Prostate cancer symptoms: signs many men ignore until the advanced stages

• The Dominican Republic has the highest incidence of prostate cancer in Central America and the Caribbean, a disease that usually advances without symptoms in its early stages.

Talking about prostate cancer symptoms is still uncomfortable for many men, especially because the disease tends to advance silently. The problem is that, by the time the clearest signs appear, the cancer may already be at an advanced stage.

In the Dominican Republic, the picture is worrying. The incidence of prostate cancer is the highest in Central America and the Caribbean, and ranks 37th worldwide, according to figures cited by the Central American and Caribbean Federation of Pharmaceutical Laboratories (FEDEFARMA). The Global Cancer Observatory (GLOBOCAN) also records around 4,918 new cases and 2,120 deaths a year in the country.

“Although it is one of the most common cancers in men, prostate cancer can be treated with better chances of success when it is caught early. The problem is that many people do not seek medical attention until the symptoms are more obvious,” explains Dr Dror Michaelson, director of the Hematology and Oncology Fellowship Programme at Massachusetts General Hospital.

What prostate cancer symptoms look like

Prostate cancer develops in the prostate gland, a small organ of the male reproductive system responsible for producing part of the seminal fluid. One of the main challenges is that, in its early stages, it may cause no discomfort at all. That is why many people do not know they have the disease until the more noticeable symptoms begin.

The most frequent prostate cancer symptoms in the advanced stages include:

• Difficulty urinating
• A weaker urine flow
• Blood in the urine or semen
• Unexplained weight loss
• Bone pain
• Erectile dysfunction

These symptoms do not always mean cancer, but they are signs that should be assessed by a doctor.

What the first symptoms of prostate cancer are

One of the biggest problems is that the first changes are often mistaken for urinary discomfort associated with ageing. Some people start to notice that it takes longer to urinate, that the flow is weaker or that they need to get up several times a night to go to the bathroom. Although these changes can be linked to other prostate conditions, they can also be an early sign of cancer, so they should not be treated as normal or ignored.

“Waiting for symptoms to get worse can delay diagnosis and narrow the options for timely treatment,” explains the specialist from Mass General Brigham, a healthcare system that brings together the best minds in medicine to improve the lives of patients around the world.

Factors that raise the risk

“Age and family history are the main risk factors. Men over 50 are more likely to develop this disease, especially if there is a history in close relatives such as a father, grandfather or uncles,” says Dr Dror Michaelson.

Other factors can play a part too, such as an unhealthy diet, a sedentary lifestyle, excess weight and environmental factors.  “Improving general health can help reduce the risk. Staying physically active, keeping weight under control and following a balanced diet are measures that support not only prostate health but overall wellbeing,” says the specialist from Massachusetts General Hospital.

The PSA prostate test: the most widely used

The main detection method today is the PSA prostate test, a blood test that measures levels of prostate-specific antigen. A raised PSA does not necessarily mean cancer, but it does indicate that further tests may be needed.

Based on that result, the doctor may recommend repeating the test after a few months, performing an MRI scan, carrying out a prostate ultrasound or requesting a biopsy. The primary care doctor usually starts this process and, where necessary, refers the patient to a urologist.

Prostate cancer detection methods

Detection methods should be assessed case by case, taking into account age, family history and general state of health. In people at higher risk, testing can begin before the age of 50.

Talking to your doctor about family history is especially important, since it can change the screening recommendations.

Catching the cancer at an early stage also widens the treatment options considerably and improves the outlook.

What treatments are available today

Treatment for prostate cancer depends on how advanced it is and how aggressive it is. To determine that, specialists use the Gleason system, which helps assess how quickly the tumour might grow or spread. The treatment options include:

• Radiotherapy
• Surgery
• Chemotherapy

In some cases, when the cancer grows slowly, the doctor may opt for active surveillance before starting more invasive treatments.

Why the signs should not be ignored

Recognising prostate cancer symptoms and seeing a doctor at any urinary change can make a significant difference. The problem is that many men put off check-ups out of fear, misinformation or because they consider certain symptoms a normal part of ageing.

Acting early, however, remains one of the most important tools for facing this disease.

“Although prostate cancer can advance silently, catching it in time considerably increases the chances of controlling it and treating it successfully,” the specialist concludes.

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About Mass General Brigham

Mass General Brigham is a healthcare system that brings together the best minds in medicine to improve the lives of patients around the world. The system is made up of 16 hospitals, including 5 ranked among the best in the country by US News & World Report: Massachusetts General Hospital, Brigham and Women’s Hospital, Mass Eye and Ear, McLean Hospital and Spaulding Rehabilitation; along with community and specialist care centres, health insurance plans, physician networks, home care and long-term care services.

Mass General Brigham is a non-profit organisation committed to patient care, teaching and research. With an annual budget of almost 2 billion dollars, Mass General Brigham’s research programme is one of the largest in the United States, funding more than 2,700 clinical trials. It is also one of the country’s leading biomedical research organisations and the principal teaching affiliate of Harvard Medical School.

For more information about Mass General Brigham, visit massgeneralbrigham.org/international