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Blood In Urine Male Prostate Cancer

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Possible Side Effects Of Ebrt

Why Do I Have Blood In My Urine?

Some of the side effects from EBRT are the same as those from surgery, while others are different.

Bowel problems: Radiation can irritate the rectum and cause a condition called radiation proctitis. This can lead to diarrhea, sometimes with blood in the stool, and rectal leakage. Most of these problems go away over time, but in rare cases normal bowel function does not return. To help lessen bowel problems, you may be told to follow a special diet during radiation therapy to help limit bowel movement during treatment. Sometimes a balloon-like device or gel is put between the rectum and the prostate before treatment to act like a spacer to lessen the amount of radiation that reaches the rectum.

Urinary problems: Radiation can irritate the bladder and lead to a condition called radiation cystitis. You might need to urinate more often, have a burning sensation while you urinate, and/or find blood in your urine. Urinary problems usually improve over time, but in some men they never go away.

Some men develop urinary incontinence after treatment, which means they cant control their urine or have leakage or dribbling. As described in the surgery section, there are different levels and types of incontinence. Overall, this side effect occurs less often with radiation therapy than after surgery. The risk is low at first, but it goes up each year for several years after treatment.

Blood In Urine Experienced As Symptom Of Prostate Cancer

Blood in urine is known as hematuria, and it can be related to a number of conditions, often not severe or consequential. But in the case of prostate cancer, it usually occurs in advanced stages of the disease and it should not be ignored. Instead of the normal pale yellow color of the urine, men may note it is pink, red, brownish-red, or tea-colored. In some cases, it may not be seen with naked eye, but the presence of red blood cells in urine can be detected in the lab.

Blood in urine is associated with damage to the kidneys, where urine is created, or to a problem in another part of the urinary tract, including the ureters , the bladder , or the urethra . The tumor may press one of these structures, while blood in urine also may be a side effect of radiation therapy. Reporting blood in urine to a doctor may help readjust the treatment and improve patients quality of life.

Side Effects Of Prostate Radiation

Side effects of prostate radiation is an important topic, which many doctors and their patients have to discuss before proceeding to the procedure further on. In most cases, radiation treatment for prostate cancer has the same side effects as brachytherapy . But its important to keep in mind that every person will have different side effects from the same procedure and health in general.

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What Are The Symptoms Of Prostate Cancer

If you have any symptoms that worry you, be sure to see your doctor right away. They may be caused by conditions other than prostate cancer.

Different people have different symptoms for prostate cancer. Some men do not have symptoms at all.

If you have any of the following symptoms, be sure to see your doctor right away

  • Difficulty starting urination.
  • Weak or interrupted flow of urine.
  • Urinating often, especially at night.
  • Trouble emptying the bladder completely.
  • Pain or burning during urination.
  • Pain in the back, hips, or pelvis that doesnt go away.

Keep in mind that these symptoms may be caused by conditions other than prostate cancer.

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Metastatic Spinal Cord Compression

Prostate cancer symptoms: Spotting blood in your urine could indicate ...

Metastatic spinal cord compression happens when cancer cells grow in or near to the spine and press on the spinal cord. MSCC isnt common, but you need to be aware of the risk if your prostate cancer has spread to your bones or has a high risk of spreading to your bones. The risk of MSCC is highest if the cancer has already spread to the spine. Speak to your doctor or nurse for more information about your risk.

MSCC can cause any of the following symptoms.

  • Pain or soreness in your lower, middle or upper back or neck. The pain may be severe or get worse over time. It might get worse when you cough, sneeze, lift or strain, or go to the toilet. It might get worse when you are lying down. It may wake you at night or stop you from sleeping.
  • A narrow band of pain around your abdomen or chest that can move towards your lower back, buttocks or legs.
  • Pain that moves down your arms or legs.
  • Weakness in your arms or legs, or difficulty standing or walking. You might feel unsteady on your feet or feel as if your legs are giving way. Some people say they feel clumsy.
  • Numbness or tingling in your legs, arms, fingers, toes, buttocks, stomach area or chest, that doesnt go away.
  • Problems controlling your bladder or bowel. You might not be able to empty your bladder or bowel, or you might have no control over emptying them.

Dont wait

Read more about metastatic spinal cord compression .

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When To See Your Doctor

If you see blood or what may be blood in your urine, you should see your provider as soon as possible to figure out the cause.

And if you also experience any of the below symptoms, it is particularly important that you seek medical attention right away. This may mean a visit to your local emergency room, if you are unable to see your regular provider on short notice.

These symptoms include:

  • Large amounts of bright-red blood in the urine, especially if you are on blood-thinning medications

  • Peeing a lot more or a lot less than usual

  • Not peeing for more than 24 hours

  • Inability to empty your bladder

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Radiation Cystitis Causing Hematuria

Less common but challenging to treat is what we call radiation cystitis. This occurs in 1-2% of men after radiation treatment to the pelvis all the prostate. The bladder and the prostate become friable and bleed easily. Hematuria as a result of radiation cystitis typically occurs many years after treatment. A number of treatment options available, including fulguration, intravesical instillations, medical treatment. Hyperbaric oxygen treatment has been shown to be beneficial for men with persistent intermittent hematuria.

