Understanding Prostate Cancer

Symptoms of Prostate Cancer

How can I tell if I have prostate cancer, will I see any symptoms?

A man with prostate cancer may not have any symptoms. For men who have symptoms of prostate cancer, common symptoms include:

• Urinary problems
  • Not being able to urinate
  • Having a hard time starting or stopping the urine flow
  • Needing to urinate often, especially at night
  • Weak flow of urine
  • Urine flow that starts and stops
  • Pain or burning during urination
• Difficulty having an erection
• Blood in the urine or semen
• Frequent pain in the lower back, hips, or upper thighs

Most often, these symptoms are not due to cancer. BPH, an infection, or another health problem may cause them. Any man with these symptoms should tell his doctor so that problems can be diagnosed and treated as early as possible. He may see his regular doctor or a urologist. A urologist is a doctor whose specialty is diseases of the urinary system.

Screening for Prostate Cancer

What kind of testing will I need to have to check for prostate problems?

Your doctor can check you for prostate cancer before you have any symptoms. Screening can help doctors find and treat cancer early. But studies so far have not shown that screening tests reduce the number of deaths from prostate cancer. You may want to talk with your doctor about the possible benefits and harms of being screened. The decision to be screened, like many other medical decisions, is a personal one. You should decide after learning the pros and cons of screening.

Your doctor can explain more about these tests:

• Digital rectal exam: The doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall. The prostate is checked for hard or lumpy areas.
• Blood test for prostate-specific antigen (PSA): A lab checks the level of PSA in a man’s blood sample. A high PSA level is commonly caused by BPH or prostatitis (inflammation of the prostate). Prostate cancer may also cause a high PSA level.

The digital rectal exam and PSA test can detect a problem in the prostate. They cannot show whether the problem is cancer or a less serious condition. Your doctor will use the results of these tests to help decide whether to check further for signs of cancer. Information about other tests is in the “Diagnosis” section.

Diagnosing Prostate Cancer

How will my doctor diagnose whether or not I have prostate cancer?

If you have a symptom or test result that suggests cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor will ask about your personal and family medical history. You will have a physical exam. You may have lab tests. Your visit may include a digital rectal exam, a urine test to check for blood or infection, and a blood test to measure PSA level.

You also may have other exams:

• Transrectal ultrasound: The doctor inserts a probe into the man’s rectum to check for abnormal areas. The probe sends out sound waves that people cannot hear (ultrasound). The waves bounce off the prostate. A computer uses the echoes to create a picture called a sonogram.
• Cystoscopy: The doctor uses a thin, lighted tube to look into the urethra and bladder.
• Transrectal biopsy: A biopsy is the removal of tissue to look for cancer cells. It is the only sure way to diagnose prostate cancer. The doctor inserts a needle through the rectum into the prostate. The doctor takes small tissue samples from many areas of the prostate. Ultrasound may be used to guide the needle. A pathologist checks for cancer cells in the tissue.

You may want to ask the doctor these questions before having a biopsy:

• Where will the biopsy take place? Will I have to go to the hospital?
• How long will it take? Will I be awake? Will it hurt?
• What are the risks? What are the chances of infection or bleeding after the biopsy?
• How long will it take me to recover?
• How soon will I know the results?