Symptoms of Prostate Cancer
Prostate cancer does not usually have symptoms in the early stages. However, the National Cancer Institute lists the following as possible prostate cancer symptoms:
- A need to urinate frequently, especially at night
- Difficulty starting urination or holding back urine
- Inability to urinate
- Weak or interrupted flow of urine
- Painful or burning urination
- Difficulty in having an erection
- Painful ejaculation
- Blood in urine or semen
- Frequent pain or stiffness in the lower back, hips, or upper thighs
Because these symptoms may be caused by prostate cancer, or by other, less serious conditions, be sure to check with a doctor.
When a man is having symptoms such as those listed above, he should check with a doctor. Tests that the doctor may use to help find out the cause of symptoms include digital rectal exam, PSA blood test, and transrectal ultrasound. If prostate cancer is suspected, examining tissue from the prostate gland will help to confirm a cancer diagnosis. For additional information on a diagnosis of prostate cancer, visit the National Cancer Institute.
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Screening and Diagnosis of Prostate Cancer
Men are encouraged to talk with their doctors about the benefits and risks of being screened for prostate cancer. Prostate Cancer Screening: A Decision Guide and Prostate Cancer Screening: A Decision Guide for African Americans are helpful publications from the Centers for Disease Control and Prevention.
Tests typically used to screen for prostate cancer include:
- Digital Rectal Exam (DRE) – a physical examination to check for hard or lumpy areas of the prostate gland.
- PSA blood test – Prostate Specific Antigen is a protein produced in the prostate gland that can be detected in the blood. Several prostate conditions, including prostate infections and prostate cancer, increase the amount of PSA. Because conditions other than cancer can cause an elevated PSA, other tests are needed to confirm a cancer diagnosis.
More information is available in the National Cancer Institute’s publication, Understanding Prostate Changes: A Health Guide for All Men.
Although screening tests to detect prostate cancer are available, to date, research on screening men without symptoms of the disease has not been shown to reduce the number of prostate cancer deaths. Two large-scale clinical trials are now in process to determine if screening for prostate cancer saves lives. (Clinical trials are research studies of new methods or agents to prevent, detect, or treat a disease, or to study quality of life issues.) Results of the National Cancer Institute's Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial are expected in 2006. Results from the European randomized Screening for Prostate Cancer trial are expected in 2008.
Current tests to detect prostate cancer have a high rate of false positive results (indicating the possibility of cancer when it is not present). This may lead to many unnecessary additional tests and may cause undue worry, physical problems, and stress for men and their families.
Professional review organizations have different recommendations on screening average-risk men for prostate cancer. These are summarized in the following chart.
Because of the potential harms of diagnosing and treating prostate cancer, all review organizations recommend providing patients with information on the benefits and limitations of early detection and treatment to help each person make an informed decision, based on personal values and other health issues.
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Review Organization
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Screening Recommendations
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American Cancer Society
Date: 2004
Source: www.cancer.org
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Offer Prostate Specific Antigen (PSA) and digital rectal exam (DRE) annually to men:
- at average risk, age 50+ with a life expectancy of 10+ years
- at high-risk (African Americans or men with 1 or more first-degree relatives diagnosed with prostate cancer at early age), beginning age 45
- at higher risk (multiple first-degree relatives affected at early age); could begin at age 40
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American College of Physicians
Date: 1997
Source: www.acponline.org
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- Recommends against the use of routine population screening
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American College of Preventive Medicine
Date: 1998
Source: www.acpm.org
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- Recommends against routine population screening with DRE and PSA test
- Offer information on potential benefits and harms of screening, and limits of current evidence, to men age 50+ who have a life expectancy of 10+ years
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American Urological Association
Date: 2001
Source: www.auanet.org
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Endorses American Cancer Society's policy statement; summary: Offer PSA test and DRE annually to men:
- at average risk, age 50+ with a life expectancy of 10+ years
- at high-risk (African Americans or men with 1 or more first-degree relatives diagnosed with prostate cancer at early age), beginning age 45
- at higher risk (multiple first-degree relatives affected at early age); could begin at age 40
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Canadian Task Force on Preventive Health Care
Date: 1994
Source: www.ctfphc.org
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- Recommends against the use of routine population screening using PSA test; insufficient evidence to recommend for or against DRE
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U.S. Preventive Services Task Force
Date: 2002
Source: US Preventive Services Task Force
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- Insufficient evidence to recommend for or against routine screening using PSA test or DRE
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Last updated on 02/25/2005 11:08 pm.
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