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What are the symptoms of prostate cancer?

Prostate cancers usually do not have any symptoms in the early stages. Early cases are either diagnosed because the physician performs a digital rectal exam (DRE) and feels an abnormality in the gland, or because the PSA blood test is used to screen for the cancer. The presence of symptoms usually indicates advanced disease.

Advanced prostate cancers can lead to many symptoms such as weakness in urinary stream, difficulty in initiation of urination, difficulty with emptying the bladder completely, a burning sensation with urination, blood in the urine, weight loss, or bone pain. However, these symptoms are NOT specific for cancer and in fact are much more commonly associated with other prostate and bladder conditions such benign prostatic hyperplasia (BPH) or bladder infection.

The most common site for prostate cancer to spread is to bones. Pain in the lower back, ribs, pelvis, and other bony structure are the most common presenting symptom in patients with bony metastases. When the patient has metastatic disease to the spine, symptoms of spinal cord compression may develop. Common symptoms found in spinal cord compression include pain, urinary incontinence, paraplegia, and paralysis. Spine cord compression is a medical emergency and may cause permanent paralysis if not treated appropriately within a limited amount of time. 

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