Prostate cancer is one of the most common tumors in men. Diagnosis can be tricky as this cancer does not usually cause symptoms until it reaches an advanced stage. At this point, treatment can also be complicated. Occasionally, prostate cancer can affect surrounding areas, producing symptoms. As the cancer spreads, more symptoms can be experienced as more body systems are affected.
Obstructive Voiding Symptoms
These symptoms include difficulty in initiating the flow of urine, dribbling of urine, and intermittency, in which the urine stream starts and stops repeatedly. This can typically be caused by local growth of the prostate cancer into the urethra or neck of the bladder, thereby obstructing urine flow.
Irritative Voiding Symptoms
Irritative voiding symptoms include nocturia (frequent need to wake up at night to pass urine), frequency (an frequent need to urinate without an increase in the total output), urgency (a sudden, powerful urge to urinate) and urge incontinence (leakage of urine as a result of bladder muscles contracting inappropriately). This is also a result of tumor growth into the bladder neck or urethra, which can cause stimulation that results in voiding problems.
Kidney Failure
Prostate cancer can invade locally, affecting the trigone of the bladder, which sends signals to the brain that the body needs to urinate. When that signal is disrupted, urine can build up in the bladder and back flow up to the kidneys, eventually resulting in failure of the kidneys. This can also occur if the tumor obstructs the ureters, which will also obstruct urine flow. Since there are two ureters, however, it would have to obstruct both in order to cause sufficient obstruction.
Sexual Side Effects
Although this is rare, impotence can result from the tumor's local growth outside the capsule of the prostate. It can also put pressure on the pelvic plexus of nerves and its branches that are involved in producing erections. Also, the tumor can grow into the ejaculatory ducts and cause obstruction; this is associated with decreased ejaculate volume and hematospermia (blood in the semen).
Systemic Symptoms
As a result of the spread of the cancer to other sites in the body (metastasis), persons with prostate cancer might experience bone pain and/or anemia, fractures and replacement of bone marrow, and swelling in the lower limbs, among other symptoms.
References
- "Campbell-Walsh Urology, 9th Edition;" Wein; 2007
- "Textbook of Family Medicine, 7th Edition;" Rakel; 2007
- Mayo Clinic: Prostate Cancer Symptoms
