5 early signs of prostate cancer men should not ignore, according to urologist

Prostate cancer is one of the most common cancers affecting older men globally, including in  Indian population. Increased awareness, annual health checks and widespread screening could explain the rise in the number of cases in recent times. Screening helps to detect cancers at an early stage, that is when the cancer is likely to be easier to treat with a potential for complete cure.

Often, prostate cancer is asymptomatic and the diagnosis is incidental. The possible existence of prostate cancer is picked up through blood Prostate Specific Antigen (PSA) levels. PSA blood test is prostate gland specific, but not prostate cancer specific. This means, PSA levels could be elevated in conditions affecting prostate gland but not prostate cancer.

So, the question that needs to be addressed is, how to diagnose early? To understand the same, Dr Raghavendra Kulkarni, Consultant Urologist, Asian Institute of Nephrology and Urology Secunderabad lists down to Moneycontrol various ways in which prostate cancer could manifest.

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Prostate cancer could present symptoms secondary to an enlarged prostate, like:

• Frequent urination
• Urgency
• Night-time urination
• Poor urinary flow
• Intermittent flow
• Trouble initiating the flow
• Straining to urinate

The above symptoms are seen in cases with excessively sensitive bladder and also in cases with bladder outflow obstruction. These above symptoms could also be seen in a few other conditions. As there is overlap of symptoms between different conditions affecting either the bladder or the prostate, patients tend to attribute the symptoms to old age and are likely to ignore, which usually results in delayed diagnosis.

Some of the atypical lower urinary tract symptoms that could also be seen in prostate cancer include:

• Painful urination
• Burning urination
• Haematospermia  which means, blood in the semen
• In advanced stages, patients tend to have the below symptoms that indicate spread outside the prostate gland:
• Dull pain in the lower pelvic area
• Haematuria which means, blood in the urine
• Painful ejaculation
• Bone pain
• Loss of appetite / weight

As there are no specific symptoms pertaining to prostate cancer, and as the cancer could co-exist with age related enlargement of the prostate gland, any kind of bothersome lower urinary tract symptom should alert the patient. This should be seen as a red flag and a consultation with a Urologist should be sought. The only way to early diagnosis is consultation with Urologist & PSA test screening.

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Is PSA testing routinely required? 

Routine PSA screening in urban areas has become a commoner. It is either ordered by the treating Physician / Urologist. But we have to understand the nuances, PSA testing comes with its own merits & demerits, namely, significant false-positive results – meaning, absence of cancer even if the PSA levels are abnormal. It is also associated with false-negatives – meaning, presence of cancer with normal PSA levels.

Detecting prostate cancer at an early stage might seem to make sense, but, due to the slow growing nature of prostate cancer, it is said that prostate cancer would not cause any major problem during a man’s lifetime in large majority. With technological advances in the diagnosis and treatment of prostate cancer, the concept of, do nothing, doesn’t hold relevance in the current era.

Who should undergo routine PSA testing and how frequently?

Yearly PSA check is the common recommendation. Some set of patients in whom annual PSA checks is mandatory, include:

• Men between 45 – 69 years of age
• Men with family history of prostate cancer
• Men with lower urinary tract symptoms
• Prompt medical attention with urologist consultation followed by screening is prudent to diagnose prostate cancer in its early stages.

FAQs on Prostate Cancer Diagnosis:

1. What is prostate cancer?
Prostate cancer is a type of cancer that occurs in the prostate gland of men, often affecting older men.

2. How is prostate cancer detected?
Prostate cancer is often detected through blood Prostate Specific Antigen (PSA) levels, though it can also be identified incidentally.

3. What are the symptoms of prostate cancer?
Common symptoms include frequent urination, urgency, night-time urination, poor urinary flow, intermittent flow, trouble initiating the flow, and straining to urinate. Advanced stages may include dull pelvic pain, haematuria, painful ejaculation, bone pain, and loss of appetite/weight.

4. Who should undergo PSA testing?
Men aged 45-69, men with a family history of prostate cancer, and men with lower urinary tract symptoms should undergo routine PSA testing.

5. Is PSA testing always accurate?
PSA testing has its limitations with both false-positive and false-negative results, meaning it is not always accurate in detecting prostate cancer.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.