Prostate cancer usually causes no symptoms until it is quite advanced. Some men notice difficulties with urinating Table 01. Most men with prostate cancer notice no symptoms. Usually the extra tissue growth is small, or does not impinge on other structures, and therefore causes no symptoms. If the extra growth presses on the urethra, men typically experience difficulty urinating. This may involve a sense of urgency, difficulty starting the flow of urine, a slow or intermittent stream, or painful or burning sensations while urinating. Many men notice that they must get up several times during the night to urinate. These symptoms can also be caused by benign prostatic hyperplasia, or BPH, a non-cancerous enlargement of the prostate. Prostate cancer may also occasionally involve painful ejaculation, and blood may be evident in urine or semen.
In cases of advanced cancer that has metastasized, bone pain and symptoms of generalized ill health may be apparent. Once cancer has metastasized to bone, it typically causes progressive back pain or sciatica (nerve pain or tingling in the legs). Cancer that has spread also leads to weight loss, fatigue, and weakness.
Table 1. Symptoms of Prostate Cancer
Difficulties with urination Difficulties with ejaculation Advanced (metastasized) disease UrgencyDifficulty initiating flowSlow or intermittent streamPainful or burning sensationsFrequency, especially at nightBlood in urine Painful ejaculationBlood in ejaculate Bone painNerve pain or tingling in legsWeight lossFatigueWeakness
Prostate cancer is common in American men; African-Americans have an especially high risk. Latent prostate cancer cells are found in a majority of men who are over the age of 65 at autopsy. These cells, however, do not cause disease. Latent prostate cancer is present in a significant number of Asians as well as Europeans, although the incidence is lower in Asians. It is felt that an additional genetic event is required to activate latent prostate cancer to become clinical prostate cancer. Prostate cancer was estimated to cause 27,350 deaths in 2006.
The risk of prostate cancer increases with age; usually men are between the ages of 60 and 70 when diagnosed. African-Americans are more likely to get the disease at a younger age, and to have a more virulent course. Prostate cancer also seems to run in some families.
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