Anatomy And Metastasis Of Prostate Cancer
The pudendal nerve innervates the few striated muscles within the prostatic capsule. The parasympathetic nerves emanate from S2 to S4 and form the pelvic nerve. The sympathetic preganglionic nerves, which reside in the thoracolumbar region between T6 and L2, provide the major neural input to the prostate and reach the pelvis through the hypogastric nerve .
Prostate cancer has been shown to metastasize by following the venous drainage system through the lower paravertebral plexus, or Batson’s plexus.4,9 Although hematogenous spread of other malignancies is most commonly to the lungs and liver, 90 percent of prostatic metastases involve the spine, with the lumbar spine affected three times more often than the cervical spine. Prostate cancer also spreads to the lungs in about 50 percent of patients with metastatic disease, and to the liver in about 25 percent of those with metastases.4
Epidural metastases are the result of contiguous spread from lesions of the calvaria to the meninges. Because of the protective layer of the dura mater, subdural and intra-parenchymal metastases from prostate cancer are rare .
Back Pain Can Actually Be Caused By Prostate Cancer And By The Time This Happens The Cancer Has Spread It Is At An Advanced Stage
In general, prostate cancer causes no symptoms, begins Kenneth Peters, MD, chief of urology for Beaumont Hospital, Royal Oak, MI.
Dr. Peters continues, In advanced cases, the cancer can metastasize to the bones, leading to back pain. Urinary retention or incomplete emptying of the bladder due to an enlarged prostate can at times be perceived as low back pain.
Low back pain has many possible causes, and there are different kinds of LBP, in that it can present in different ways.
Sometimes its accompanied by tingling or numbness radiating down a leg.
Sometimes LBP occurs only when you are in certain body positions, such as bending over, or standing up after sitting for long periods.
And there are people for whom LBP occurs only in the morning after getting out of bed, then dissipates soon after.
Sometimes low back pain is nearly constant but dull in nature.
The persistence is something to be concerned about, even if the level of pain is dull.
If youve been experiencing low back pain and it doesnt seem to be related to certain body positions and/or has not gone away after a week or two, do not blow this off.
Rather, bring this to the attention of your doctor and ask that your prostate be examined and that cancer be ruled out.
Dr. Peters, in practice for 30+ years, is board certified by the American Board of Urology. One of his specialties is treating bladder pain.
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Symptoms Of Prostate Cancer You Shouldn’t Ignore
After skin cancer, prostate cancer is the second most common type of cancer in men. It affects 1 in 6 men in the United States and is the leading cause of death among American men, after lung cancer.
However, dont let these statistics scare you. When detected early, the cure rate is very high. Most men who are diagnosed and treated before the cancer has spread to other parts of the body have a survival rate of 96 percent or higher.
The prostate is a gland about the size of a walnut and is located between the bladder and urethra. It is responsible for producing fluid for semen. Prostate cancer is typically a slow-developing progressive disease.
Men over 65 years old, those with a family history of the disease, or who are African-American have an increased risk of developing prostate cancer.
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Can Back Pain Be A Symptom Of Prostate Cancer
Prostate cancer cells may spread to a persons bones.
There can be a connection between back pain and prostate cancer, but back pain alone is not necessarily a sign of the disease.
In advanced prostate cancer, cancer cells spread beyond the prostate to other parts of the body. These cells usually spread to the bones first, and doctors refer to this as bone metastasis.
If prostate cancer spreads to the bones, it most often reaches the spine, ribs, and hips. This occurs in stage 4 prostate cancer, and it can cause pain. According to ZERO, an advocacy group, bone metastases will affect more than 60 percent of men with advanced prostate cancer.
Individuals with chronic back pain that has no obvious cause should see a physician for an evaluation.
Prostate Cancer And Incontinence
Incontinence the inability to control urine flow is a common side effect of all therapies directed at the prostate gland. Most patients do eventually regain complete urinary control. Exercises to strengthen the sphincter and surrounding pelvic muscles can help you regain urinary control. These are called Kegel exercises. A training program called biofeedback helps reinforce the proper performance of Kegel exercises. Medications may also help relieve incontinence. A male sling is a surgical option, as is an artificial urinary sphincter which can be surgically inserted in cases of severe incontinence. Ask your doctor about these options.
