appears at the beginning of an otherwise clear urinary stream, suggesting a cause localized to the lower urinary tract. These symptoms warrant further investigation to rule out prostate cancer.
Back and Hip Pain: Indicators of Metastasis
In cases where prostate cancer has metastasized, back and hip pain are common symptoms. These pains are usually related to bone involvement and can be the first signs of distant metastases. In some instances, patients may also experience hydronephrosis (swelling of a kidney due to urine buildup) secondary to ureteral obstruction by local extension of the cancer or involvement of lymph nodes.
Acute Urinary Retention and Other Severe Symptoms
Although rare, acute urinary retention caused by bladder-neck obstruction, bilateral hydronephrosis due to periaortic lymph-node enlargement, or spinal cord compression from epidural extension of prostate cancer can be initial presenting features. These severe symptoms should prompt immediate medical evaluation.
Digital Rectal Examination (DRE) Findings
A digital rectal examination (DRE) can often detect early lesions in prostate cancer. The normal smooth surface of the prostate may be replaced by a hard nodule, or the gland itself may feel enlarged, hard, and "craggy" to the touch. The normal midline sulcus may also be lost.
Elevated Prostate-Specific Antigen (PSA) Levels
Prostate-specific antigen (PSA) is a protease produced by prostatic epithelium and is widely used as a serum tumor marker in the management of prostate cancer. Elevated PSA levels can indicate the presence of prostate cancer, although they can also be elevated in benign conditions like BPH and prostatitis . A PSA level greater than 4.0 ng/mL is generally considered abnormal and warrants further investigation.
Conclusion
Prostate cancer presents with a variety of signs and symptoms, many of which overlap with benign conditions like BPH. Common symptoms include urinary frequency, urgency, hesitancy, erectile dysfunction, hematuria, and back or hip pain. Digital rectal examinations and elevated PSA levels are crucial for early detection. Understanding these signs can lead to timely diagnosis and better management of prostate cancer.
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