What are the Symptoms of Prostate Cancer

In my book, The Prostate Storm, I write at some length about my prediagnosis experience with hematuria (blood in the urine), urinary tract irritation and infections, chronic and acute prostatitis, frequency, dribbling, burning and urgency.  They're all potential signs of advanced prostate cancer, as well as BPH and prostatitis, the other two common prostate diseases. 

I had the targeted, high-dose radiation in 2008 and, interestingly, all those symptoms have disappeared.  The cancer is gone, but so is the annoying BPH and prostatitis (apparently), which was everywhere in my pathology report. As one doctor later told me, "you got a three-fer."

With that in mind, here's a look at the symptoms for prostate cancer from an excellent site on all-things-prostate, Prostate Cancer Treatment Guide:

First of all … there are no early prostate cancer symptoms. In fact, men who develop prostate cancer may never exhibit signs and symptoms of prostate cancer, even during advanced stages. The tumor associated with adenocarcinoma of the prostate or prostatic adenocarcinoma is so small, that men do not experience symptoms. The symptoms listed below occur more commonly with BPH or prostatitis.

Yale Study: Prostate cancer treatment may do more harm than good in older men

From Yale News, February 27, 2012:

Treatment is not always warranted for older men with prostate cancer and a short life expectancy, Yale School of Medicine researchers report in the Feb. 27 Archives of Internal Medicine.

“Treatment can do more harm than good in some instances,” said senior author on the study Dr. Cary Gross, associate professor of internal medicine at Yale School of Medicine.

“Among men who are older and have less aggressive forms of prostate cancer, their cancer is unlikely to progress or cause them harm in their remaining years.”

Gross and his team analyzed nine years of Medicare data and found that over the past decade, there has been a trend towards higher use of curative treatment for prostate cancer among men with certain types of tumors and a short life expectancy. The study included 39,270 patients between the ages of 67 and older.

Inherited prostate cancer gene discovered

Men who inherit the mutation in the HOXB13 gene are at 10 to 20 times more risk of developing prostate cancer, according to a study published January 12 in The New England Journal of Medicine.  Scientists say they've been looking for this gene mutation for 20 years, and hopefully it will provide insight on prostate cancer development and ultimately finding a cure.  Click here for the story.

Breakthrough—New gene screen identifies aggressive prostate cancer

Gene screens will eventually replace Gleason scores

Your Gleason score can tell you if your prostate is cancerous, but it cannot always tell you how aggressive that cancer is -- in other words, if it's likely to be lethal.  Even patients with low Gleason scores of 5 or 6 can have a dangerous and aggressive form of cancer.

When patients have low Gleason scores, doctors may suggest watchful waiting, but many still recommend some form of aggressive treatment -- such as radiation or surgery, which can result in "collateral damage" (varying degrees of incontinence and impotence) from the therapy.

What to do if diagnosed with "low risk" prostate cancer

As much as half of all diagnosed prostate cancer is low risk, meaning it's nonlethal and growing very slowly, if at all, and may be something you can live with, depending on your age and health. Yet most men, once they hear they have prostate cancer, want to get rid of it and often decide on an aggressive treatment such as surgery or radiation. As a result, they risk some potentially nasty side effects -- i.e., varying degrees of incontinence and impotence. Unfortunately, there is no single test that can clearly differentiate between low risk and high risk or aggressive prostate cancer. 

In deciding what you should do if diagnosed with prostate cancer, here is criteria that the Brady Urological Institute at John Hopkins Medicine has published on its website, in an article entitled "Active Surveillance for Prostate Cancer: What A Man Needs to Know Before Deciding on Treatment."

Guest Column: Q&A with a Radiologist on Prostate Cancer

How does radiation kill  prostate cancer cells—and leave healthy cells to recover? What is the difference between proton therapy and high-dose radiation? What is the future of radiotherapy in treating prostate cancer?

Radiologist Lisa Livingston

Radiologist Lisa Livingston tackles these and other questions, as our first guest columnist. Lisa has created the online site, Radiation Technician Schools, a good resource for radiation technicians on schools, career options, scholarship opportunities and more. Plus, you can find interesting articles on the history of the pharmaceutical industry in America, how mobile computing is changing health care delivery, and many other health care topics that interest everyone.  Check out her website and blog — and if you have additional questions about radiation and prostate cancer, send them to The Prostate Storm blog, and we’ll get them answered. (SV)

How does radiation kill cancer cells?

