Complaints usually occur only in the already advanced stage of prostate cancer. This is because at the beginning of the disease, usually only the outer area of the prostate is affected.Only when the tumor spreads further inside the prostate and narrows the urethra (urethra), complaints occur:
- Bladder voiding dysfunction (obstructive symptoms/occlusion symptoms):
- Weakened urinary stream
- Start delay
- Residual urine formation
- Ischuria (urinary retention)
- Irritative symptoms (an expression of detrusor instability due to obstruction or, less commonly, a consequence of carcinoma invasion of the bladder).
- Pollakiuria – urge to urinate frequently without increased urine output.
- Imperative urination – uncontrollable urge to urinate.
- Dysuria – painful urge to urinate with difficulty urinating.
- Symptoms of local tumor infiltration
- Erectile dysfunction (ED/erectile dysfunction; infiltration of neurovascular bundles).
- Hematuria (blood in the urine)
- Incontinence (inability to hold and release urine in a controlled manner).
- Hematospermia – erythrocytes (red blood cells) in the semen (sperm fluid).
- Constipation (walling of the rectum / rectum).
- Perineal (“affecting the perineal area”) or suprapubic (“above the pubic bone”) pain (infiltration of prostate cancer into the neurovascular bundles that run lateral to the prostate on both sides)
- Low back and back pain
- Tumor metastases (daughter tumors of the tumor)/lymph node metastases (metastasizes primarily to the obturator and iliac lymph nodes. At times, lymph node metastases are also found in the inguinal, cervical, or axillary lymph nodes).
- Anemia (normochromic, normocytic anemia/anemia).
- Urinary stasis kidney with flank pain (lymph nodes obstructing the ureters).
- Bone pain due to osseous metastases; preferentially to the lower spine and small pelvis.
- Low back pain/lumbago (cardinal symptom of metastatic prostate cancer).
- Metastases (daughter tumors) in the vertebral bodies (can lead to compression of the spinal canal with neurological deficits due to tumor invasion of the spinal canal or fracture of the vertebral body)
- Pathologic fractures (synonym: spontaneous fracture; result of osseous metastasis/bone metastases of prostate carcinoma).
- Lymphedema (proliferation of tissue fluid caused by damage to the lymphatic system) of the lower extremity (obturator or iliac lymph nodes)
