Early Symptoms of Prostate Cancer

According to the World Journal of Oncology, the second-most commonly diagnosed cancer in men after Lung Cancer is — Prostate Cancer. This is a worldwide statistic. Prostate Cancer is caused by an abnormal growth of cells in the Prostate Glands. The Prostate also secretes Prostate Specific Antigen (PSA) which helps aid urine control.

There are two types of conditions: in the benign state a person may be asymptomatic or in their early stages of progression. As such, the course of action may only require surveillance or monitoring through frequent medical tests and managing the condition. In the malignant state, the cancer cells may either grow slowly and be confined to the prostate gland or rapidly spread to other parts of the body. Here, early detection of prostate cancer may be key to diagnosing and treating the condition. Depending on the medical intervention, it can increase the survival rate of a Prostate Cancer patient.

What is the prostate?

The prostate is located below the bladder in front of the rectum. Just behind the prostate gland, are seminal vesicles that are responsible for making fluid for the semen. A tube that goes through the center of the prostate, carrying urine and semen out of the body through the penis is called the urethra. The prostate gland is regulated by testosterones. Prostate glands provide fluid that nourish and transport sperms. In younger males, the size of the prostate is the size of a walnut but with age it can change to a much bigger size.

Early symptoms and warning signs

In the benign stage the Prostate Gland may get larger and is known as Benign Prostatic Hyperplasia (BPH) which is rarely a threat and may not invade nearby lymph nodes, tissues or organs. Sometimes cancer cells can move out of the primary (original) tumor and attack surrounding tissues to form a new tumor which is same as the primary tumor composition.

The most common type of Prostate Cancer is that of Adenocarcinoma. There are other types which include Sarcoma, Neuroendocrine Tumors and other rarer Carcinomas. By identifying signs & symptoms of Prostate Cancer and early detection/screening there can be an effective increase in the survival rate of Prostate Cancer patients. Early onset may be asymptomatic but advanced cases can throw up symptoms like:

  • Problems while urinating, weak stream (also known as dribbling) or even frequent urination in the night
  • Passing blood in the urine or semen
  • Having an erectile dysfunction
  • Severe pain in the back, spreading to the hips, chest or ribs and even bones (in serious cases it can cause a
    fracture to the bones)
  • Complete weakness or numbness in legs/feet to even swelling in severe cases (edema)
  • Loss of bladder/bowel movement
  • Abnormal weight loss or fatigue

Sometimes one can face a few issues from BPH or Prostatitis which is defined as an inflamed Prostate Gland and may not be cancerous. Prostatitis may sometimes be caused by an injury or through different kinds of bacterial infection or even through sexually transmitted infections. The best thing to do when faced with such a situation is to get in touch with your care provider at the earliest to rule out any possibilities. In such cases, managing the symptoms or getting treated early can iron out any escalation or discomfort. Routine check-ups and screening enable doctors to detect and control the spread of malignant cancers.

Click here for to know what you can do to reduce the risk of prostate cancer

Advancement of Prostate Cancer

If Prostate Cancer is not detected in a timely manner, it may result in several complications. These include Metastasis where the cancer grows slowly or rapidly outside the Prostate Gland and spreads to the nearby organs, bones or tissues through the bloodstream or urinary tract. Other complications include Urinary Incontinence which results in bladder control. Erectile Dysfunction can both be a symptom as well as a permanent result of being diagnosed with Prostate Cancer at a later stage. In some cases, it may result in the removal of the Prostate Gland or bladder, if the cancer spreads to the urinary tract. The treatment may then require a combination of medication, surgery and support of catheters to discharge urine. If you are between the ages of 30-40 years and are experiencing any symptoms or early warning signs, it is advisable to see a doctor or medical practitioner immediately. Bloody discharge, unbearable pain in the pelvic area may warrant an immediate screening without delay.

Stages of Prostate Cancer

When a person is diagnosed with Prostate Cancer, a doctor uses the process of staging to determine its spread. This process is called Staging. To determine as to how much a cancer has spread, an internationally credited system called the TNM system is widely accepted.

