One of every six men will develop prostate cancer in his lifetime. After diagnosis and treatment, the first indicator that prostate cancer has returned is a rise in the PSA (protein specific antigen) level. This is why regular follow ups with the oncologist are so important after cancer treatment.
Initial Signs
Once a patient has completed surgery and radiation, PSA levels drop and stabilize. After surgery, some prostate cells left in the body can continue to excrete PSA. If PSA levels increase post treatment, it may be a sign of lymph node involvement or metastasis (spread to another organ). Many men are asymptomatic (present no symptoms) with prostate cancer and elevated PSA levels are the only indicators that the cancer has returned.
Dysuria
Dysuria (difficult urination) is a common symptom of advanced prostate cancer. If a man has trouble starting a urine stream, pain upon urination, blood in the urine, burning sensation while urinating, whether or not he has been treated for prostate cancer, he needs to consult his physician. Frequently needing to urinate at night is another indicator that there is a problem that requires a trip to the doctor.
Bone Pain
In prostate cancer, metastasis tends to spread from the local prostate area outward. Bones are almost always the first sites of prostate metastasis (spread of cancer to a new organ). If bone pain in the pelvis, lumbar spine or femurs is experienced, it may be a sign that the cancer has spread. To evaluate for cancer recurrence and determine sites of metastasis, a doctor will usually order a bone scan.
Weight Loss
As is true in most cancer cases, weight loss is another sign of advanced metastatic disease. In the earlier stages of prostate cancer, weight loss is not usually evident. However, in patients with progressive, metastatic cancer, 90 percent will suffer from loss of appetite. As many as 60 percent of advanced cancer patients will develop cachexia, otherwise known as "wasting syndrome." Researchers have discovered a chemical link between cancer cells and the wasting effect observed in cancer patients. These patients may consume normal or nearly normal diets, but are unable to use nutrients in an efficient manner.
Prediction
A recent study at Johns Hopkins University (presented in June, 2009) tracked 774 prostate cancer patients, and out of the research, a prediction tool for prostate cancer recurrence was formulated. The first element is how long it takes for the PSA level to double post treatment. The second factor is the original Gleason score (staging tool on the aggressiveness of the cancer). The final determinant is the time frame between surgery and the first detectable PSA level. The results show that it takes approximately 10 years on average for metastasis to be detectable radiologically. For those men whose PSA doubled in three months, they were 20 times more likely to progress to metastatic cancer.
Tags: prostate cancer, cancer patients, cancer returned, indicator that, metastasis spread
