Management Of Prostate Cancer Pain
The same study reveals that pain has a major impact on numerous dimensions of patients quality of life. Patients with poorly controlled pain experience significant physical effects, such as decreased strength, limited mobility, and difficulty sleeping. In terms of psychological effects, patients with pain have increases in fear, anxiety, and depression and a decrease in their overall enjoyment of life. Socially, pain has an effect on the patients ability to form and maintain relationships with others and also places an increased burden on caregivers. However, there are treatment options for the management of pain in patients with prostate cancer.
Pharmacologic management of pain usually start with nonsteroidal anti-inflammatory drugs , and opioid analgesics, while step-two drugs include codeine, dihydrocodeine, hydrocodone, oxycodone, and propoxyphene. Step-three drugs are usually opioids like morphine, hydromorphone, oxycodone, and fentanyl. For a small percentage of people who cant take oral medication, transdermal fentanyl or rectal morphine suppositories are also options. Adjuvant medication may be used to increase the efficacy of opioids or to treat pain of a different etiology, and it includes tricyclic antidepressants, anticonvulsants and corticosteroids. Local therapy may consist of palliative radiation, multimodal chemotherapy or physical therapy, while systemic therapies refers to the use of bisphosphonates.
Do You Live In Fear Of Prostate Cancer Every Time Your Hip Bone Area Begins Aching As You Imagine That This Is A Metastasis From A Tumor In Your Prostate
Every prostate cancer is unique, says Michael Herman, MD, Director of Urologic Oncology at South Nassau Communities Hospital in Oceanside, NY.
Occasionally, there are aggressive prostate cancers that spread to the bones early , but the majority of prostate cancers take years to spread to the bones, if in fact they ever do, continues Dr. Herman.
In most cases of these metastases, the first area is actually the bones including the hip.
Luckily, many prostate cancers are not aggressive, and if men are diagnosed with these types of prostate cancer, they typically die with the disease, not because of the disease.
The important thing is to distinguish between these non-aggressive, or indolent, prostate cancers, and the more aggressive types.
As of now, the only way to know whether or not you have an aggressive or indolent prostate cancer is to go to a urologist and get screened for prostate cancer.
If it turns out that you are at risk for aggressive prostate cancer, a prostate biopsy may be necessary.
If youre having hip pain but have not been diagnosed with prostate cancer, chances are exceedingly high that your hurting hip is musculoskeletal in origin or reacting to pressure applied to it such as from a tight seatbelt.
Prostate cancer metastases to the spine, pelvis and femur. Wan-Hsiu Liao, Sheng-Hsiang Lin and Tsu-Tuan Wu, CC BY-SA 2.0/creativecommons.org/licenses/by-sa/2.0/Wikimedia Commons
When To See A Doctor
Consult with your doctor if you experience any of the symptoms discussed on this page particularly if they have been going on for a while. You will need a thorough work-up to determine the underlying cause, which may or may not be prostate cancer.
Its important to understand that other diseases or disorders can share these same symptoms. Benign prostatic hyperplasia , also called enlargement of the prostate, and are quite common. Men with these benign conditions can experience symptoms more often and more severely than men with prostate cancer.
Erectile dysfunction is relatively common, especially as one ages, and can also have causes unrelated to prostate cancer, such as smoking or cardiovascular disease. Experiencing a lower amount of fluid during ejaculation can be related to something as simple as diet or dehydration.
Its important to keep track of your symptoms, determining whats normal or abnormal for your own body. If you are worried about a particular symptom, or if its interfering with a relationship, you should discuss your concerns with your primary care physician.
Prostate Cancer | Bills Story
After being diagnosed with prostate cancer, Bill Shipp, a championship swimmer, came to The Johns Hopkins Hospital seeking a second opinion. Watch his story.
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What Are The Complications Of Prostatitis
Men with acute bacterial prostatitis may develop . This widespread inflammation can be life-threatening. It requires immediate medical treatment.
Antibiotics can cause an upset stomach. Men with chronic bacterial prostatitis may need lots of antibiotics to treat recurring infections. Some people develop antibiotic resistance, making treatment ineffective.
