Despite the fact that prostate cancer has no definitive set of symptoms, all of the following have been identified by the National Cancer Institute as possible indicators of prostate cancer — and of many other clinical problems:.
An important clinical goal for you and your doctor should be to detect risk for prostate cancer long before it can cause symptoms. Thus, any initial detection of signs that you may have prostate cancer is now most commonly the result of a regular check-up carried out by your primary care physician, which may include a digital rectal examination DRE or a prostate specific antigen PSA test.
The most common symptom which may make a man go to either his primary care physician or a urologist, and which might subsequently lead to a diagnosis of prostate cancer, is some form of problem with normal urination.
If your doctor inserts a finger into your rectum, he can feel the back and sides of your prostate through the thin, soft wall of the rectum. This examination of the prostate is called a digital rectal examination DRE see Figure 1. DRE can be used to raise suspicion of prostate cancer.
DRE can not be used to rule out prostate cancer. Many prostate cancers produce no physical signs that can be felt by DRE. In other words, a normal DRE is not a sign that there is no prostate cancer. It is also well known that if different doctors carry out a DRE on the same patient even on the same day, one immediately after the other , they may come to different decisions about what they think they feel.
Because physical examination with DRE is not always helpful, there is great interest in laboratory tests that can be used to measure things in the blood and the urine. Many such tests have been developed. The most widely known and studied is a test known as the prostate specific antigen or PSA test. PSA is a normal protein produced in the prostate and found at high levels in your semen.
It is also normally found at very low levels in the blood. News and information provided on this site should not be used for diagnosing or treating any health problem or disease. Treatment is started only if symptoms become too much of a problem. Some medications can make BPH symptoms worse, so talk with your doctor or pharmacist about any medicines you are taking such as:. Many American men with mild to moderate BPH symptoms have chosen prescription drugs over surgery since the early s.
Two main types of drugs are used. One type relaxes muscles near the prostate, and the other type shrinks the prostate gland. Some evidence shows that taking both drugs together may work best to keep BPH symptoms from getting worse. Taking these drugs can help increase urine flow and reduce your symptoms. You must continue to take these drugs to prevent symptoms from coming back. It's important to note that taking these drugs may lower your PSA test number.
There is also evidence that these drugs lower the risk of getting prostate cancer, but whether they can help lower the risk of dying from prostate cancer is still unclear. The number of prostate surgeries has gone down over the years. But operations for BPH are still among the most common surgeries for American men. Surgery is used when symptoms are severe or drug therapy has not worked well. Be sure to discuss options with your doctor and ask about the potential short- and long-term benefits and risks with each procedure.
Prostate cancer means that cancer cells form in the tissues of the prostate. Prostate cancer tends to grow slowly compared with most other cancers. Cell changes may begin 10, 20, or even 30 years before a tumor gets big enough to cause symptoms.
Eventually, cancer cells may spread metastasize. By the time symptoms appear, the cancer may already be advanced. By age 50, very few men have symptoms of prostate cancer, yet some precancerous or cancer cells may be present. More than half of all American men have some cancer in their prostate glands by the age of Most of these cancers never pose a problem.
They may never cause symptoms or become a serious threat to health. Prostate cancer can spread to the lymph nodes of the pelvis. Or it may spread throughout the body. It tends to spread to the bones. So bone pain, especially in the back, can be a symptom of advanced prostate cancer. Some risk factors have been linked to prostate cancer.
A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesn't mean that you will get prostate cancer.
It just means that your risk of the disease is greater. Screening means testing for cancer before you have any symptoms. A screening test may help find cancer at an early stage , when it is less likely to have spread and may be easier to treat. By the time symptoms appear, the cancer may have started to spread. The most useful screening tests are those that have been proven to lower a person's risk of dying from cancer. Doctors do not yet know whether prostate cancer screening lowers the risk of dying from prostate cancer.
Therefore, large research studies, with thousands of men, are now going on to study prostate cancer screening. Although some people feel it is best to treat any cancer that is found, including cancers found through screening, prostate cancer treatment can cause serious and sometimes permanent side effects.
Some doctors are concerned that many men whose cancer is detected by screening are being treated—and experiencing side effects—unnecessarily. Talk with your doctor about your risk of prostate cancer and your need for screening tests.
Large research studies are looking at how prostate cancer can be prevented. Studies have shown that 5-alpha reductase inhibitors finasteride and dutasteride can lower the risk of developing prostate cancer, but whether they can decrease the risk of dying of prostate cancer is still unclear. This first step lets your doctor hear and understand the "story" of your prostate concerns.
You'll be asked whether you have symptoms, how long you've had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing. DRE is a standard way to check the prostate.