  • Through a physical exam or a Digital Rectal Exam (DRE), prostate biopsy or other tests the extent of Primary Tumor can be determined (Also known as T Category
  • Its spread to the nearby lymph nodes (Also known as N Category)
  • If it has Metastasized to other parts of the body (Also known as M category)
  • PSA levels at the time of diagnosis. The higher levels, higher the risk
  • Grade Group or Gleason Score to determine how likely is the growth of the cancer cells and their rate of spread

Grade Group is assigned on Prostate Biopsy where a Prostate Tissue is extracted and examined under the microscope to the semblance of a normal prostate tissue. A grade is then given basis the growth rate of the abnormal cells. A Gleason score on the other hand ranges from 1 to 5. It assigns a lower score to a tissue that looks healthy or a higher score if tissue is abnormal. Both tests may be used to increase the accuracy in the detection basis growth and likelihood of spread of the cancer cells. The higher the numbers in the TNM system, the more advanced the Cancer would be regarded as.

Prostate Cancer is divided into 4 stages and the spread may be through tissue, lymph nodes or blood.

Stage 1

The least advanced stage where the Cancer spread is still low and is confined to the Prostate Gland with lower PSA and lower Grade Group and/or Gleason Score

Stage 2

This stage is more localized and maybe confined to the Prostate. It may not have spread to the lymph nodes or other parts. An examining doctor will be able to feel the presence of a lump and the examination may be conclusive through an ultra-sound guidance. The survival rate of a Prostate Cancer patient is 100% at this stage. This stage can be further divided into 3 more phases depending on the Grade Group and/or Gleason Score

Stage 3

This stage is more regional and may or may not have spread outwards to the other tissues. At this stage if the spread of the cancerous cells is not much then the survival rate of a Prostate Cancer patient may be close to 100% still. Again, depending on the Grade Group and/or Gleason Score this stage may be divided into 3 phases.

Stage 4

Different Stages & Signs of Prostate CancerThis stage may be classified as a distant stage and it is the most advanced stage. It is divided into 2 phases. The spread of the Cancer cells may be to the distant parts of the body such as rectum, bladder, pelvis, bones etc. There are many treatment methods available – both invasive and non-invasive. Post diagnosis, the course of action will depend on the Staging, Rate of Spread, Rate of growth, side effects and recovery goals.

Given here are the various stages alongside their Grade Groups and Gleason Scores.

To read these scores and interpretation, please consult your Doctor in case you have undergone screening. These values are generally indicative as per common values and there may be more reasons for your symptoms. Please make sure that you undergo thorough check-up and diagnosis through qualified professionals before analyzing any medical reports or conditions.

Is self-check advisable?

There are several home PSA test options available in the market. This requires taking a blood sample to determine the PSA levels in the blood. The higher the score – higher will be the risk. However, this test alone cannot be conclusive and to get a PSA kit a person may need to meet certain risk criteria. It is not advisable to self-examine as only a skilled medical practitioner would be able to assess or give an accurate diagnosis. Self-examination may also lead to the risk of injury. However, if you are undergoing any symptoms in any measure you may consult your doctor for a screening. If there are persisting signs & symptoms of Prostate Cancer, call your physician immediately for a diagnosis

Types of early screening

Screening decisions can be based on a number of factors. In fact, discussing these with your doctor first will highly benefit you in choosing a suitable course of action. These can be individual risk factors, person’s complete health picture and wellness goals as well as deciding the treatment plan if diagnosed with Prostate Cancer. There are two main methods of early stages screening. These are:

  1. Digital Rectal Exam (DRE) – A doctor uses a glove that is lubricated by inserting a finger into the rectum to feel the Prostate Gland. It may be accompanied by an Ultrasound.
  2. A blood test measuring PSA levels. There are many types of PSA tests such as 4K Score Tests, Prostate Health Index (PHI) or Percent-free PSA. These may be a little more advanced whereby if the results are abnormal, then your doctor may refer different types of them.

