Prostate Cancer and Back Pain



Prostate Cancer and Back Pain


Prostate cancer is the second most common cancer affecting Australian men. According to the Cancer Council Australia (CCA), nearly 20 thousand cases were diagnosed in 2010. Men are more likely to develop prostate cancer if they have a family history that includes the diagnosis of prostate cancer in a close relative and the incidence is greater again if that relative was diagnosed before the age of 60. Prostate cancer is rare in men under the age of 50.

Symptoms of prostate cancer typically involve urinary or sexual dysfunction, however a significant number of men will develop prostate cancer without symptoms. It is important to note that the symptoms of prostate cancer are also found in benign forms of prostatic disease.

Symptoms of prostatic disease:

Difficulty in passing urine
A weak or interrupted flow of urine
Increase in urination frequency
Increase in frequency of nocturia
Urinary incontinence
Painful ejaculation
Erectile dysfunction

Left untreated, prostate cancer metastasises to the skeletal system in 85{95f364b8aea3ba4afb976a81c1dcc2e8147daac1866ef443968911255633a999} of cases. Once it has metastasised, it is considered incurable. Early detection of prostate cancer is essential. The 5 year survival rate for patients in whom the cancer has been confined to the prostate is nearly 90{95f364b8aea3ba4afb976a81c1dcc2e8147daac1866ef443968911255633a999}, whereas the 5 year survival rate in cases where metastasis has occurred is at approximately 30{95f364b8aea3ba4afb976a81c1dcc2e8147daac1866ef443968911255633a999}.

Bone metastasis from prostate cancer most typically involves the lumbar spine, ribs, pelvis and proximal femurs. Metastasis from prostate cancer also has a predilection for the lungs and liver.

Bone metastasis from prostate cancer begins as an osteolytic process which transitions in time to an osteoblastic type. In the osteolytic phase, alkaline phosphatase is elevated, although this enzyme is also elevated in liver disease and its detection in laboratory testing could also implicate liver metastasis.

It is important to consider bone metastasis in patients who present with a new complaint of low back pain after the age of 50. Unrelenting pain, nocturnal pain, evidence of unexplained weight loss or any other signs and symptoms of underlying illness should be thoroughly investigated.

Stages of Prostate Cancer

Prostate cancer is classified into 4 stages:

In Stage I, the cancer is confined to the prostate but is non-palpable by rectal examination.

In Stage II, the cancer is confined to the prostate but is palpable by rectal examination.

In Stage III, the cancer has broken through the prostate capsule and may involve the seminal vesicles.

In Stage IV, the cancer has invaded adjacent structures other than the seminal vesicles.





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