Today, the vast majority of men diagnosed with prostate cancer have no symptoms.1,2 However, localised disease may present with bothersome lower urinary tract symptoms that resemble those of benign prostatic hyperplasia (BPH).1 These may include increased frequency of urination, urgency, urge incontinence, weak stream, hesitancy, sensation of incomplete bladder emptying and urinary tract infection.1 Although usually caused by BPH, these symptoms should be carefully checked as they could indicate the presence of a prostate malignancy.1,3
Locally advanced cancers may be symptomatic and can involve haematuria, dysuria, perineal or suprapubic pain, erectile dysfunction, incontinence, loin pain or anuria due to obstruction of the ureters, symptoms of renal failure, haematospermia, rectal bleeding or tenesmus.1
In advanced disease, bone metastases may cause bone pain, particularly in the pelvis or lumbar spine, pathological fracture (particularly in the femoral neck) or neurological symptoms including paraplegia. Another example of a symptom that may be caused by distant metastases includes anuria due to ureteric obstruction. Widespread metastases can lead to constitutional symptoms such as lethargy, weight loss and cachexia.1,2 Patient information on this topic can be found at Unitedagainstprostatecancer.com.
References:
1. Kirby RS, Patel MI. Fast facts: prostate cancer (5th ed). Health Press Ltd: Oxford, 2008.
2. Wilt TJ, Thompson IM. Clinically localised prostate cancer. BMJ 2006;333:1102-6.
3. Edwards JL. Diagnosis and management of benign prostatic hyperplasia. Am Fam Physician 2008;77:1403-10.