Radiation stops or slows the growth of cancer cells. It kills the genes (DNA) in cancer cells so that they can no longer grow and divide. Cancer cells tend to divide quickly and grow out of control, but radiation can impede this growth. It can also shrink a tumor and keep it from spreading to other parts of the body.

Radiation therapy does not always kill cancer cells immediately. Sometimes it can take days or weeks of treatment to kill cancer cells, and they may even continue to die after treatment ends. Tissues that grow quickly such as skin and bone marrow are generally affected right away, while nerve, breast, prostate and bone tissue will take longer to show affects.

The final debunking of Vitamin E: Now it raises prostate cancer risk

Vitamin E -- No longer miracle supplement for PC.

Tough week for guys trying to deal with the threat of prostate cancer:  First the PSA screen came under attack (previous post), now vitamin E.

Once believed to be a super supplement that could reduce the risk of prostate cancer, vitamin E (and selenium) were  shown to have no benefit at all several years ago. That was about the time of my diagnosis, years after I'd begun taking vitamin E.

Natually, this came as disappointing news. Since the early 2000s, men had been popping high doses of vitamin E, thinking this was an easy over-the-counter antidote to the second most deadly cancer among American men. 

I was among the poppers. Since the late '90s, I'd been besieged by urinary tract issues and an enlarged prostate, so I tried everything — including buying bottles of vitamin E at the local GNC and trying high doses, believing vitamin E was good for prostate health and would relieve my symptoms.  It didn't seem to help much. But I took vitamin E off and on for years, adding it to a cocktail of other so-called "miracle" supplements.

Interestingly, the researchers who revealed vitamin E and selenium had no benefit in 2008, continued to study the 35,000 men in the trial.  Now, three years later, they're reporting high doses of vitamin E actually increase the risk of prostate cancer.

They found an increased risk of 17 percent in men who took 400-unit capsule of vitamin E every day for about five years.  Look, that's a lot of vitamin E — about 20 times more than the recommended amount. But that wasn't unusual for guys who believed they might be preventing prostate cancer, or at least improving prostate health — like me.

Just goes to show you, if you wait long enough, all common wisdom will eventually be upended by another study.

PSA test not recommended by Task Force — but have they gone too far (again)?

The PSA test is an unreliable test that has led to serious overtreatment of prostate cancer. Few argue it's anything but a lousy screen for the second deadliest cancer among American men.

Grading cancer from 1 to 5, the least to the most aggressive

But the U.S. Preventative Services Task Force's recommendation (released next Tuesday, Oct. 11th) that the screen should no longer be given to healthy men is going way too far. (Reuters--PSA Test for prostate cancer not recommended: panel.)  Also read Prostate cancer test under fire.)

They may've over-reached in trying to protect men from the "collateral damage" of radiation and surgical treatments — i.e., varying degrees of impotence and incontinence.

I understand giving guys a "warning" that the test is not cracked up to what everyone may think — but hey, it's still the only game in town for early detection.

September Prostate Cancer Awareness Month; Raiders-Jets Show Support

Employees are encouraged to GO BLUE on Friday, September 16, 2011 to raise awareness for prostate cancer within the workplace. This campaign encourages employees to wear casual Friday attire, paint employee faces blue and create a blue fundraising event benefiting the Prostate Cancer Foundation. Learn more about BLUE FRIDAY.

OAKLAND RAIDERS SUPPORT PC RESEARCH

The Oakland Raiders NFL team is supporting Blue September at their home game opener against the New York Jets on Sunday, September 25.  The game will support prostate cancer awareness and a portion of specially priced tickets purchased HERE will go to support prostate cancer research. 


Raiders legend Jim Otto, a Blue September supporter since 2010, was diagnosed with a severe case of prostate cancer in 2002 and underwent treatment that was hard on him and his family. Jim encourages people to support Blue September and support the Raiders by buying tickets to the game and getting the word out.

 --PROSTATE CANCER FOUNDATION

Urine test for prostate cancer

This development might save guys  a lot of pain and suffering — with unnecessary biopsies and even unnecessary surgeries and radiation.

A new urine test may be "significantly better" at identifying aggressive prostate cancer than a PSA test, which is very unreliable as most everyone knows. Here's the article from the Los Angeles Times article with all the details and the link to the journal Science Translational Medicine, where the study was published.

