What Are The Signs & Symptoms Of Prostate Cancer
Prostate cancer symptoms do not usually manifest themselves in the early stages of the disease. Less than five percent of men with prostate cancer show early urinary symptoms. The condition has usually progressed to later stages when prostate cancer symptoms do arise.
Some men may experience symptoms that can indicate the presence of prostate cancer. Others may find out during a routine check-up, a blood test, or a rectal exam with their doctor. Because the symptoms of prostate cancer are similar to other symptoms patients, will need to go through further testing to determine whether they actually have prostate cancer.
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.
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:
- adrenal gland
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:
- weight loss
Other symptoms of advanced prostate cancer depend on where it has spread and how big the tumors are:
Advanced Prostate Cancer Symptoms
Men with advanced prostate cancer may experience additional symptoms. Thats because the cancer has spread from the prostate to other parts of the body, such as the bones or lymph nodes.
A wide range of treatment options are available for managing advanced cancer. These treatments kill cancer cells, but they may also help patients manage pain.
Signs of metastatic prostate cancer may include:
- Swelling in legs or pelvic area
- Numbness or pain in the hips, legs or feet
- Bone pain that persists or leads to fractures
Blood In Urine Experienced As Symptom Of Prostate Cancer
Depending on the stage of the disease, patients with prostate cancer may experience symptoms related to urinary problems, including a slow or weak urinary stream or the need to urinate frequently , erectile dysfunction, pain in the hips, back, chest, or other areas from cancer that has spread to bones, weakness or numbness in the legs or feet. Blood in the urine or semen also is a symptom.
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.
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How Is Benign Prostatic Hyperplasia Treated
Treatment options for benign prostatic hyperplasia may include
- lifestyle changes
- minimally invasive procedures
A health care provider treats benign prostatic hyperplasia based on the severity of symptoms, how much the symptoms affect a mans daily life, and a mans preferences.
Men may not need treatment for a mildly enlarged prostate unless their symptoms are bothersome and affecting their quality of life. In these cases, instead of treatment, a urologist may recommend regular checkups. If benign prostatic hyperplasia symptoms become bothersome or present a health risk, a urologist most often recommends treatment.
Talking With Your Doctor
Different kinds of doctors and other health care professionals manage prostate health. They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:
- Family doctors and internists
- Physician assistants and nurse practitioners
- Urologists, who are experts in diseases of the urinary tract system and the male reproductive system
- Urologic oncologists, who are experts in treating cancers of the urinary system and the male reproductive system
- Radiation oncologists, who use radiation therapy to treat cancer
- Medical oncologists, who treat cancer with medications such as hormone treatments and chemotherapy
- Pathologists, who identify diseases by studying cells and tissues under a microscope
View these professionals as your partnersâexpert advisors and helpers in your health care. Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect.
- By Patrick J. Skerrett, Former Executive Editor, Harvard Health
When it comes to prostate trouble, the lions share of attention goes to prostate cancer and an enlarged prostate. A third condition, prostatitis, flies under the radar even though it affects up to one in six men at some point in their lifetimes. It triggers more than two million visits to doctors and untold agony each year.
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Who Is More Likely To Develop Hematuria
People who are more likely to develop hematuria may
- have an enlarged prostate
- take certain medications, including blood thinners, aspirin and other pain relievers, and antibiotics
- do strenuous exercise, such as long-distance running
- have a bacterial or viral infection, such as streptococcus or hepatitis
- have a family history of kidney disease
- have a disease or condition that affects one or more organs
Metastatic Spinal Cord Compression
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.
It is very important to seek medical advice immediately if you think you might have MSCC.
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Medication For Urinary Problems
Your doctor may suggest various medications to help ease your urinary problems, including:
- medications to reduce the tone of the muscles of the urethra and prostate to minimise any constriction to urine flow caused when these muscles contract
- medication to reduce the size of the prostate gland. These medications work by blocking the action of male hormones produced by the prostate gland
- medications to relax the bladder, making unwanted contractions less likely and reducing the symptoms of urgency and frequency of urination
- the over-the-counter preparation âsaw palmettoâ is sometimes used. This may help some men, especially if frequent urination at night is a problem.
However, recent reviews of the evidence for using saw palmetto as a treatment for mild or moderate urinary symptoms did not show any improvement, compared to no treatment, in men with BPH.
Questions You May Want To Consider Asking Your Doctor Include:
- What type of prostate problem do I have?
- Is more testing needed and what will it tell me?
- If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
- What type of treatment do you recommend for my prostate problem?
- For men like me, has this treatment worked?
- How soon would I need to start treatment and how long would it last?
- Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
- What are the side effects of the medicine?
- Are there other medicines that could interfere with this medication?
- If I need surgery, what are the benefits and risks?
- Would I have any side effects from surgery that could affect my quality of life?
- Are these side effects temporary or permanent?
- How long is recovery time after surgery?
- Will I be able to fully return to normal?
- How will this affect my sex life?
- How often should I visit the doctor to monitor my condition?
