Prostate Cancer: Symptoms, PSA Testing, Diagnosis and Treatment
Introduction
Prostate cancer develops when abnormal cells grow in the prostate gland. Some prostate cancers grow slowly and may never cause serious health problems, while others can be more aggressive and may spread to other parts of the body.
Early prostate cancer may cause no symptoms. This is why understanding risk factors, possible symptoms, PSA testing, diagnosis and treatment options is important.
Who Is at Risk?
The risk of prostate cancer generally increases with age. Family history and certain inherited genetic changes can also increase risk.
Risk factors can help healthcare professionals decide when further assessment may be appropriate, but having one or more risk factors does not mean that a person has prostate cancer.
Possible Symptoms
Early prostate cancer often causes no symptoms.
When symptoms occur, they may include:
Difficulty starting urination
Weak or interrupted urine flow
Frequent urination, particularly at night
Difficulty emptying the bladder completely
Blood in the urine or semen
Erectile difficulties
Persistent pain in the back, hips or pelvis
These symptoms do not automatically mean prostate cancer. Benign prostate enlargement, infection and other urinary or prostate conditions can cause similar symptoms.
Persistent or concerning symptoms should be evaluated by a qualified healthcare professional.
Understanding the PSA Test
Prostate-specific antigen (PSA) is a protein produced by prostate tissue. A PSA blood test measures the amount of PSA in the blood.
A raised PSA level does not automatically mean that someone has prostate cancer.
PSA levels may also rise because of:
Benign prostatic hyperplasia (BPH)
Prostate inflammation or infection
Recent prostate procedures
Other factors affecting the prostate
There is no single PSA value that can confirm prostate cancer by itself.
If a PSA result is elevated, a healthcare professional may recommend repeating the test or performing additional investigations.
Prostate Cancer Screening
PSA screening has potential benefits and harms.
Screening may help detect some clinically important prostate cancers before symptoms develop. However, it can also produce false-positive results and lead to additional tests or biopsies.
Screening may also detect slow-growing cancers that would never have caused serious health problems during a person's lifetime. This can sometimes result in unnecessary treatment and treatment-related side effects.
The decision about PSA screening should therefore be made after discussing individual risk factors, potential benefits, possible harms and personal preferences with a healthcare professional.
How Is Prostate Cancer Diagnosed?
If prostate cancer is suspected, evaluation may involve:
Medical and family history
Physical examination
PSA testing
Digital rectal examination when appropriate
Additional blood or urine tests
Imaging such as MRI
Prostate biopsy
A prostate biopsy allows tissue samples to be examined for cancer cells and is used to confirm the diagnosis.
If cancer is found, additional information helps determine its grade, stage and likelihood of growing or spreading.
Treatment Options
Treatment depends on several factors, including the cancer's stage and grade, PSA findings, age, other health conditions and individual preferences.
Treatment options may include:
Active surveillance
Surgery
Radiation therapy
Hormone therapy
Chemotherapy
Targeted therapy
Immunotherapy
Other treatments depending on the individual situation
Active surveillance is structured medical monitoring used for selected lower-risk prostate cancers. It does not mean ignoring the cancer.
Healthcare professionals should discuss the potential benefits and side effects of each treatment option with the patient.
Possible Treatment Side Effects
Some prostate cancer treatments can affect:
Urinary control
Sexual function
Bowel function
Energy levels
Overall quality of life
The likelihood of these effects depends on the treatment and the individual's health.
Understanding potential benefits and side effects is an important part of shared decision-making.
Questions to Ask Your Healthcare Professional
Consider asking:
What does my PSA result mean?
Should the PSA test be repeated?
Do I need additional testing?
If cancer is confirmed, what are its grade and stage?
Is active surveillance appropriate for me?
What treatment options are available?
What are the benefits and risks of each option?
How could treatment affect urinary, sexual and bowel function?
Key Takeaway
Prostate cancer can behave very differently from one person to another. Some cancers grow slowly, while others require prompt treatment.
Urinary symptoms or an elevated PSA level alone cannot confirm prostate cancer. Appropriate medical evaluation and, when necessary, further testing are required.
Do not rely on supplements or unproven remedies to diagnose, prevent or treat prostate cancer. Discuss symptoms, screening decisions and treatment options with qualified healthcare professionals.
References
National Cancer Institute (NCI). Prostate-Specific Antigen (PSA) Test.
National Cancer Institute (NCI). Prostate Cancer Screening.
National Cancer Institute (NCI). Prostate Cancer Treatment.
About the Author
Uche Flora Okonkwo, MPH, is the founder and writer of Wellness by Flora. She holds a Master of Public Health in Community Health and develops practical, evidence-informed health education to help readers make informed decisions.
Medical Disclaimer
This article provides general educational information. It is not a diagnosis or a substitute for individualized advice from a qualified healthcare professional. Do not stop or change prescribed treatment because of information on this website.
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