Asymptomatic inflammatory prostatitis can lower sperm count, affecting fertility.
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How Is Prostate Cancer Diagnosed
Screenings are the most effective way to catch prostate cancer early. If you are at average cancer risk, youll probably have your first prostate screening at age 55. Your healthcare provider may start testing earlier if you have a family history of the disease or are Black. Screening is generally stopped after age 70, but may be continued in certain circumstances.
Screening tests for prostate cancer include:
- Digital rectal exam: Your provider inserts a gloved, lubricated finger into the rectum and feels the prostate gland, which sits in front of the rectum. Bumps or hard areas could indicate cancer.
- Prostate-specific antigen blood test: The prostate gland makes a protein called protein-specific antigen . Elevated PSA levels may indicate cancer. Levels also rise if you have BPH or prostatitis.
- Biopsy: A needle biopsy to sample tissue for cancer cells is the only sure way to diagnose prostate cancer. During an MRI-guided prostate biopsy, magnetic resonance imaging technology provides detailed images of the prostate.
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How Will Your Doctor Diagnose A Prostate Infection
A prostate infection diagnosis is based on your medical history, a physical exam, and medical tests. Your doctor can also rule out other serious conditions such as prostate cancer during the exam. During a physical exam, your doctor will conduct a digital rectal exam to test your prostate and will look for:
- enlarged or tender lymph nodes in the groin
- swollen or tender scrotum
Your doctor may also ask about your symptoms, recent UTIs, and medications or supplements youre taking. Other medical tests that can help your diagnosis and treatment plan include:
- urinalysis or semen analysis, to look for infections
- a prostate biopsy or a blood test for prostate-specific antigen
- urodynamic tests, to see how your bladder and urethra store urine
- cystoscopy, to look inside the urethra and bladder for blockage
Your doctor may also order an ultrasound to get a closer look. The cause will help determine the correct course of treatment.
What Are The Symptoms Of Prostate Cancer
Early-stage prostate cancer rarely causes symptoms. These problems may occur as the disease progresses:
- Frequent, sometimes urgent, need to urinate, especially at night.
- Weak urine flow or flow that starts and stops.
- Painful urination .
- Painful ejaculation and erectile dysfunction .
- Blood in semen or urine.
- Lower back pain, hip pain and chest pain.
- Leg or feet numbness.
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Other Professionals Who Can Help
Your doctor, nurse or GP can refer you to these professionals.
- Physiotherapists can help with mobility and provide exercises to help improve fitness or ease pain. This can help you stay independent for longer.
- Counsellors, psychologists or psychotherapists can help you and your family work through any difficult feelings and find ways of coping. Many hospitals have counsellors or psychologists who specialise in helping people with cancer. You can also get free counselling on the NHS without a referral from your GP. Visit nhs.uk/counselling to find out more.
- Dietitians can give you advice about healthy eating, which might help with fatigue and staying a healthy weight. They can also help if you are losing weight or having problems eating.
- Occupational therapists can provide advice and access to equipment and adaptations to help with daily life. For example, help with dressing, eating, bathing or using the stairs.
- Social services, including social workers, can provide practical and financial advice and access to emotional support. They can give you advice about practical issues such as arranging for someone to support you at home. Whats available varies from place to place. Your GP, hospital doctor or nurse might be able to refer you to some services. The telephone number for your local social service department will be in the phonebook under the name of your local authority, on their website and at the town hall.
Metastatic Spinal Cord Compression
Metastatic spinal cord compression happens when cancer cells that have spread from the prostate 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, go to the toilet, or lie down. 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 or loss of control of 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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Radiotherapy To The Prostate
Some men who have just been diagnosed with advanced prostate cancer may be offered external beam radiotherapy as part of their first treatment. This is where high-energy X-ray beams are directed at the prostate from outside the body. The X-ray beams damage the cancer cells and stop them from dividing and growing. Read more about radiotherapy for advanced prostate cancer.
Radiotherapy to the prostate isnt suitable for all men with advanced prostate cancer. If it isnt suitable for you, you might be offered a type of radiotherapy to help manage symptoms instead.
