10 Early Signs of Prostate Cancer That Often Go Unnoticed
Leaking or dribbling urine
Here’s one almost no one talks about, but we need to. It’s basically the male version of urinary incontinence, which typically occurs on a small but still noticeable scale. Longer bathroom trips while you wait for the dribbling to stop or leakage on the way to the bathroom are the telltale signs. Women, if while doing the laundry you notice that his pants or jeans smell like pee, delicately suggest a visit to the doctor.
You’re over 50 and have risk factors
Since early prostate cancer most often has no symptoms at all, men who are at risk need to talk to their doctors and have regular PSA tests and rectal exams (sorry!) whether they notice anything odd happening or not. Family history - especially a father who had prostate cancer - being overweight, eating a high-fat diet, being of African-American descent, and smoking all increase your risk of prostate cancer. Another one many men don’t know: If the women in your family have a history of breast cancer, you may carry faulty genes that increase your prostate cancer risk.
Diagnostic tests are limited
We always knew that prostate cancer is common and that, until recently, it often went undiagnosed: Autopsies of men who died of other causes have shown that about one-third of men over age 50 have some cancerous cells in their prostate, while 90% of men over age 90 have such cells.
As PSA screening has grown more widespread, we are finding more tumors that otherwise would have escaped detection. Yet current diagnostic technology does not always enable urologists to determine which tumors will lie dormant and which will become active, spreading elsewhere in the body.
Studies estimate that anywhere from 16%–56% of men diagnosed with prostate cancer, generally because of an abnormal PSA test, have tumors that might never have caused problems had they not been found. And the landmark Prostate Cancer Prevention Trial (PCPT) unexpectedly yielded data that early-stage prostate tumors are incredibly common, even at PSA levels considered normal.
The PCPT was a randomized controlled study - the type considered to be the gold standard in research. The study, which involved almost 19,000 healthy men, was designed to evaluate whether the drug finasteride (Proscar) could prevent prostate cancer from developing. Finasteride is a hormonal medication originally approved to treat benign prostatic hyperplasia (an enlarged prostate, which can cause problems with urination), but which has also been investigated as a potential treatment for prostate cancer.
All participants were ages 55 and older with PSA levels of no more than 3.0 nanograms per milliliter (ng/ml) and normal digital rectal exams - in other words, by the traditional testing standards, they showed no evidence of prostate cancer. Investigators randomly assigned participants to take finasteride or a placebo, and the men were followed for seven years. Every year, all participants underwent a digital rectal exam and had their PSA levels tested.
Every participant in the PCPT also agreed to undergo a prostate biopsy at the end of the study, whether he met the clinical criteria for such a biopsy or not. The reason investigators included this requirement was that they wanted to eliminate any “detection bias,” a technical term for unintended differences in diagnosis between comparison groups in a study - in this case, between the men randomly assigned to finasteride and those assigned to receive placebo.
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By Melanie Haiken, Caring.com