The urine test could be a first step toward putting the brakes on overtreatment, which takes place about half the time when prostate cancer is detected through a PSA test and then verified with a biopsy.  Biopsies can't differentiate between nonaggressive and aggressive cancers, so treatment is often recommended when cancer is found.

I suspect the way it MIGHT work is that physicians will continue to give PSA tests. But if cancer is detected, they might then take the urine test and see if the lab can find the two gene markers for aggressive prostate cancer in the urine. If the markers are not found, guys could be spared a biopsy and treatment — instead, proceed on a "watchful waiting" track.

FREE Guides from Prostate Cancer Foundation

	An Introduction to Prostate Cancer is designed to help men, their families, and friends quickly understand the risk factors for prostate cancer, find out how it is diagnosed, and review different treatment options. (8 pages) Order a free copy or download a copy in PDF format.
	Report to the Nation on Prostate Cancer: A Guide for Men and Their Families provides in-depth information about the diagnosis of prostate cancer, the available treatment options at each stage of the disease, key issues men face at every step, and more. (108 pages) Order a free copy or download a copy in PDF format.
	Nutrition, Exercise and Prostate Cancer summarizes the “best of the best” data and information available in the research arena today. Newly revised in 2009, the guide can help everyone affected by or at risk for prostate cancer understand how to incorporate key nutritional and lifestyle strategies into their everyday life. (32 pages) Order a free copy or download a copy in PDF format.
	Straight Talk for African-American Men and Their Families provides special facts and guidance regarding African-American men and prostate cancer. Research shows that African-American men are 1.6 times more likely to be diagnosed with prostate cancer and 2.4 times more likely to die from it than Caucasian men. The guide includes personal thoughts from Charlie Wilson, D.L. Hughley and Snoop Dogg. (8 pages) Order a free copy or download a copy in PDF format.

Five Powerful Foods for Prostate Cancer Prevention

I found this article about eating for a healthy prostate from The Cancer Project, a collaborative effort of physicians, researchers, and nutritionists who have joined together to educate the public about the benefits of a healthy diet for cancer prevention and survival. Based in Washington, D.C., The Cancer Project is a program of the Physicians Committee for Responsible Medicine.  The article was written in 2006, but it supports the current view that an anti-inflammatory diet, as I discuss in The Prostate Storm,  can reduce the risk of prostate disease, including prostate cancer.  ***

Vaccine cures prostate cancer in mice: Mayo Clinic

Mayo Clinic researchers have successfully cured prostate cancer in mice (80% of the time) ... using a HUMAN vaccine that triggers a response in the immune system ... a response that recognizes and attacks prostate cancer tumors ... with no side effects ... leaving the surrounding healthy tissue unharmed.

A vaccine, really?  You get a shot in your arse, instead of emasculating major surgery, radiation or chemo. Granted, this is another study with mice, but it sounds very promising and...it's the Mayo Clinic.

Human trials are still 2-5 years away (why years?????) ... According to Majo researchers, the vaccine also shows promise for treating melanoma, and lung, brain and pancreatic cancer. 

Here's an article and video about it in the Huffington Post ... another longer article in Health Day .... and here's the abstract of the study, published in the journal Nature Medicine this week.

Smoking linked to more aggressive prostate cancer

Smokers, if you're sweating lung cancer or heart disease or stroke, put prostate cancer on your list of diseases now stalking you.  The bad news...

• If smoking when diagnosed with prostate cancer, you're 61% more likely to die from it than a nonsmoker
• Smoking might directly affect the aggressiveness of cancer
• Smokers are 61% more likely to experience a recurrence of prostate cancer after treatment
• Men who smoked a pack a day for 40 years (or the equivalent of two packs over 20 years) were 82% more likely to die of prostate cancer than non-smokers
• Even former smokers who kicked the habit are more likely to succomb to PC than nonsmokers.

This from a new study, published in the Journal of American Medical Association, that

Prevention: Coffee, green tea lower risk of prostate cancer

Men who regularly drink coffee – caffeinated or decaf – are significantly less likely to develop prostate cancer.  And the more java, the better.

According to a Harvard study published online on May 17 in The Journal of the National Cancer Institute, Harvard scientists followed 47,911 men who periodically described their coffee intake. The researchers found that those who consumed six or more cups a day were almost 20 percent less likely to develop prostate cancer over two decades than those who drank none. The study was part of the Health Professionals Follow-Up Study.

Controversy? FDA warns hair loss, BPH meds increase prostate cancer risk. Or not...

