The (early) symptoms of prostate cancer

Prostate cancer is the most common cancer in men. It causes more than 8,000 deaths, or about 1 death every hour. Pain, fatigue… How to spot it? At the advanced stage?

the Prostate cancer is cancer the more common in men with about 50,000 new cases discovered each year in France. He is responsible for more than 8000 deaths, that is 1 death every hour. On the occasion of Movember which promotes prostate cancer screening every November, we take stock of the signs that may or may not alert you to prostate cancerwhether at beginning disease or a more advanced stagewith Dr Natacha Naoun, oncologist specializing in Genito-Urinary oncology at Gustave Roussy.

What are the first signs of prostate cancer?

“Most of the time, prostate cancer does not give symptoms, it is said to be asymptomatic, Dr. Natacha Naoun immediately replies. The symptoms which can lead to the fortuitous identification, when there are any, can be urinary signs with difficulty urinating and/or bleedingand digestive signs as the back of the prostate is close to the rectum but all this is extremely rare when the cancer is localized. Generally, the man discovers it during a balance sheet for urinary disorders or by the PSA assay (prostate specific antigen)”

Diagram of prostate cancer © blueringmedia – stock.adobe.com / Journal des Femmes

Is prostate cancer responsible for urinary disorders?

The prostate is located below the bladder, hence the fact that a problem with the prostate can manifest as urinary dysfunction (frequent urination, feeling unable to empty the bladder, difficulty urinating…) but it is not necessarily a sign of cancer. The prostate is a gland that tends to degenerate into hypertrophy with ageit is a phenomenon normal and progressive which can be accompanied by an increase in its volume which is called “adenoma” or benign prostatic hyperplasia, explains Dr. Naoun.

Prostate adenoma does not mean cancer.

The adenoma is what gives the most symptoms, including urinary symptoms. The adenoma is benign and not related to cancer. In case of urinary disorders, it is advisable to consult the urologist or the attending physician to see if there is an adenoma. “On this occasion, prostate cancer can be found via the PSA assay or on tissue analysis when the adenoma is removed to relieve urinary disorders (but this is not systematic, adenoma does not mean cancer, editor’s note)” says Dr. Naoun.

Can prostate cancer cause physical symptoms?

“Most of the time, none. The person feels good” responds our interlocutor. When there are physical symptoms “they are most often linked to prostate adenoma which can lead to the discovery of cancer but it is not he who causes it”. A advanced disease can cause physical symptoms “but they are not specific to prostate cancer and can be seen in other cancers.”

“Advanced disease may manifest as bone pain”

What are the symptoms of advanced prostate cancer?

About 10% of prostate cancers are metastatic from the outset that is, when they are discovered. People who have localized forms of cancer can also progress to metastatic forms.The primary site of prostate cancer metastasis is the bonesadvanced disease may manifest as bone pain” explains the oncologist. The man can also present a deterioration in general condition, fatigue, weight loss, loss of appetite “but these signs of metastatic disease are not specific for prostate cancer. It may be metastases from other cancers since prostate cancer occurs at an age when the risk of cancer is already greater.” she continues.

Does prostate cancer cause pain?

“There is no pain specific to prostate cancer” answers Dr. Naoun. If pain does not pass, consult the attending physician to discuss it. At advanced stagethere may be painsnotably bone as bone is the main site of metastatic spread of prostate cancer.

At what age does prostate cancer occur?

“The average age of onset of prostate cancer is around 68 years old, in any case beyond the age of 65. There are also some early forms in subjects of African and Afro-Caribbean origin, and when there is a history of prostate cancer in the family, especially if the related have fallen sick younganswers Dr. Naoun.

When to consult your doctor?

“You should not rely on the symptoms to talk to the doctor but anticipate” recommends Dr. Naoun. It is therefore advisable for all men to discuss with their attending physician a possible screening for prostate cancer at 50 years “even earlier, around 40-45 years old, depending on their ethnic origins (African/Afro-Caribbean) and family background”. It is important to inform the doctor, during this consultation, of cases of cancer of the prostate, but also of the breast, the ovary or the pancreas in the family. “In the context of mutations that can be hereditary, we can find cases grouped in the family” says our interlocutor. There is no organized screening for prostate cancer (as it exists for breast cancer in women, editor’s note) because “We are not sure that early diagnosis is relevant. There is debate. For subjects of a certain age in whom a PSA has been done, there is a risk of over-treating them and of worsening their overall state of health for a cancer which would probably not have taken them away, so screening is done on a case-by-case basis. ” explains our interlocutor. In case of doubt, the doctor will ask for a dosage of the PSA.

An elevated PSA level is not 100% indicative of prostate cancer.

“PSA is the specific antigen of the prostate, it is a blood marker of prostate cancer but its increase does not mean in 100% of cases that there is cancer. It can also increase in the event of prostatitis (inflammation or infection of the prostate, editor’s note), warns the oncologist. SIf it is high on a first dosage, we will check it again. Other examinations may be carried out depending on the results: digital rectal examination, prostate MRI or even prostate biopsies.

Can a woman have symptoms of prostate cancer?

Nope, a woman cannot have symptoms of prostate cancer since she does not have a prostate. “The prostate is a gland that exists only in men and is part of the male reproductive system” recalls Dr. Naoun. There is therefore no prostate cancer in women.

Thanks to Dr Natacha Naoun, oncologist specializing in Genito-Urinary oncology at Gustave Roussy.

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