Some younger, healthier men may benefit from early screening leading to early detection and treatment. Low-risk Prostate cancer may be followed up with active Surveillance or managed better rather than opting for more aggressive treatment methodologies.

Click here for to know other causes of higher PSA readings apart from prostate cancer

Early detection, diagnosis and treatment

It is better to opt for Screening before symptoms. Older men over the age of 50 years should regularly have Prostate examination during their regular health check-ups. If the Prostate check-up procedure shows abnormality, then Prostate Biopsy is recommended. During this, a small part of the tissue is removed and analyzed with an Ultrasound that guides the biopsy. However, you can wait to do the early screening tests again or there may be a specific problem to be referred to a Urologist. With early detection it can help stop or even slow down the spread of cancerous cells. There is a chance that the survival rate of Prostate Cancer patients can be far better and higher.

There are many kinds of treatment available which are based on the stages and grades, types of risks, age, health status, preferences as well as effects of treatment goals. The first type is Surveillance which works for the early stages followed by Localized Therapy which works at an intervention level and a Systematic Therapy that can battle the condition in the long run.

Surveillance

    • Actively monitoring and keeping a track of the spread through PSA level testing, DREs and periodic biopsies. If the cancer is not stopped or controlled in its tracks, then radiation or surgery may be needed. However, for smaller or slower growing cancers with no symptoms, this method is apt
    • Another method is monitoring without treating by just waiting as a patient may be asymptomatic or unable to undergo treatment because of other medical complications

    Localized Therapy

        • Surgery is the most widely accepted form of treatment where the cancer spreads beyond the Prostate Gland. Through Robotic Assisted Laparoscopic Radical Prostatectomy (RALRP); hereby the Prostate is removed, and reconstruction of the urinary tract and bladder is enabled. It also helps lower the PSA values.
        • Radiation therapy may be employed to remove excessive or rapidly growing cancer cells, if surgery has not been a complete success. There may also be a resurgence of the cancer cells and thereby Radiation Therapy may be the primary treatment which may prove to be less invasive and better in the early stages.
        There are other treatment methods such as Cryotherapy or Focal Therapy and further research into these treatment methods can be considered basis the effects and treatment goals. Some of the methods may have side-effects and may require further consideration.

        Systemic Therapy

              • Certain drugs can be used to either block or lower testosterone – the main hormone stimulating the Prostate. Such male hormones can fuel cancer cells. This method is also called Androgen Deprivation Therapy or ADT.
              • Chemotherapy is a common method used for cancer treatment. By introducing drugs into the blood stream these drugs counter and attack any rapidly growing cells. However, the only downside maybe that these drugs may not be able to tell the difference between cancerous and non-cancerous cells. By carefully controlling the doses and frequency, side-effects can be brought down to a great extent

              There is also Immunotherapy under the systemic method and if a patient is experiencing any symptoms or early warning signs, they must contact their doctor at the earliest.

              Preventive measures

                    The increase in cases of Prostate Cancer seem to increase with age, especially in men over 65 years. Certain ethnicities are also more at risk in studies carried out worldwide; it was found that African men may be more susceptible. This could be largely due to social, economic and biological factors. There may be many more factors that cause Prostate Cancer such as family history of cancers including Prostate or Breast Cancer or genetic factors.

                    Doctors do not know the exact cause of Prostate Cancer and some recent studies have even suggested that hormone therapy can lower the risk up to 25%. However, the side effects of these drugs may prove to be higher for those in more advanced Cancer stages. 

                    There may be certain reactions to environment related carcinogens or common lifestyle habits of predecessors. The underlying fact could be in shared genetic disorder or similar patterns of exposure. Certain food or dietary factors may also be triggers for Prostate Cancer. Reducing saturated fats or excessive fatty foods, red meat, dairy products and increasing consumption of vegetables, dietary soy, green tea, tomatoes etc. can boost Prostate health. Other steps like quitting smoking, exercising regularly, taking appropriate diet supplements as well as monitoring symptoms could help prevent this condition. Regular screening tests along with annual health check is highly advisable.

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