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Can Lower Back Pain Be A Sign Of Something Serious Like Cancer
Lower back pain can be related to cancer. In fact, it is one of the first symptoms of prostate cancer when it metastasizes and creates lesions. Almost any cancer can spread to the back and some, like sarcoma, can originate in the back. Be cautious, especially if you are experiencing other symptoms besides lower back pain. Talk to your doctor if you have additional symptoms or concerns.
Risk Factors For Prostate Cancer
Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesnt mean that you will get prostate cancer. It just means that your risk of the disease is greater.
- Age. Men who are 50 or older have a higher risk of prostate cancer.
- Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
- Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a mans relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
- Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.
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Urinating Frequently During The Day
It may be more difficult to notice a change in frequency during the day than at night. Most of us dont go around counting how many times we use the washroom in a given day!
Besides, whats normal, anyway?
Normal urination during the day is considered to be within a range offour to seven times for most healthy adult men. If youre going more often than this, it could indicate a prostate issue.
It can be easy to miss this sign. Drinking more water or caffeinated beverages than usual can be an easy explanation for a few extra trips.
Even a night out for dinner with a few more glasses of beer than usual can cause several extra trips to the bathroom because alcohol is a diuretic, meaning it triggers anincrease in urine production.
But like your nighttime routine, if you notice an ongoing pattern of having to go more often during the day, ask your doctor about it. A simple blood test and rectal examination is often the first diagnostic step, which is quick and painless.
What Can I Do For Low Back Pain At Home
If your lower back pain has just started, the best thing you can do is start a log. Record your symptoms, times, dates and which activities trigger the pain or make it worse or better. Take this information to your family physician if the pain doesnt resolve on its own. It will make diagnosing the cause much easier.
Once you know which motion or position causes your lower back pain, try to avoid it and see if you get better. Icing the painful spot can also help. And so can over-the-counter pain relievers that help reduce inflammation. Just remember that pain killers treat only the symptom pain and not its cause.
Short Term Side Effects
Patients who receive any type of radiation therapy to treat their prostate cancer can have side effects. Short term side effects are ones that start during or shortly after your radiation treatment. Below is a list of possible short term side effects. Treatments can affect each patient differently, and you may not have these particular side effects. Talk with your care team about what you can expect from your treatment
Do All Men With Advanced Prostate Cancer Have Pain
No, not all men with advanced prostate cancer have pain. Men who do have pain experience different levels of pain. Pain is more common in men whose cancer has spread to their bones. If the cancer has spread to several places in your body, you might not get pain in all of these places.
With the right treatment and management, pain can usually be relieved or reduced. Tell your doctor or nurse if youre in pain or your pain relief isnt working well.
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Where Does Prostate Pain Hurt
Pain is usually localized in the areas around the penis and scrotum, with sharp pain or pressure in the perineum . Pain in the lower back, hips, knees, and ankles can be a result of some prostrate conditions. Prostate cancer is the most common type of cancer in men, and its the second-leading cause of death among men.
Its also one of the leading causes of prostate-specific antigen tests, which are used to screen for the disease. PSA test is a blood test that looks for a protein called prostaglandin E2 , which is produced by the prostate gland. PGE2 is linked to a number of health problems, including cancer.
What Causes The Pain
We feel pain when our bones, muscles, organs, nerves or other parts of our bodies are damaged or irritated. Cancer which has spread into these areas might cause pain.
Sometimes pain can be due to cancer treatments. For example, radiotherapy to treat bone pain can sometimes cause your pain to get worse during treatment and for a few days afterwards. But this isnt very common.
Pain can also be caused by problems not linked to the cancer, such as an infection.
Your doctors and nurses will work with you to find out what is causing your pain and will talk to you about suitable treatments. There are effective ways to treat different types of pain.
If prostate cancer spreads to the bone, it can damage or weaken the bone and may cause pain. But not all men with cancer in their bones will get bone pain. Prostate cancer can spread to any area of bone around the body. It most commonly spreads to the spine. Pain in these areas can sometimes make it painful to walk and move around. The pain might remain in only one area, but over time it can spread to several parts of your body.
Bone pain is a very specific feeling. Some men describe it as feeling similar to a toothache but in the bones, or like a dull aching or stabbing. It can get worse when you move and can make the area tender to touch. Each mans experience of bone pain will be different. The pain may be constant or it might come and go. How bad it is can also vary and may depend on where the affected bone is.
