Signs and Symptoms of Prostate Cancer
Although like any other tissue Prostate is also made up of different types of cells serving different purpose, generally majority of Prostate Cancers develop from the gland cells, i.e. the cells that
- Generally no symptoms are observed at Early Stage of Prostate Cancer.
- More advanced Prostate Cancers can sometimes cause symptoms, such as:
- Problems passing urine
- A slow or weak urinary stream
- Need to urinate more often, especially at night
- Blood in the urine
- Trouble getting an erection (erectile dysfunction)
- Pain in the hips, back (spine), chest (ribs), or other areas( from cancer that has spread to bones)
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord (advanced cancer).
It is not necessary that all these symptoms are seen in (early) Prostate Cancer.
It may be possible to have blood in urine in case of Kidney Cancer (Renal Cancer) and Bladder Cancer apart from Prostate Cancer. Even Urinary calculi (solid particles in the urinary system) may cause painful urination, nausea, vomiting, hematuria (blood in urine), and, possibly, chills and fever due to secondary infection.
Some non-cancerous conditions like Benign Prostatic Hyperplasia (BPH) may cause similar symptoms. In fact trouble passing urine is much more often caused by BPH than cancer.
The disease usually progresses very slowly and, if detected early, is not fatal in most cases. During prostate cancer awareness month (at Johns Hopkins Institute), men ages 50 and older (45 for African Americans) are encouraged to speak with their physicians about prostate cancer and the benefits of screening.
Early Detection and Prostate Cancer Treatment gives you a better control or even an option for cure.
Prostate & Different Medical Conditions
Prostate, which sits below the urinary bladder and in front of the rectum, is an important gland found only in males. Of the size of a walnut at younger age, growing rapidly during puberty under the influence of the androgens - the male sex hormones - testosterone and Dihydrotestosterone, Prostate is responsible for production of some of the fluids that make semen more liquid and protect and nourish sperm cells in semen. Passing through the center of Prostate, the urethra carries urine and semen out of the body through the penis.
Benign Prostate Hyperplasia
The prostate usually stays about the same size or grows slowly in adults, as long as male hormones are present. However, the inner part of the prostate (around the urethra) may keep growing with age which is known as Benign Prostate Hyperplasia (BPH). This is not Prostate Cancer, yet in BPH just by pressing the urethra it may cause problems in passing urine. Some medicines are available which may cause shrinkage of the (enlarged) prostate and resolve or control symptoms of BPH by improving the urine flow. If medicines fail to give desirable results, a type of surgery called Transurethral Resection of the Prostate (TURP) may be needed.
Considered the most effective treatment for BPH, TURP is a urological operation designed to treat BPH by visualizing the prostate through urethra and removing the tissue by electro-cautery or sharp dissection. The dictionary meaning of Benign is ‘Gentle or Kind’ and in medicine ‘not harmful’ against ‘Malicious’ (intending to do harm) or the Malignant (evil) like the Cancer.
We know that due to irreparable DNA damage, unlike normal cells, growth of cancer cells follows a different path. Instead of dying, they continue to grow and form new, abnormal cells, form a tumor (except in blood related – i.e. hematologic cancers) and invade other tissues, called metastases.
Although like any other tissue Prostate is also made up of different types of cells serving different purpose, generally majority of Prostate Cancers develop from the gland cells, i.e. the cells that make the ‘prostate fluid’ which is added to the semen. In pathology parlance, tumors deriving from a gland are called Adenocarcinoma. Other types of Prostate Cancers emanating from the prostate gland include: • Sarcomas • Small cell carcinomas • Neuroendocrine tumors and • Transitional cell carcinomas, which are rare.
Growth Pattern of Prostate Cancer
We know that different cancers grow at different intensity and the Prostate Cancer is no exception. For example while only some prostate cancers may grow at a rapid rate and spread quickly, most of the Prostate Cancers grow slowly. There are many reports of elderly people dying of other causes, being detected to have had Prostate Cancer (which was detected after autopsy). In other words, neither they nor their doctors knew of their prostate cancer till death.
Is Pre Cancerous Condition, Prostatic Intra-epithelial Neoplasia (PIN) Possible
Precancerous condition means the cells in a tissue have undergone some change and can be identified as being different than normal cells of that tissue. Yet the abnormality at that stage is not enough for them to be termed or classified as cancer as they do not show propensity to migrate or grow in other parts of the prostate like cancer cells. Depending upon the pattern of abnormality they may be classified as Low Grade PIN (almost like normal cells) or High Grade PIN (more abnormality).
Low Grade PIN may begin in early twenties. Presence of Low Grade PIN and its correlation with development of Prostate Cancer is as yet unclear. Even if it is found during biopsy, still doctors may consider a follow up of these patients as normal. Abnormalities of cells in Prostate may increase with age and by the age of fifty about 50% of adults may have PIN.
A positive Prostate Biopsy for High Grade PIN suggests to a 20 percent possibility of presence of malignant Prostate Cancer Cells somewhere in the prostate of such a person. Hence doctors keep these patients under watch and may advise a repeat biopsy for these patients.
Proliferative Inflammatory Atrophy (PIA)
Prostate Biopsy may sometimes reveal presence of PIA, wherein the prostate cells look smaller than normal accompanied with signs of inflammation in the area. PIA is not cancer. However, PIA may sometimes lead to high-grade PIN or perhaps to Prostate Cancer directly.
- American Cancer Society, Prostate Cancer:
2. Shalu Jain, Sunita Saxena, Anup Kumar ; Review: Epidemiology of prostate cancer in India; Meta Gene 2: (2014)596–605, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287887/pdf/main.pdf
3. Prostate Cancer Awareness: Story Ideas From the Johns Hopkins Hospital's Brady Urological Institute. http://www.hopkinsmedicine.org/news/media/releases/prostate_cancer_awareness_story_ideas_from_the_johns_hopkins_hospitals_brady_urological_institute