If you experience blood in urine before, after, or during treatment for prostate cancer, urological evaluation should be sought.

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What You Can Do

Its important that you learn all you can about advanced prostate cancer so you can make informed decisions. Be open with your doctors and others on your healthcare team. Express your concerns and feel free to advocate for yourself and your quality of life. Get another medical opinion if you feel its necessary.

Some complementary therapies may prove helpful in coping with advanced cancer. For example:

  • tai chi, yoga, or other movement therapy
  • meditation, breathing exercises, or other relaxation techniques

A variety of services can help you with everything from lodging while youre getting treatment to getting some help around the house. Communicating with online or in-person groups are a good way to share information and lend mutual support.

What Causes Blood In The Urine

Urine test for prostate cancer?

There are several possible causes for this symptom, explains Memorial Sloan Kettering Cancer Center surgeon and urologic cancer specialist Eugene Pietzak.

  • Urinary tract infections. UTIs are more common in women than men, explains Dr. Pietzak, because a womans urethra is shorter than a mans. This makes it easier for bacteria to get into the bladder or kidney. Occasionally, a UTI can cause an increase of white blood cells in the urine, a condition known as pyuria. This can cause the urine to appear cloudy, but it is not what most people think of as blood in the urine.
  • Bladder or kidney stones. Solid masses that form from chemicals in the urine might scrape the lining of the bladder or kidney and damage blood vessels, causing them to leak.
  • Cancer of the bladder, kidney, or prostate. A tumormay grow, and the blood vessels within it become fragile so that they rupture and bleed, Dr. Pietzak says. Ive heard people tell vivid stories of having normal urine and then suddenly it becomes completely red.
  • Often, the person has had no other symptoms before the blood appears. The most likely cancer is bladder cancer, although the blood also could be a sign or kidney cancer or prostate cancer.
  • Blood in the urine is more likely to be cancer in men than in women, mainly because men develop bladder cancer at a much higher rate about four times as much than women. Unfortunately, this often leads women to dismiss this cancer warning sign when the disease is at an early stage.

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Why Is There Blood In My Urine

Theres no doubt: Seeing blood in your urine can be scary! This condition, called hematuria, is fairly common and has many possible causes. If medical intervention is required, the treatment will depend on the underlying cause of the condition.

Gross hematuria describes blood in the urine you can see with the naked eye. Microscopic hematuria, on the other hand, describes blood in the urine only visible under a microscope. Both types of hematuria should be investigated to understand their root cause.

At Urological Associates in Charlottesville, Virginia, our team of providers is dedicated to helping the men and women of Central Virginia feel their best and experience optimal urological health. As part of our comprehensive line of urological services, we specialize in diagnosing and treating the many causes of hematuria.

Our team of experts has curated this guide to help you understand the common causes of blood in the urine and when you should seek help.

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Gross Hematuria In Patients With Prostate Cancer: Etiology And Management

Ofer N. Gofrit

1Department of Urology, Hadassah Hebrew University Hospital, P.O. Box 12000, Jerusalem 91120, Israel

2Department of Pathology, Hadassah Hebrew University Hospital, P.O. Box 12000, Jerusalem 91120, Israel

3Department of Urology, University of Montreal Hospital Center , 1560 Sherbrooke E, Montreal, Quebec, Canada


The objective of the study is to assess the etiology and prognosis of gross hematuria in patients with carcinoma of the prostate . From 1991 to 2011, 81 men with CAP were hospitalized with GH. Primary treatment of CAP was radical surgery in 13 patients and nonsurgical therapy in 68 , mostly radiotherapy and hormonal treatment . The common etiologies of GH in group 1 were bladder cancer and urinary infection . In contrast, CAP itself caused GH in 60% of the patients in group 2. Thirty-nine patients required transurethral surgery to manage GH which was effective in all cases nevertheless, the prognosis of group 2 patients was dismal with median overall survival of 13 months after sustaining hematuria, compared to 50 months in group 1 . We conclude that the etiology of GH in patients with CAP varies according to primary treatment. After radical prostatectomy, it is habitually caused by bladder cancer or infection. When the primary treatment is not surgical, GH is most commonly due to CAP itself. Although surgical intervention is effective in alleviating hematuria of these patients, their prognosis is dismal.

1. Introduction

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What Tests Find Causes For Blood In The Urine

Your urologist will likely examine your upper urinary tract using a scan with dye that gives images from your kidneys to your bladder. This can check for stones, tumors or other abnormalities.

He or she will check the lower urinary tract with a scope that looks at the bladder, prostate and urethra. Your doctor also may perform other tests, such as a test for prostate cancer, as needed.

Sometimes doctors find that hematuria shows up in routine testing. A sample taken during an annual physical may find blood that isnt visible. When this happens, your doctor will send the sample to a lab to check for red blood cells.

Dr. Abouassaly stresses the importance of getting in to see your physician if you see even a trace of blood in your urine.

Cancers can bleed just one time and not again, he says. If you have doubts, a quick visit to your primary care provider can sort it out.

