The warning signs of prostate cancer

As a physician assistant at MultiCare Capital Urology, David Elkins, PA-C, can tell you how important screenings are in diagnosing prostate cancer at an early stage.

As a prostate cancer survivor, he can also tell you early prostate cancer typically causes no symptoms.

“I didn’t have any symptoms,” Elkins explains. “My cancer was caught during my annual PSA [prostate-specific antigen] screening. It was localized, stage 1 cancer, and very treatable.”

If symptoms are present, however — like back pain, problems urinating, blood in the urine or semen, trouble getting an erection, fatigue, or unexplained weight loss — that usually signifies prostate cancer has spread and is in a later stage.

These symptoms can also be caused by other medical conditions.

Symptoms that mimic other health issues

Urination problems, for example, are common symptoms of a noncancerous condition called benign prostate hyperplasia (BPH), or enlarged prostate. The prostate gland surrounds the urethra, and because the gland often continues to grow as men age, it then puts pressure on the urethra, causing urinary frequency and urgency, among other symptoms.

“If there are significant, acute changes in urinary symptoms, it’s best to be seen by a urologist,” says Basil Ferenczi, MD, of MultiCare Urology Northwest. “If there’s blood in the urine, we want to rule out kidney and bladder cancer.”

Back pain is another symptom that can be present for a multitude of reasons.

“Bottom line: Don’t minimize your symptoms. If you’re experiencing anything out of the ordinary, make sure you talk to your doctor and get checked out.”

“Intense lower back pain that doesn’t go away with rest and gets worse at night, however, may indicate prostate cancer has metastasized to the lower spine,” says Patrick Murray, MD, also with MultiCare Capital Urology.

Unintended weight loss and fatigue are warning signs that can be caused by various medical conditions, but they are also very common with metastatic cancers.

“The reason this happens is because cancer expends so much energy in order to grow — it causes a person to feel extreme fatigue, and they can’t maintain their weight,” adds Dr. Murray.

“Bottom line: Don’t minimize your symptoms,” advises Elkins. “If you’re experiencing anything out of the ordinary, make sure you talk to your doctor and get checked out.”

Early detection is key to effective treatment

Because Elkins’ cancer was in an early stage, he had a prostatectomy, which is the surgical removal of the prostate. He’s cancer-free and will continue to get an annual PSA screening to make sure the cancer doesn’t recur.

“If caught early, prostate cancer can be cured; seldom is chemo or radiation needed,” Elkins says.

While prostate cancer treatments have advanced in the last five to 10 years, the intention of these treatments in later-stage cancers is to keep the cancer at bay.

“These therapies can slow progression, but they aren’t meant for curative intent,” says Dr. Murray.

Know your risk factors and when to start screening

MultiCare providers recommend men at average risk who are age 55 and older should have a discussion with their provider about when to begin prostate cancer screening.

Those with factors that put them at a higher risk of prostate cancer, including family history, inherited gene mutations and being African American, should start the conversation as early as age 40.

“The decision on when to screen is one that should be made between you and your provider,” adds Dr. Ferenczi. “That said, if someone is experiencing any symptoms, even if BPH is suspected, we will check the PSA.”