The FDA now warns that Proscar, Propecia, Avodart and Jalyn increase the risk of high-grade prostate cancer. But not every expert agrees, including the chief medical officer of the American Cancer Society.

Bloomberg reports: Merck and GlaxoSmithKline Plc (GSK)’s drugs for hair loss and enlarged prostate will carry new U.S. warnings about a low risk of being diagnosed with a more serious form of prostate cancer.

Study: Little evidence radiation is superior to watchful waiting for "early prostate cancer"

If you're in the throes of making a treatment decision on prostate cancer, the choices can seem bewildering.  Radiation (and all the different flavors), surgery (robotic and open), and watchful waiting -- what to do?  You don't want to risk your life, on the other hand, if you don't need an aggressive treatment, why risk the collateral damage, i.e. incontinence and ED? I'm posting the following story by HealthDay, because it's worthwhile reading if you're weighing those risks.  The article Jury Still Out on Radiation for Early Prostate Cancer cites a new Tufts University study funded by the Agency for Healthcare Research and Quality that says there's little evidence radiation is more likely to save your life than watchful waiting, if you have early prostate cancer.  I'm assuming "early prostate cancer" means the low-grade (Gleason 6 and under), nonlethal, slow-growing variety, although it's not clear. The Tufts study is yet another reminder that treatment for low-grade prostate cancer still has the medical experts baffled.  Best advice: Do your homework, consider all your options, talk to multiple physicians, and don't rush into a decision.

In another article this week from Reuters Health, Prostate Cancer: Is it safe to skip radiation?, a review of many recent studies reveals there is no clear picture of what works best for the majority of men when comparing different radiation treatments.  Interestingly, last year a research group in the article found that among 466 patients who chose active surveillance rather than immediate treatment, those with tumors at intermediate risk for progression fared as well as men with low-risk prostate cancer over four years.  Granted, most of us are looking for no cancer beyond four years, but it's an interesting comparison and something to keep in mind ... especially if you have a Gleason of 6 or under.

Prostate Cancer Survival Rates Up Dramatically with Exercise

Run, walk, bike, sweat a little — if you’re a guy treated for prostate cancer, you can reduce your risk of the cancer reoccurring by over 60% with three hours a week of vigorous exercise compared to men who got less than one hour per week of vigorous exercise.     These findings came from the Health Professionals Follow-Up Study, of 2705 men observed every two years over 18 years. "Vigorous" simply means "a very brisk pace" — in other words, work up a sweat for 30 minutes a day, six days a week.       For anyone who has gone through surgery or radiation and all that anxiety about how things are gonna turn out, a little exercise every day is a small price to pay (and a cheap insurance policy). Why the positive outcomes from all that exercise?  The study's authors suggest physical activity might influence cancer survival by modulating insulin activity and inflammation and/or by altering the immune system's behavior. More research is required, according to an article in The Washington Post.

'Magic Mushroom' Prevents Prostate Cancer - New Study with Mice

This is no joke.  What would you think if researchers stumbled onto a compound that (a) cured existing prostate cancer 100% of the time, (b) prevented the development of prostate cancer, (c) produced no side effects, and (d) could be found in huge quantities in mushrooms that grew in forests all over the world?

Turkey Tail mushrooms grow on  bark

Wow is right. A cure.

Well, mice ain't people, and more study is warranted ... but this one is worth keeping an eye on. So here are some facts:

Incredible new research out of Australia last month has shown that a compound called polysaccharopeptide (PSP), which comes from a type of mushroom called "Turkey Tail," is 100 percent effective at targeting prostate cancer stem cells and suppressing tumor formation in mice. The research, which has been published in the online journal PLoS ONE, represents the first to show that a natural substance is totally and completely effective in every single trial, according to an article in NaturalNews.com (June 1, 2011).

Survivor Story posted on Prostate.net

Photo credit to my son Nick

Last month, Craig Cooper, the founder of Prostate.net contacted me, wondering if I'd like to contribute my story to his Survivor series.

Today, that story got posted -- and it's all great, I'm thrilled to get the message out to Craig's readers, and I thank him for helping putting it all together.

Prostate.net is fantastic site and has a huge presence on Facebook.  It's filled with great information for anyone with prostate disease, those recently diagnosed with cancer and wondering what's next, or guys looking for a smarter approach to prostate health and healthy living. 

My thanks, again, to Prostate.net and Craig for sharing the stories and information that hopefully will help others.