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Prostate cancer: symptoms and treatment

Updated in October 2019

What is:

Prostate cancer is a very common type of cancer in men, especially after the age of 50. In general, this cancer grows very slowly and most often does not produce symptoms in the early stages, but it can be manifested by signs such as changes in urine, pain while urinating or difficulty maintaining an erection, which is common to other problems such as benign prostatic hyperplasia.

Treatment is usually done with surgery, radiotherapy or chemotherapy, depending on the stage of the disease, which when discovered at an early stage, is more likely to cure.

Although prostate cancer is one of the leading causes of death in men, in the US it is decided that the choice to undergo periodic prostate-specific antigen (PSA)–based screening in men aged 55 to 69, is up to them, because of the potential benefits and harms. In the UK there is currently no screening programme for prostate cancer, because it has not been proved that the benefits would outweigh the risks.

Prostate cancer: symptoms and treatment

Initial symptoms of prostate cancer

The initial symptoms of prostate cancer are unspecific and very similar to any other problem in this region. So to find out if there is a risk of having a prostate problem, point out what you are feeling:

  1. 1. Difficulty in starting to urinate
    Yes
    No
  2. 2. Very weak urine stream
    Yes
    No
  3. 3. Frequent urge to urinate, even at night
    Yes
    No
  4. 4. Feeling of a full bladder even after you have urinated
    Yes
    No
  5. 5. Presence of urine drops in the underwear
    Yes
    No
  6. 6. Impotence or difficulty in maintaining an erection
    Yes
    No
  7. 7. Pain when ejaculating or urinating
    Yes
    No
  8. 8. Presence of blood in semen
    Yes
    No
  9. 9. Sudden desire to urinate
    Yes
    No
  10. 10. Pain in the testicular area or near the anus
    Yes
    No
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However, the risk of having a prostate problem does not mean that it is cancer, as other problems, such as prostatitis or benign prostate hypertrophy, are more frequent. These problems, although they require treatment, are easier to control and do not pose as high a health risk as cancer.

However, if any of these symptoms develop, a urologist should always be consulted for tests to identify if this is really a cancer case, such as a rectal or PSA exam, as early diagnosis increases greatly the chances of being cured.

Symptoms of advanced prostate cancer

In more advanced cases, where the prostate is greatly enlarged or cancer metastasis has occurred to other regions of the body, the symptoms may include:

  • Urinary or fecal incontinence;
  • Weakness in the legs;
  • Renal insufficiency.

In addition, if the cancer has spread to other regions of the body, it is also common to have symptoms such as back, thigh, shoulder or other bone pain, for example.

In the more advanced stages, it is important to seek a doctor to assess the extent of the disease and whether other organs have been affected, so that treatment can bem adjusted.

How to confirm the diagnosis

Since this cancer does not cause symptoms early in its course, the best way to evaluate that cancer is developing in the prostate is to do the rectal exam and the PSA blood test.

If during rectal examination the doctor palpates a lump or PSA blood test is greatly altered, the prostate should be further investigated by ultrasound, ultrasound-guided biopsy and urine tests. 

Prostate Cancer Stages

Once it is confirmed the existence of prostate cancer it is essential to identify the stage of cancer to guide treatment, so:

  • Stage A - Tumor is not visible or palpable to the touch;
  • Stage B - Tumor inside the prostate that is palpable to the touch and visible on imaging;
  • Stage C - Tumor that has reached the seminal vesicles, which are near the prostate;
  • Stage D - Tumor that has already reached other organs and there are already metastases, which may affect the urethra, rectum, bladder, for example.

The stage of cancer allows to determine the best treatment and understand if there is a cure for the disease.

What Causes Prostate Cancer

There is no specific cause for the development of prostate cancer, however, some factors are associated with an increased risk of prostate cancer, which are:

  • Having a first-degree relative (parent or sibling) with a history of prostate cancer;
  • Being over the age of 50;
  • Making a poorly balanced diet high in fat or calcium;
  • Suffering from obesity or being overweight.

In addition, men of African American ethnicity are also twice as likely to have prostate cancer as any other ethnic group.

How to cure prostate cancer

Prostate cancer, in most cases, is curable and can be achieved through treatments that include surgery, chemotherapy or radiotherapy, and treatment is paid both in the UK and US, but there are finantial support foundations that can help you with the payment of your treatment.

In most cases, there is a greater chance of cure when the disease is diagnosed early on, and usually treatment may include:

  • Surgery: Prostate removal and, in some cases, groin tongue removal;
  • Radiotherapy: It is usually used when the tumor has not yet reached other organs or has only reached the nearest organs;
  • Chemotherapy: Treatment is done with drugs to the vein or through pills.

In many cases, these treatments can cause side effects such as urinary incontinence, impotence and the impossibility of having children, but if left untreated the disease can spread throughout the body and is potentially fatal.

In some cases, prostate cancer is only diagnosed when it spreads to other parts of the body, which reduces the chances of a cure.


Bibliografia

  • MCANINCH, Jack W.; LUE, Tom F. Urologia Geral de Smith e Tanagho. 18 ed. Porto Alegre: Artmed, 2014. 349-373.
  • GUIMARÃES, Marcos D.; CHOJNIAK, Rubens. Oncologia. Rio de Janeiro: Elsevier, 2015. 651-671.
  • GOLDMAN, Lee; SCHAFER, Andrew I.. Goldman-Cecil Medicina. 25.ed. Rio de Janeiro: Elsevier, 2018. 1394-1397.
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