Prostate cancer is the most common tumor disease in men. In the early stages of the disease, prostate cancer is usually asymptomatic and does not cause any symptoms. There are also no typical warning signs that specifically indicate prostate cancer. Therefore, the precaution with the digital rectal examination, which the doctor scans the prostate via the rectum, and the determination of the PSA value (prostate-specific antigen) in the blood is an important part of the early detection of prostate cancer. In Germany, men aged 45 and over have the option of having their prostate examined by their doctor every year.
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Symptoms that can indicate prostate cancer usually only appear at a more advanced stage. Most patients are symptom-free at the onset of the disease. The symptoms of prostate cancer are varied and not necessarily specific as a number of other conditions cause similar problems. Men who have one or more of the symptoms listed below should see their GP or urologist immediately. The doctor can quickly determine whether there is prostate cancer or not through suitable examinations.
Typical symptoms include problems urinating and difficulty defecating. The tumor on the prostate can narrow the urethra and press the lower part of the rectum, making it difficult to empty the bladder and bowel. The affected patients feel an increased need to urinate, especially at night. These symptoms also occur with benign enlargement of the prostate (prostatic hyperplasia), which many men suffer from.
Pain when urinating or ejaculating are further warning signs that the prostate may be diseased. Blood in the urine (hematuria) or seminal fluid can also indicate prostate cancer. In the more advanced stages, the tumor has often metastasized that can spread to various parts of the body and cause problems there. For example, pain in the back or pelvic area can be caused by bone metastases.
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Read more on the topic: Prostate cancer and Metastases in prostate cancer
The prostate lies behind the urinary bladder and encloses the first section of the urethra. Tumors in the prostate usually originate from the glandular tissue (so-called adenocarcinomas) and arise in the outer zone of the prostate. As the tumor grows, the urethra within the prostate is increasingly narrowed.
As a result, patients have difficulty urinating. This manifests itself mainly in a weak urine stream and a constant urge to urinate, which is especially noticeable at night. Most of the time, these problems only arise when the tumor is already relatively large and the disease is at an advanced stage.
The narrowing of the urethra caused by prostate cancer also leads to pain when urinating. A complication of the urinary tract blockage is acute urinary retention, in which the bladder continues to fill, but the urine can no longer be released due to the tumor. Acute urinary retention is extremely painful. Those affected feel a feeling of pressure in the stomach and can no longer urinate. Acute urinary retention is an absolute emergency that requires immediate medical treatment.
$config[ads_text3] not foundFor more information, see: Pain when urinating in men
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During ejaculation, the muscle cells in the prostate contract, which means that a secretion that keeps the sperm moving is transferred to the seminal fluid in the urethra. A tumor in the prostate may cause pain just before or during ejaculation from contraction.
The pain is described as sharp and very uncomfortable and is felt mainly in the area between the scrotum and anus.Pain during ejaculation is in most cases due to diseases of the prostate and should be clarified by a doctor.
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Blood in the urine (hematuria) or in the seminal fluid (hematospermia) can be signs of a tumor in the prostate. The invasive growth of the tumor into the surrounding tissue of the prostate can destroy blood vessels, from which blood then escapes.
As a result, the urine or semen show a red or brown discoloration. Blood in the urine or semen can also have more harmless causes, such as inflammation of the prostate (prostatitis) or the urethra (urethritis). Nevertheless, this symptom is a warning sign and urgently requires a doctor's visit.
This article might also interest you: Causes of blood in the urine
Prostate cancer can cause pain in the prostate, which is usually a later symptom of the disease. The tumor grows, breaks the capsule around the prostate, and spreads to the surrounding tissue, causing pain. Often the pain worsens when urinating or during ejaculation.
The pain occurs mainly between the testicles and anus, in the so-called perineal area, and is perceived as stabbing or burning. Very often, however, prostate pain arises from other causes, such as irritation or bacterial inflammation of the prostate. The cold, sitting for long periods of time or drinking alcohol can also lead to prostate discomfort.
Also read the article on the topic: Prostate cancer
In addition to pain during ejaculation, a tumor in the prostate can also affect erectile function. In such cases, the growth of prostate cancer damages the nerves and blood vessels that are responsible for building an erection, resulting in erectile dysfunction (impotence or erectile dysfunction). The narrowing of the urethra also means that less seminal fluid is expelled. For erectile dysfunction, men aged 45 and over should always be screened for prostate cancer.