With a gloved and lubricated finger, your doctor feels the prostate from the rectum. The test lasts about seconds. The DRE allows the doctor to feel only one side of the prostate.
A PSA test is another way to help your doctor check the health of your prostate. The U. PSA is a protein made by prostate cells.
It is normally secreted into ducts in the prostate, where it helps make semen, but sometimes it leaks into the blood. In prostate cancer, more PSA gets into the blood than is normal. However, a high PSA blood level is not proof of cancer, and many other things can cause a false-positive test result.
Even things that disturb the prostate gland--such as riding a bicycle or motorcycle, or having a DRE, an orgasm within the past 24 hours, a prostate biopsy , or prostate surgery--may increase PSA levels.
Also, some prostate glands naturally produce more PSA than others. PSA levels go up with age. African-American men tend to have higher PSA levels in general than men of other races. And some drugs, such as finasteride and dutasteride, can cause a man's PSA level to go down. PSA tests are often used to follow men after prostate cancer treatment to check for signs of cancer recurrence.
It is not yet known for certain whether PSA testing to screen for prostate cancer can reduce a man's risk of dying from the disease. Researchers are working to learn more about the PSA test's ability to help doctors tell the difference between prostate cancer and benign prostate problems, and the best thing to do if a man has a high PSA level. For now, men and their doctors use PSA readings over time as a guide to see if more follow-up is needed. Doctors often use a value of 4 nanograms ng or higher per milliliter of blood as a sign that further tests, such as a prostate biopsy, are needed.
Rapid increases in PSA readings may suggest cancer. This test is used for men who have higher PSA levels. The percentage of free PSA can help tell what kind of prostate problem you have. You and your doctor should talk about your personal risk and free PSA results.
Then you can decide together whether to have follow-up biopsies and, if so, how often. There is no magic PSA level below which a man can be assured of having no risk of prostate cancer nor above which a biopsy should automatically be performed.
A man's decision to have a prostate biopsy requires a thoughtful discussion with his physician, considering not only the PSA level, but also his other risk factors, his overall health status, and how he perceives the risks and benefits of early detection. If your symptoms or test results suggest prostate cancer, your doctor will refer you to a specialist a urologist for a prostate biopsy.
For a biopsy, small tissue samples are taken directly from the prostate. Your doctor will take samples from several areas of the prostate gland.
This can help lower the chance of missing any areas of the gland that may have cancer cells. Like other cancers, prostate cancer can be diagnosed only by looking at tissue under a microscope. Most men who have biopsies after prostate cancer screening exams do not have cancer.
A positive test result after a biopsy means prostate cancer is present. A pathologist will check your biopsy sample for cancer cells and will give it a Gleason score. The Gleason score ranges from 2 to 10 and describes how likely it is that a tumor will spread.
The lower the number, the less aggressive the tumor is and the less likely it will spread. Treatment options depend on the stage or extent of the cancer stages range from 1 to 4 , Gleason score, PSA level, and your age and general health. This information will be available from your doctor and is listed on your pathology report. Reaching a decision about treatment of your prostate cancer is a complex process.
Many men find it helpful to talk with their doctors, family, friends, and other men who have faced similar decisions. Different kinds of doctors and other health care professionals manage prostate health.
They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:. View these professionals as your partners—expert advisors and helpers in your health care.
Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect. Menu Contact Dictionary Search. Understanding Cancer.
What Is Cancer? A malignant or cancerous nodule is a sign of prostate cancer. If you develop BPH, you may have difficulty urinating or ejaculating. Cancer can be present without symptoms, so regular prostate exams are important.
If your doctor finds a nodule, they will probably order a prostate-specific antigen PSA test. PSA is a type of protein made by prostate cells. A simple blood test can measure the PSA in your bloodstream. High levels suggest cancer may be present, but PSA levels may be elevated for many reasons. You may have a condition known as benign prostatic hyperplasia BPH , which simply means you have an enlarged prostate.
Learn more: 8 non-cancerous causes of high PSA levels ». If your levels are higher than normal, your doctor may schedule another test to compare the results. A rapid increase in PSA levels suggests cancer. During that period, your doctor will check your prostate annually and look out for any symptoms or changes in your health.
If a nodule or enlargement of your prostate seems suspicious to your doctor, they may advise a prostate biopsy. During a biopsy, the doctor removes several tiny samples of prostate tissue, which are studied in a lab for signs of cancer cells. Doctors often grapple with false positives when screening for prostate cancer. Prostate cancer treatments can cause incontinence and impotence. If necessary, seek a second opinion.
Do not rush into a battery of tests or treatments until you feel you have the best medical advice possible. A nodule or enlargement of the prostate is usually not a sign of cancer. If the nodule turns out to be cancer, know that prostate cancer is very treatable, especially if caught early.
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