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Blood That You Cant See
Sometimes there is blood in your urine that you canât see. This is called microscopic hematuria because it is only visible under a microscope. âGuidelines state that any more than three red blood cells in a urine sample under microscope should prompt a referral to a urologist,â Dr. Bakare says. Routine urine tests can be part of annual wellness exams.
What Is Blood In Urine
Blood in the urine, also called hematuria, is due to blood cells leaking from some part of the urinary tract. This includes the kidneys, the ureters , the bladder and the urethra, which carries urine out of the body.
Blood in urine may be gross, meaning it is visible and the urine will be pink, brownish red, tea-colored, red or cloudy. It may also be microscopic, visible only under a microscopea situation that is usually discovered during a medical evaluation for some other reason or routine urine test.
Observing blood in the urine can be alarming, but it does NOT always indicate a serious condition. But because it can be a sign of a problem, a physician should always evaluate visible blood in urine. Often, treatment isnt necessary.
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How Is Advanced Prostate Cancer Diagnosed
If youve previously been diagnosed with prostate cancer, be sure to tell your doctor if you have any new symptoms, even if youve completed treatment.
To determine if prostate cancer has returned or has spread, your doctor will likely order some imaging tests, which may include:
- PET scans
- bone scans
You probably wont need all of these tests. Your doctor will choose the tests based on your symptoms and physical exam.
If any of the images reveal abnormalities, it doesnt necessarily mean that you have cancer. Additional testing may be necessary. If they find a mass, your doctor will probably order a biopsy.
For a biopsy, your doctor will use a needle to remove samples from the suspicious area. A pathologist will then analyze the removed cells under a microscope to see if theyre cancerous. The pathologist can also determine if you have an aggressive form of prostate cancer.
Causes And Symptoms Of Benign Prostatic Hyperplasia
Changes in hormones that occur through aging are what contribute to BPH. Genetics, too, can be a possible cause for BPH. The prostate continues to grow from the age of 25, but when the prostate becomes too enlarged it can cause complications in older men.
Symptoms of BPH include:
- Dribbling at end of urination
- Straining while urinating
- Control your portion size.
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When Does A Prostate Problem Need Treatment
BPH requires treatment only if the symptoms are severe enough to be troublesome to the patient, if the function of the urinary tract is seriously affected or if there are other complications, such as bleeding, kidney infections or kidney damage. An enlarged prostate by itself is not enough reason to need treatment.
How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms arenât noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
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Hematuria: Blood In The Urine
Blood in the urine should never be ignored. This could be the first sign of a serious condition. In order to help your doctor with the correct diagnosis, you may try to provide details such as:
- Was it associated with pain?
- Did you see blood clots?
- What shape did the clots have?
- The color of the blood
- At what time during urination did you see blood in the urine ?
Blood in the urine can present in one of two ways:
- Gross hematuria
When Should I Seek Medical Attention
Since some of the causes of blood in the urine are serious, you should seek medical attention the first time you see it. You shouldnt ignore even a small amount of blood in your urine.
Also see your healthcare provider if you dont see blood in your urine but experience frequent, difficult, or painful urination, abdominal pain, or kidney pain. These may all be indications of microscopic hematuria.
Seek emergency help if you cant urinate, see blood clots when you urinate, or have blood in your urine along with one or more of the following:
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What Is The Treatment For Advanced Prostate Cancer
No matter where prostate cancer spreads, its still treated as prostate cancer. Its harder to treat when it reaches an advanced stage.
Treatment for advanced prostate cancer involves targeted and systemic therapies. Most men need a combination of treatments and they may have to be adjusted from time to time.
What Causes Small Blood Clots In Urine
Urinary tract infections, kidney stones, and prostate problems are common causes of small blood clots, which can sometimes look like coffee grounds. If you notice blood clots in your urine even small ones you should contact your doctor. Larger blood clots can block the flow of urine and cause discomfort, and theyre often a sign of a medical emergency.
If you notice different shapes of blood clots in your urine, such as a wormlike form, it may be a sign that you are experiencing bleeding from the urethra or prostate. If the clots are painful, they might be coming from the tubes that connect your kidneys to your bladder, known as ureters.
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Is Blood In Your Urine A Reason To Be Concerned
If you notice blood in your urine, don’t ignore it. There are many possible causes of this condition, known as hematuria. While some are simply treated and not dangerous, others may need immediate medical attention.
Not all hematuria can be seen with the human eye. In fact, the most common type of hematuria-called microscopic hematuria-can only been seen by a health care expert under a microscope. In many cases, microscopic hematuria is spotted when a person has a urine test during a health exam.
When a person can see the blood in his or her urine, the condition is called gross hematuria. People with gross hematuria have urine that is pink, red or brown.
“There’s a common misconception that if you see blood in your urine once and then it goes away that you’re in the clear,” says Angela B. Smith, MD, Assistant Professor of Urology at the University of North Carolina School of Medicine in Chapel Hill. “But it’s important to seek care the very first time you see blood in the urine, so your doctor can confirm that it’s there and refer you to a urologist for an evaluation.”
In most cases, people with either type of hematuria do not have pain or any other signs or symptoms.