What Is The Prostate Gland
The prostate is a gland about the size of a walnut. It is part of the male reproductive system and wraps around the tube that carries urine out of the bladder. It grows larger as you get older. If your prostate gets too large, it can cause health issues. Having prostate problems does not always mean you have cancer.
Sometimes a doctor may find a problem during a routine checkup or by doing a rectal exam. If you think there is something wrong with your prostate, see your doctor right away.
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Prostate Cancer Treatment: Radiation Therapy
Radiation, focused as a beam, can be used to kill cancer cells, especially those cells that have migrated from the prostate gland. Beams of radiation can be used to reduce bone pain caused by invasive cancer cells.
Low Dose Rate Brachytherapy
In another type of radiation therapy termed low dose rate brachytherapy, radioactive pellets about the size of a grain of rice are inserted into the prostate.
High Dose Rate Brachytherapy
High dose rate brachytherapy applies more radioactive sources temporarily into the cancerous prostate gland.
What Does Bone Cancer In The Hip Feel Like
Bone cancers are malignant tumors that arise in the bone due to the abnormal growth of bone cells in the body. The most common symptom of bone cancer in the hip is hip pain, which can be severe enough to disrupt sleep and daily activities. The bones involved can weaken, resulting in fractures caused by trivial trauma. Sometimes, swelling or a mass may be felt in the hip in absence of any history of trauma to the body pain.
Cancers that originate in the hip bones are primary bone cancers. In general, the primary bone tumors of the hip are rare. Chondrosarcoma is the most common primary tumor of the bone. Most tumors seen in the hip bone are secondary tumors. This means cancer from other body parts has spread to the bones.
A type of cancer can also originate in the spongy part of the hip bone . These are blood cancers , which manifest as throbbing hip pains, hip fractures, fevers, night chills, kidney failure, bleeding, etc. Other cancers that may develop in the hip include osteosarcoma, chondrosarcoma, Ewing sarcoma and soft tissue sarcomas.
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What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- What type of prostatitis do I have?
- What is the best treatment for this type of prostatitis?
- What are the treatment risks and side effects?
- How can I avoid getting prostatitis again?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostatitis is a common problem that affects many men. Unfortunately, theres a lot of confusion about the disease. People use the word prostatitis to describe four different conditions. There isnt a one-size-fits-all treatment for prostatitis, which is why an accurate diagnosis is so important.
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What Questions Should I Ask My Healthcare Provider
If you have prostate cancer, you may want to ask your healthcare provider:
- Why did I get prostate cancer?
- What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
- Has the cancer spread outside of the prostate gland?
- What is the best treatment for the stage of prostate cancer I have?
- If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
- What are the treatment risks and side effects?
- Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.
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Short Term Side Effects
Patients who receive any type of radiation therapy to treat their prostate cancer can have side effects. Short term side effects are ones that start during or shortly after your radiation treatment. Below is a list of possible short term side effects. Treatments can affect each patient differently, and you may not have these particular side effects. Talk with your care team about what you can expect from your treatment
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Urinating Frequently During The Day
It may be more difficult to notice a change in frequency during the day than at night. Most of us dont go around counting how many times we use the washroom in a given day!
Besides, whats normal, anyway?
Normal urination during the day is considered to be within a range offour to seven times for most healthy adult men. If youre going more often than this, it could indicate a prostate issue.
It can be easy to miss this sign. Drinking more water or caffeinated beverages than usual can be an easy explanation for a few extra trips.
Even a night out for dinner with a few more glasses of beer than usual can cause several extra trips to the bathroom because alcohol is a diuretic, meaning it triggers anincrease in urine production.
But like your nighttime routine, if you notice an ongoing pattern of having to go more often during the day, ask your doctor about it. A simple blood test and rectal examination is often the first diagnostic step, which is quick and painless.
Health And Social Care Professionals You Might See
You might see a range of different professionals to help manage your symptoms and offer emotional and practical support. Some may have been treating you since your diagnosis. Others provide specific services or specialise in providing treatment to manage symptoms .
If you have questions or concerns at any time, speak to someone in your medical team. They can explain your diagnosis, treatment and side effects, listen to your concerns, and help you get support.
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