There are no early warning signs or symptoms of prostate cancer. It usually grows very slowly, and due to its location, many men do not have any physical symptoms. However, if the prostate grows large enough, you may experience some symptoms.
Still, there are some symptoms, while not specific to prostate cancer, that should be reported to your physician for further study. These include urinary frequency and urgency, or obstructive urinary symptoms such as slowing of the urinary stream or difficulty emptying the bladder.
That's why many cases of prostate cancer aren't detected until it has spread beyond the prostate.
When signs and symptoms do occur, they may include the following:
- Dull pain in your lower pelvic area
- Urgency of urination
- Difficulty starting urination
- Pain during urination
- Weak urine flow and dribbling
- Intermittent urine flow
- A sensation that your bladder doesn't empty
- Frequent urination at night
- Blood in your urine
- Painful ejaculation
- General pain in your lower back, hips or upper thighs
- Loss of appetite and weight
- Persistent bone pain
In fact, men who have a family history of prostate cancer are at least three times more likely to develop prostate cancer in their lifetime. If they have two or more relatives with prostate cancer, such as a brother, uncle or father, they are five times more likely to develop the disease, and if they have three or more relatives afflicted by prostate cancer, they are 11 times more likely to develop it themselves.
Diagnosed
Prostate cancer is diagnosed from the results of a biopsy of the prostate gland. If the digital rectal exam of the prostate or the PSA blood test is abnormal, a prostate cancer is suspected. A biopsy of the prostate is usually then recommended. The biopsy is done from the rectum (trans-rectally) and is guided by ultrasound images of the area. A small piece of prostate tissue is withdrawn through a cutting needle. The TRUS-guided Tru-Cut biopsy is currently the standard method to diagnose prostate cancer. Classically a 6-core set is taken by sampling the base, apex and mid gland on each side of the gland. More cores may be sampled to increase the yield, especially in larger glands. A pathologist then examines the tissue under a microscope for signs of cancer in the cells of the tissue.
When prostate cancer is diagnosed on the biopsy tissue, the pathologist will then grade each of two pieces of the tissue from 1 to 5 on the Gleason scale. The scale is based on certain microscopic characteristics of the cancerous cells and reflects the aggressiveness of the tumor. The two scores are then added together. Sums of 2 to 4 are considered low, indicating a slowly growing tumor. Sums of 5 and 6 are intermediate, representing an intermediate degree of aggressiveness. Sums of 7 to 10 are considered high, signaling a rapidly growing tumor with the worst prognosis (outcome). Gleason scores can be helpful in guiding treatment that is based, at least in part, on the aggressiveness of the tumor.
