Men’s Day Special: Early Symptoms of prostate cancer

Prostate cancer is the second most common cancer in men globally, and the fourth most common cancer overall. It is particularly prevalent in developed countries, with incidence rates varying significantly across regions. There were 1,467,854 new cases of prostate cancer diagnosed globally in 2022. It caused 397,430 deaths worldwide in 2022. Living with it can be challenging, especially cause of the symptoms of prostate cancer. Depending on the stage and treatment, men may experience urinary problems, sexual dysfunction, fatigue, and other side effects. Some men may need to reduce work hours or modify their daily activities, especially during treatment.

Experts like University of Alberta oncology professor John Lewis say the vast majority of men will have “some cancer in their prostate at some point in their lives.” It’s important to remember that treatment options have significantly improved in recent years, offering hope and better outcomes for many patients.

Let’s explore the early signs or symptoms of prostate cancer, along with the main treatment approaches in a way that provides both information and reassurance. For many men with low-risk prostate cancer, active surveillance is a viable option. This approach allows you to avoid immediate treatment and its potential side effects while closely monitoring your condition.

What are the first signs or symptoms of prostate cancer?

1. Jaundice: Yellowing of the skin and whites of the eyes, often accompanied by dark urine and pale stools. This is often one of the earliest noticeable signs, especially for cancers in the head of the pancreas.
2. Abdominal or back pain: A dull pain in the upper abdomen or upper back that may come and go. This pain can sometimes be relieved by leaning forward.
3. Unexplained weight loss: Losing weight without trying is a common early symptom.
4. Loss of appetite: Feeling full quickly or not wanting to eat.
5. Digestive issues: These may include nausea, vomiting, indigestion, or changes in bowel habits like diarrhea or constipation.
6. Fatigue: Extreme tiredness that doesn’t improve with rest.
7. New-onset diabetes: Pancreatic cancer can affect the pancreas’s ability to produce insulin, leading to diabetes.
8. Itchy skin: This can be related to jaundice.

What to do next?

The first warning symptoms of pancreatic cancer can be subtle and easily mistaken for other conditions. However, some common early symptoms to be aware of include:

Regular check-ups and screenings are crucial for prostate health. Men should start discussing prostate cancer screening with their doctor at age 50, or earlier if they’re at higher risk. It’s important to seek medical attention if you experience difficulty urinating, frequent urination, pain during urination or ejaculation, or blood in your semen. These symptoms don’t necessarily indicate cancer but warrant investigation. Immediate medical care is necessary for severe symptoms like urinary tract infections with fever, inability to urinate, or signs of kidney failure.

If you experience weakness in your legs, difficulty walking, or loss of bladder/bowel control, seek emergency care as these could indicate spinal cord compression. Between appointments, don’t hesitate to contact your doctor if you notice any new or concerning symptoms. Remember, early detection is key in managing prostate cancer, so it’s always better to err on the side of caution and get checked out if you’re worried about any changes in your health.

Read More: How to reduce your risk for cancer?

Treatment Options- What’s best for you?

If your cancer is localized and you’re in good overall health, surgery might be recommended. The most common procedure is a radical prostatectomy. What to expect:

• The entire prostate gland and some surrounding tissue are removed
• Can be done through traditional open surgery or minimally invasive techniques (laparoscopic or robotic-assisted)
• Hospital stay is typically 1-3 days, with full recovery taking several weeks

Potential benefits:
Surgery offers the possibility of completely removing the cancer if it’s confined to the prostate. Modern techniques have improved outcomes and reduced side effects. Radiation therapy uses high-energy beams to kill cancer cells. It’s an effective option for many men, especially those who may not be candidates for surgery. So, here are the two main types:

1. External beam radiation therapy (EBRT): Typically involves daily treatments over several weeks
2. Brachytherapy (internal radiation): Places radioactive seeds directly into the prostate. Often combined with hormone therapy for higher-risk cancers and advanced symptoms of prostate cancer.

Hormone Therapy: What Does It Mean for symptoms of prostate cancer

Hormone therapy, also called androgen deprivation therapy (ADT), works by lowering testosterone levels to slow or stop cancer growth. It’s administered either through injections or implants to suppress testosterone production or oral medications to block testosterone’s effects. It’s recommended for advanced prostate cancer that has spread beyond the prostate and sometimes before other treatments to shrink the tumor. While effective for the symptoms of prostate cancer, hormone therapy can have side effects like fatigue, hot flashes, and loss of bone density. Your doctor can help manage these effects.

Emerging Treatments: What to look out for?

Research is continually advancing prostate cancer treatment, especially since some symptoms of prostate cancer show too late. Some newer options of treatment include:

• Focal therapies: Treatments like cryotherapy or high-intensity focused ultrasound (HIFU) that target specific areas of the prostate
• Immunotherapy: Treatments that boost your immune system to fight cancer cells
• Targeted drug therapies: Medications that attack specific weaknesses in cancer cells

These treatments may be options in specific cases or as part of clinical trials.

Making Your Decision

Step 1: Confirm the diagnosis. First, ensure that the patient has undergone a proper diagnostic process, including:

• PSA blood test
• Digital rectal exam (DRE)
• Prostate biopsy to confirm cancer and determine the Gleason score

Step 2: Determine the stage and risk group. Work with the doctor to understand:

• The clinical stage (T1-T4)
• PSA level
• Gleason score
  These factors will help determine his risk group (low, intermediate, or high-risk).

Step 3: Discuss treatment options. Based on the risk group, age, and overall health, explain the main treatment options:

• Active surveillance (for low-risk cases)
• Surgery (radical prostatectomy)
• Radiation therapy (external beam or brachytherapy)
• Hormone therapy (usually combined with other treatments)

Step 4: Know about the potential side effects:

1. Urinary incontinence
2. Erectile dysfunction
3. Bowel problems
4. Fatigue

Step 5: Consider quality of life factors. Doctors and medical assistants shall help the patient think about how each treatment might affect daily life, work, and relationships.

Step 6: Evaluate personal preferences:

• Is the patient more concerned about eliminating the cancer or preserving quality of life?
• How does the patient feel about the possibility of needing multiple treatments?

Step 7: Seek second opinions. The patient should consult with different specialists (urologist, radiation oncologist) to get a well-rounded perspective.

Step 8: Use decision-making tools. Introduce him to tools like the Predict Prostate tool to help visualize potential outcomes of different treatments.

Step 9: Consider a multidisciplinary approach. Suggest discussing his case with a tumor board for a comprehensive treatment plan.

Step 10: Make an informed decision. After gathering all this information, help him weigh the pros and cons of each option. Remind him that there’s often no single “right” answer, and the best choice is the one that aligns with his values and goals.

Additional note: Regular follow-up appointments allow doctors to monitor for any signs that the cancer may be returning:

• PSA testing is crucial, typically done every 3-6 months initially, then annually. Any rise in PSA levels could indicate recurrence.
• Imaging tests like CT, PET, or bone scans may be ordered if there are concerns about recurrence.
• Early detection of recurrence allows for prompt intervention with salvage treatments.

Throughout this process, emphasize that he has time to make this decision carefully. Prostate cancer often grows slowly, so he shouldn’t feel rushed. Encourage him to involve his family or trusted friends in the decision-making process for additional support. Remember, you’re not alone in this journey. Many men have faced prostate cancer and gone on to live full, active lives. With the right treatment plan and support, you can too. Don’t hesitate to ask questions, seek second opinions, and take the time you need to make the best decision for you. Your medical team is there to support you every step of the way.