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Management Of Prostate Cancer Pain
The same study reveals that pain has a major impact on numerous dimensions of patients quality of life. Patients with poorly controlled pain experience significant physical effects, such as decreased strength, limited mobility, and difficulty sleeping. In terms of psychological effects, patients with pain have increases in fear, anxiety, and depression and a decrease in their overall enjoyment of life. Socially, pain has an effect on the patients ability to form and maintain relationships with others and also places an increased burden on caregivers. However, there are treatment options for the management of pain in patients with prostate cancer.
Pharmacologic management of pain usually start with nonsteroidal anti-inflammatory drugs , and opioid analgesics, while step-two drugs include codeine, dihydrocodeine, hydrocodone, oxycodone, and propoxyphene. Step-three drugs are usually opioids like morphine, hydromorphone, oxycodone, and fentanyl. For a small percentage of people who cant take oral medication, transdermal fentanyl or rectal morphine suppositories are also options. Adjuvant medication may be used to increase the efficacy of opioids or to treat pain of a different etiology, and it includes tricyclic antidepressants, anticonvulsants and corticosteroids. Local therapy may consist of palliative radiation, multimodal chemotherapy or physical therapy, while systemic therapies refers to the use of bisphosphonates.
Can Prostatitis Cause Back Pain
When you start to understand medicine, you realize that everything isnt always what it seems. We always have patients with uncommon signs and symptoms.
Pain is sometimes reported in areas apparently far from the problem area. This is because nerve terminals are very long and receive signals from a large extent. Organs do not have the same sensitivity as the skin, and it is sometimes challenging to locate the pain. Long nerves can also cause referred pain to an unrelated area.
But is prostatitis like that? Can you feel prostatitis outside of the immediate prostate gland area?
In this article, were exploring the topic of prostatitis symptoms with a particular emphasis on back pain. Is prostatitis a cause of back pain, and why? What medical and natural therapies are there to recover from prostatitis?
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Nonmalignant Etiologies Of Back Pain Common With Metastatic Prostate Cancer
Many men with metastatic prostate cancer have back pain associated with nonmalignant etiologies at sites of metastases. These findings were published in JCO Oncology Practice.
For patients with mPC, the spine is the most common site of metastasis and can be a source of pain. These patients often receive tumor-directed therapies however, nonmalignant etiologies of back pain would not be responsive to these interventions. To better understand back pain in mPC, data were sourced from the Memorial Sloan Kettering Cancer Center patient registry, collected between 2013 and 2017. Fifty-three men with mPC who reported pain in an area of metastastic disease were retrospectively reviewed for trends in back pain.
The patients were median age 72 years , 66% had castration-resistant disease, 64% had a precancer history of back pain, 72% had abnormal posture, 68% had reduced spinal range of motion, and 51% had gait abnormalities.
Patients were stratified into malignant pain , nonmalignant pain , and mixed pain subgroups.
Of the 20 patients in the malignant pain group, 14 reported a precancer history of back pain, 7 of whom required surgical intervention. Pain was caused by either malignancy or metastasis-associated vertebral compression fracture. These patients used the most analgesics and narcotics.
The 12 patients with nonmalignant pain were the oldest cohort and most had a precancer history of back pain. The back pain in this cohort was commonly caused by activity .
Tests Used To Check The Prostate
This first step lets your doctor hear and understand the âstoryâ of your prostate concerns. Youâll be asked whether you have symptoms, how long youâve had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing.
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Signs And Symptoms Of Prostate Cancer
Most prostate cancers are found early, through screening. Early prostate cancer usually causes no symptoms. More advanced prostate cancers can sometimes cause symptoms, such as:
- Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
- Blood in the urine or semen
- Trouble getting an erection
- Pain in the hips, back , chest , or other areas from cancer that has spread to bones
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord
Most of these problems are more likely to be caused by something other than prostate cancer. For example, trouble urinating is much more often caused by benign prostatic hyperplasia , a non-cancerous growth of the prostate. Still, its important to tell your health care provider if you have any of these symptoms so that the cause can be found and treated, if needed. Some men might need more tests to check for prostate cancer.