Signs of Prostate Trouble

Question: What are the symptoms of prostate cancer?

Dr. Hibberd’s Answer:

The symptoms of prostate disorder, whether caused by obstruction, inflammation, stone, or cancer, are usually very easy to notice. Urination is often affected — weak stream, discomfort, hesitancy, and dribbling are all signs. Seen less often is pain in the perineum or rectum.

Sometimes blood is seen microscopically in the urine. Blood in urine is abnormal, and the source of bleeding should always be identified.

Prostate cancer is a malignant condition that has numerous approaches to cure but no effective prevention (though regular intercourse seems to reduce the incidence of prostatic disorders).

Prostate cancer is seen in increasing frequency as we age, but not all prostate cancers will be invasive. The difficulty is in deciding which need aggressive management and which can be managed with a more conservative approach.

A person with prostate cancer is fine as long as the malignant cells remain confined to the prostate gland. When prostate cancer spreads to the pelvis and its lymphatics, then advances to bone, spine, lungs, liver, brain, and other areas, it can take a very high toll.

Though there is a push to diagnose and treat early, we are still lacking a suitable, affordable marker to assist us with deciding how aggressive the cancer will be. Fortunately, we have a very useful tumor marker in the PSA (prostate-specific antigen) that allows us to monitor response effectively. Be aware, however, that all cancers of the prostate do not always produce measurable PSA.

So, do not neglect a biopsy if obstructive symptoms are present and the PSA is not remarkable. Use the PSA as a tool and use the biopsy of your prostate as your definitive diagnostic tool. Be sure to have a periodic rectal exam if you are a male over 40 years old. Prostate cancer is often palpable as a firm, non-tender nodule on the surface of the prostate gland. Women do not have a prostate gland and do not have to worry about this.

Prostate ultrasound has been very useful to help define prostate issues and may be used to help target a biopsy of an area that appears to be abnormal.