Also read the article on the topic: Causes of Erectile Dysfunction
A major symptom of prostate cancer is problems with bowel movements. Due to the growing tumor, the prostate presses more and more on the rectum behind, which makes it difficult to empty the bowel. The affected people suffer from irregular stool and painful bowel movements.
At an advanced stage, prostate carcinoma can develop daughter tumors (metastases), which very often settle in the bones (osseous metastases) and cause symptoms there. The tumor tissue presses on the periosteum, which is sensitively supplied by many nerves. The men affected then feel severe pain in the lower back, in the lumbar spine or on the hips, which can radiate into the legs. However, back pain is not a particularly specific symptom of prostate cancer and very often has other, harmless causes.
In addition to back pain, metastatic prostate cancer can also lead to numbness, sensory disturbances and even paralysis. This is because bone metastases in the spine can press on the spinal cord and cause this discomfort. Spontaneous fractures, for which there is no explanation, can also be an indication of osseous metastasis. If bone metastases are suspected, an X-ray of the spine and whole-body bone scintigraphy are performed in patients with prostate cancer. Metastases in the bone can be reliably diagnosed with these two examination methods.
Fever is a symptom that is very common in all forms of cancer, including prostate cancer. Together with night sweats and unwanted weight loss, doctors refer to this triad of symptoms as the so-called "B symptoms". The patients have a fever of more than 38 degrees, which lasts for a long time and is not due to any other cause (e.g. infection). It is believed that the fever is a reaction of the body against the tumor cells. The immune system attacks the tumor cells and releases certain substances, so-called pyrogens, which trigger attacks of fever.
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Prostate cancer patients often suffer from persistent tiredness and listlessness. This form of fatigue is also known as chronic fatigue syndrome. This is an extreme form of fatigue that sleep and rest do not go away. Fatigue occurs in many tumor diseases, although the exact causes are still unclear. Those affected find tiredness to be very agonizing and lead to severe restrictions in their everyday life. Medication and non-drug treatment approaches (e.g. endurance sports and relaxation procedures) can help to alleviate tiredness.
In addition to fatigue syndrome, tumor-associated anemia can also be a cause of fatigue. The lack of blood makes the patients feel exhausted and exhausted. In such cases blood transfusions or drugs that support blood formation help.
Metastases from prostate cancer often cause other symptoms in addition to the symptoms already mentioned. Tumor cells can spread throughout the body through the blood vessels and lymph vessels. The prostate carcinoma often first metastasizes to the lymph nodes, whereby the local lymph node stations of the pelvis (pelvic lymph nodes) are usually affected first. The lymphatic drainage is impeded by the lymph node metastases and so-called lymphedema develops. With lymphedema, the lymph fluid builds up and the legs become thick.
In most cases, the metastases occur in the bone, with the lumbar spine being one of the most common locations. Those affected have back pain and possibly sensory disorders. The bone metastases cause more bone to be remodeled, which increases the calcium level in the blood and can lead to kidney damage. The high calcium levels can cause severe arrhythmias that are potentially life-threatening.
Another organ that is often metastasized is the brain. The patients then suffer from headaches, dizziness, impaired consciousness or speech disorders, among other things. In principle, however, metastases from a prostate tumor can colonize any organ (liver, lungs, kidneys, gastrointestinal tract) and therefore cause a multitude of clinical pictures.
End-stage prostate cancer, like most other advanced malignant tumors, causes general symptoms of the disease. In addition to fatigue and exhaustion, this also includes loss of appetite, weight loss and anemia. Often, end-stage patients suffer from severe pain that can occur in different places. Thanks to modern medicine, the pain can now be relieved by appropriate medication and the patients do not have to suffer.
Read more on the topic: What is the terminal stage of prostate cancer?
As soon as the tumor has reached a certain size, it exceeds the boundaries of the prostate and grows into the surrounding tissue. The affected patients have problems urinating as a result. You may experience blood in the urine or semen, incontinence, an interruption in the urine stream and urinary retention (inability to urinate). At an advanced stage, prostate carcinoma has metastasized that affect the lymph nodes and internal organs of the body. Depending on which organ is affected, a wide variety of complaints can arise. Back pain in the lumbar spine is very common due to osseous metastases.
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