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Prostate cancer: symptoms, signs and screenings

Written by 
Jennifer Co

Article at a glance

  • Prostate cancer is the second leading cancer among American men. To learn more about prostate cancer, read this section.

  • Some warning signs of prostate cancer include a variety of sometimes very subtle symptoms. To learn more about early signs of prostate cancer, read this section.

  • Most cases of prostate cancer have no symptoms, so early detection is dependent on testing. To learn more about how screening is done for prostate cancer, read this section.

  • Although there are benefits to detecting prostate cancer early, there can also be some problems. To learn more about the benefits and possible drawbacks of prostate cancer screening, read this section.

Cancer has become a word feared by many people, perhaps because of its association with being untreatable and often fatal. Many people view cancer as something that can’t be cured or controlled. But this is far from the truth. There are many different types of cancer, most of which can be treated. New treatments for cancer, including prostate cancer, are being developed every day. Most men who have prostate cancer show no symptoms at first, so early screening plays an important role in its detection, especially for those who are at increased risk of developing it. Even after a diagnosis of prostate cancer, most men survive for 5 years or longer.

What is prostate cancer?

Prostate cancer is the second most common cancer in American men, after skin cancer. Additionally, it’s the second most common cause of cancer deaths in men, following only lung cancer. Cancer is a disease that disrupts the orderly manner in which cells in our bodies normally grow, multiply and die. Cancer causes damaged or abnormal cells in the body to grow and multiply uncontrollably instead of dying when they should. One cancer cell can form into a cluster of cells called a tumor, which can spread into surrounding areas. Sometimes cancer cells travel to other parts of the body and form new tumors.

The prostate gland is a small organ found only in men. It’s located deep in the groin, right below the bladder. The prostate gland plays a necessary role in semen production and is important for sperm motility and survival. Prostate cancer starts with the cells in the prostate gland that grow out of control. The majority of cases begin in the peripheral zone of the prostate, which is in the back part of the prostate, in front of the rectum.

Prostate cancer is one of the most common types of cancer. It’s estimated that around 12.5% of men (1 out of 8) will have prostate cancer during their lifetime. Men over the age of 65 and non-Hispanic African-American men are at an increased risk of prostate cancer. Those who have a family history of prostate cancer are also more likely to develop it, especially those who have first-degree relatives diagnosed with prostate cancer or other family members, including females, diagnosed with breast, ovarian, or pancreatic cancer. Most cases of prostate cancer progress slowly, and are treatable, with an overall 5‑year survival rate of 97%.

Warning signs of prostate cancer

Prostate cancer symptoms may vary, and some men might not have any symptoms at all. Since most prostate cancers grow slowly, it’s possible that symptoms may not appear until the disease is in an advanced stage. Although the symptoms of prostate cancer are usually not specific, some warning signs to look out for include:

  • Painful or burning sensation during urination or ejaculation

  • Urinating more frequently, especially at night

  • Difficulty initiating or stopping urination

  • Sudden erectile dysfunction

  • Blood in the urine or semen

  • Slow, weak or interrupted flow of urine

  • Difficulty in completely emptying the bladder

  • Pain in the lower back, hips, upper thighs or pelvis that doesn’t go away

  • Weakness or numbness in the legs or feet

  • Loss of bladder or bowel control

  • Loss of appetite or weight

  • Bone pain

If you have any of these warning signs, be sure to consult with your doctor as soon as you can. Even if these symptoms are not caused by prostate cancer, they still need medical attention so a diagnosis can be made and treatment can be started right away. It’s important to note that all of these symptoms are not specific and can also be caused by a number of other conditions.

How do you screen for prostate cancer?

Screening is another word for testing that is done by a doctor. Cancer screening means testing for the presence of cancer in your body before it starts causing symptoms. The goal of cancer screening is to catch cancer early, treat it, and prevent it from spreading. The timing of prostate cancer screening is based on an individual’s risk factors. For those who have no symptoms and no family history of prostate cancer, screening can start at age 45. But if you do have a family history, or if you’re African-American, screening is usually done earlier, at age 40. Although there’s no standardized way yet to screen for prostate cancer, there are 2 methods that are often used: a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE).

Prostate-specific antigen (PSA) blood test

Prostate-specific antigen, called PSA, is a protein produced exclusively by the prostate. A normal, healthy prostate produces very little PSA, while a rapid rise in PSA levels indicate that something is not normal. Although prostate cancer is the most serious cause of an elevated PSA level, high levels may also be caused by other, noncancerous conditions such as benign enlargement of the prostate (benign prostatic hyperplasia, abbreviated as BPH) or inflammation of the prostate (called prostatitis). PSA levels can also be affected by a man’s age, race, certain medical procedures, and certain medications. Your doctor interprets the test results, taking into account all these different factors. If cancer is suspected, the doctor may recommend a biopsy to confirm prostate cancer.

Digital rectal examination (DRE)

A digital rectal examination (DRE), is a physical examination done by a doctor. A gloved, lubricated finger is inserted in the rectum while the patient is bent over or curled on his side on the examination table. The doctor will sweep a finger around the patient’s rectum, checking for any irregularities in the shape or thickness of the prostate. This procedure only looks for abnormal growth but it cannot confirm the presence of cancer.

Additional testing

If the result of either of these tests is abnormal, further testing is usually done to confirm the diagnosis. A prostate biopsy is a procedure in which small samples of prostate gland tissue are removed, processed, and observed under a microscope. A diagnosis of prostate cancer is confirmed only if cancer cells are found in any of the samples. During the procedure, the patient lies on his side while a probe is inserted into the rectum. A picture of the prostate is taken, followed by the administration of anesthesia to numb the prostate gland. A needle is then passed through the probe to take samples of the patient’s prostate. The amount of samples removed depends on the results of the PSA and DRE.

Benefits of screening for prostate cancer

Prostate cancer screening is recommended for men between the ages of 55 to 69 who:

  • Are at average or increased risk of prostate cancer

  • Do not have symptoms of prostate cancer

  • Have never been diagnosed with prostate cancer

Other factors that warrant prostate cancer screening include having a family history of prostate cancer and being of African-American descent.

The benefit of screening is finding prostate cancer that is just beginning. Treatment can then be initiated before the cancer spreads, which can lower the chance serious complications and death. Possible issues that may arise after screening include false positive results, as well as side effects related to all biopsies, which include pain, bleeding, or infection following the procedure. It’s a good idea to talk to your doctor before getting screened for prostate cancer.

Although prostate cancer is one of the leading causes of cancer among American men, the likely outcome is usually good, especially when it’s detected during its early stages. Talk to your doctor to discuss a screening plan, particularly if you are at an increased risk of developing prostate cancer.

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