Bph Treatment After Radiation Therapy For Prostate Cancer: 73

Prostate Cancer

SL is a 63-year-old man with a diagnosis of prostate cancer treated with external beam radiation therapy with IMRT 2 years ago.

He complains of a slow urine stream, a need to urinate frequently and urge to urinate. He was previously treated with multiple medications including Rapaflo, tamsulosin, and Myrbetriq without significant benefit. He was advised TURP . He is hesitant to have TURP and wants to explore alternatives.

AUA symptom score of 19.

A thorough evaluation was performed which included bladder and prostate ultrasound, uroflow measurement, and bladder post-void residual urine volume measurement. The patient was found to have a large prostate, 73 ml peak urinary flow of 6 ml/sec, and a mean flow of 3 ml/sec. He had an elevated post-void residual of 186 ml.

Cystoscopyrevealed lateral lobe hypertrophy of the prostate and a small but obstructive median lobe Urodynamic studies revealed very high-pressure voiding and small bladder capacity.

The patient decided to undergo a Urolift procedure.

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Diagnosis Of Enlarged Prostate Gland And Urinary Problems

If you are troubled by urination problems, see a doctor no matter what your age. If your doctor agrees that your symptoms need further evaluation and treatment, you may need to undergo a few tests.These may include:

  • general examination medical history and review of any health conditions including obesity, diabetes, obstructive sleep apnoea, depression and erectile dysfunction. A rectal examination may be done to check the size and shape of your prostate gland
  • a urine check to ensure the prostate is not infected
  • a flow-rate check to estimate the speed with which you pass urine
  • an ultrasound examination to assess if the bladder is emptying completely and to examine your kidneys
  • urodynamics a series of tests on the bladder to see how your urinary system is functioning may be recommended in some circumstances.

Blood In Urine After Prostate Cancer Treatment: What You Need To Know

There are a number of reasons men with prostate cancer develop bleeding in urine. Hematuria can occur in patients with newly diagnosed prostate cancer as a result of cancer overgrowth that causes symptoms such as a urinary infection or difficulty voiding. More commonly, blood in the urine can occur during radiation treatment for prostate cancer.

Bleeding from Prostate

A small amount of bloody urine can be expected after a prostate biopsy that is performed to diagnose prostate cancer. In addition, blood in urine is expected after surgery for prostate cancer. Typically the amount of blood should be small and should resolve within a week after surgery. However, you might see a small amount of blood in urine on and off for a few weeks after surgery.

Blood in the urine can also be expected after radiation brachytherapy for prostate cancer. One may also experience blood in urine after external beam radiation to the prostate, such as IMRT.

After radiation therapy, blood in urine typically starts within a few weeks after treatment initiation it is usually minor and intermittent and resolves within the first few months after radiation therapy. In patients at risk, such as smokers and the elderly, a full evaluation should be performed. Persistent bloody urine after radiation therapy should be fully evaluated due to increased risk of bladder cancer in men with prostate cancer as well as increased risk of secondary bladder cancer after radiation therapy.

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Transurethral Electro Resection Of The Prostate

Removing the enlarged part of the prostate is usually the best long-term treatment for an enlarged prostate gland. The portion of the gland that is not squeezing the urethra stays in place. The outside capsule around the gland is also untouched.

Transurethral electro-resection of the prostate is the traditional way to remove prostate tissue using minimally invasive surgical techniques. No outside incision is needed. Thereâs less pain, fewer complications and faster healing.

Diagnosis Of Blood Clots In Urine

Urine Test Used To Screen For Prostate Cancer

A medical expert will order specific tests to determine the cause of the blood clot in the urine. The series of examination procedures may include urinalysis and intravenous pyelogram .

Moreover, cystoscopic examination may be performed which involves the use of a tiny camera in viewing the urethra to detect possible tumors in the urethra. Kidney x-ray may also be used in order to detect kidney abnormalities in patients especially when other tests cannot provide reliable findings.

There are other various tests like urine culture, abdominal ultrasound, and MRI, also helpful in identifying the condition of internal organs. See signs of internal bleeding.

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What Is Advanced Prostate Cancer

Prostate cancer is cancer that starts in the prostate gland. Advanced prostate cancer occurs when it has spread, or metastasized, from the prostate to other areas of the body.

Cancer spreads when cells break off from the original tumor and invade nearby tissue. This is called localized metastasis. Cancer can spread directly into nearby tissues or through the lymphatic system to distant parts of the body. When this happens, its called metastatic disease or prostate cancer with metastasis to a certain body part or organ system.

New tumors can grow in any organ, but prostate cancer is most likely to spread to the:

Stage 4 prostate cancer occurs when the prostate cancer has already spread to distant organs or tissues at the time of diagnosis. Most of the time, doctors diagnose prostate cancer at an earlier stage. Its generally a slow-growing cancer, but it can spread or it can come back, or recur, after treatment.

When cancer is confined to the prostate, many men have no symptoms. Others have trouble urinating or notice blood in their urine.

Metastatic cancer can cause generalized symptoms such as:

Other symptoms of advanced prostate cancer depend on where it has spread and how big the tumors are:

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