Symptoms from an enlarging prostate gland

These symptoms are particularly associated with cancer arising in the transitional zone or inner part of the prostate, which squeezes off the urethra. Of all diagnosed cases, about 30% are in the transitional zone.
     

 The symptoms include:
     -- poor urinary flow
     -- difficulty in starting (hesitancy)
     -- difficulty in finishing cleanly
     (post-micturition dribbling)
      Secondary to this, the bladder
     can become irritated as it has to
     contract harder to push the urine
     through the narrowed urethra,
     This may result in:
     -- frequency of micturition and
     nocturia
     -- an inappropriately strong urge
     to urinate.
     NB These symptoms are also
     seen in men with BPH and other
     disorders.

Symptoms from the localised spread of prostate cancer

     As the cancer advances, so it may
     invade surrounding tissues and
     structures. Specifically localised
     spread may affect:
     -- the bladder and nearby lymph
     nodes
     -- seminal vesicles and the nerves
     that control erections
     -- sensation of the perineal skin.
      If the base of the bladder has
     been invaded, it can cause:
     -- blood in the urine (haematuria)
     -- bladder irritation resulting in
     urgency and frequency
      Invasion of the seminal vesicals
     is rare but can result in blood in the
     ejaculate (haemospermia).
      Local invasion into the nerves
     can present in a variety of ways-
     including problems in getting
     erections, pain in the perineum
     and pelvic discomfort
     NB These symptoms are also seen
     in men with other urological
     disorders

Symptoms from metastatic disease

     More than 40% of men
     diagnosed with prostate cancer
     still do not present until they
     have metastatic disease
      Pain resulting from bony
     metastases, particularly in the
     pelvis and lumbar spine, is the
     major symptom, although some
     men first present with a fracture
      If many vertebrae are
     involved, spinal compression
     can occur. This causes
     weakness in the legs and loss of
     control of urinary and bowel
     sphincters
      Other symptoms of distant
     metastases are sciatica, lymph
     node enlargement, swelling in
     the lower limbs
      Widespread metastatic
     cancer may give rise to more
     generalised symptoms such as
     loss of appetite, weight loss and
     lethargy.

Last updated Nov 26/06