Symptoms of Prostate Cancer: Diagnosis, Stages, Risk Factors and Treatment

It is a cancer that occurs in a man’s prostate, the walnut-sized gland in the male reproductive system.

It is located under the bladder, in front of the rectum and surrounds the upper part of the urethra, the tube that empties the urine from the bladder. The prostate helps regulate the control of the bladder and produces the seminal fluid that nourishes and transports the sperm.

Prostate cancer is one of the most common cancers in men.

Symptoms of prostate cancer

In most cases, the symptoms of prostate cancer are not evident in the early stages of the disease. The symptoms of prostate cancer may be different for each man and any of these symptoms may be caused by other conditions.

As a result, routine evaluations in the form of digital rectal exams (DREs) and prostate-specific androgen (PSA) tests are important.

The American Cancer Society recommends that men make an informed decision with their doctor about whether they should get tested for prostate cancer, beginning at the age of 50.

Men with one or more risk factors for prostate cancer should check with their doctor about whether routine screening should be started sooner.

Urinary symptoms of prostate cancer:

Due to the proximity of the prostate in relation to the bladder and urethra, prostate cancer may be accompanied by a variety of urinary symptoms.

Depending on the size and location, a tumor can press and contract the urethra, which inhibits the flow of urine. Some signs of prostate cancer related to urination include:

  • Burning or pain when urinating.
  • Difficulty urinating, or trouble starting and stopping when urinating.
  • More frequent need to urinate at night.
  • Loss of bladder control.
  • Decrease in the flow or speed of the urine stream.
  • Blood in the urine (hematuria).

Other signs and symptoms of prostate cancer:

Prostate cancer can spread (metastasize) to nearby tissues or bones. If the cancer spreads to the spine, it can press on the spinal nerves. Other symptoms of prostate cancer include:

  • Blood in the semen.
  • Difficulty getting an erection (erectile dysfunction).
  • Painful ejaculation
  • Swelling in the legs or pelvic area.
  • Numbness or pain in the hips, legs or feet.
  • Pain in the bones that does not go away or that leads to fractures.

Diagnosis

The prostate is an organ the size of a walnut that surrounds the urethra; produces a liquid that becomes part of the semen. More than 99% of prostate cancers develop in the cells of the gland. This type of prostate cancer is called adenocarcinoma .

There are several strategies to treat prostate adenocarcinoma. You can use more than one of these treatment options, depending on your individual case and your goals.

  • Active surveillance.
  • Surgery.
  • Chemotherapy.
  • Radiation therapy
  • Immunotherapy
  • Hormonal therapy.

More rarely, prostate cancer originates in other tissues of the prostate, which is called sarcoma.

Phases

Some cancers may be more aggressive than others, early diagnosis plays an important role in decisions about their treatment.

Your doctor will assign a Gleason score to the disease based on its microscopic appearance. Cancer with a higher Gleason score is more aggressive.

  • Grade 1: The cancerous prostate looks a lot like normal prostate tissues. The glands are small, well formed and very compact.
  • Grade 2: the tissue still has well-formed glands, but they are larger and have more tissue between them.
  • Grade 3: the tissue still has recognizable glands, but the cells are darker. At high magnification, some of the cells left the glands and begin to invade the surrounding tissue.
  • Grade 4: the tissue has few recognizable glands. Many cells are invading the surrounding tissue.
  • Grade 5: the tissue does not have recognizable glands. Often there are only sheets of cells throughout the surrounding tissue.

Risk factor’s

Screening for prostate cancer allows cancer to be detected early, before symptoms are present. Knowing the risk factors can help you determine an appropriate prostate cancer screening schedule with your doctor.

General factors:

  • Race: Studies show that African-American men are about 70 percent more likely to develop prostate cancer in their lives than Caucasian or Hispanic men.
  • Age:  The risk of developing prostate cancer increases with age. While only one out of every 10,000 men under the age of 40 will be diagnosed with prostate cancer, one out of every 15 men between the ages of 60 and 60 will be diagnosed with the disease.
  • Diet: a diet high in saturated fats, as well as obesity, increases the risk of prostate cancer.
  • High levels of testosterone: men who use testosterone therapy are more likely to develop prostate cancer, since an increase in testosterone stimulates the growth of the prostate gland.

Genetic factors:

Family history: Men with an immediate blood relative, such as a parent or sibling, who have or had prostate cancer are twice as likely to develop the disease.

If there is another family member diagnosed with the disease, the chances of developing prostate cancer increase.

Treatment

Depending on each case, treatment options for men with prostate cancer may include:

  • Active surveillance.
  • Surgery.
  • Radiation therapy
  • Cryotherapy (cryosurgery).
  • Hormonal therapy.
  • Chemotherapy.
  • Treatment directed to the bones.

These treatments are usually used one at a time, although in some cases they can be combined.