Symptoms and diagnosis
Prostate cancer does not usually display any symptoms in its early stages. One of the main reasons for this is that the tumour usually occurs in the prostate gland’s peripheral zone, i.e. not close to the urethra. A diagnosis of prostate cancer is sometimes given for patients who actually go to their doctor because of difficulty urinating due to benign prostate enlargement. In such instances, an examination for the possible occurrence of prostate cancer is usually made, and diagnosis can thus sometimes be made retrospectively. In cases where the tumour grows to locally advanced disease, the patient can experience local symptoms such as difficulty urinating, local pain or reduced potency due to the pressure or size of a tumour on the nerves that are important to an erection. If the tumour becomes metastatic, the patient can experience pain, often localised to the skeleton, as prostate cancer has a tendency to spread there.
Several procedures are involved in the diagnosis of prostate cancer. A blood test is taken to measure PSA values, and the doctor will examine the prostate with a finger via the rectum. If there is a suspicion of prostate cancer after these initial examinations, biopsies (tissue samples) are taken from the prostate via the rectum with the help of an ultrasound scan. A high PSA value can indicate prostate cancer, but also conditions such as prostatitis, benign hyperplasia or urinary tract infection. PSA values rise in line with age.
Prostate cancer can be slow-growing, or more aggressive, rapid-growth life-threatening cancer. Current research is aimed at developing better diagnostic methods to be able to identify prostate cancer tumours that require treatment from those that can wait, with monitoring and regular check-ups of the patient. There is no general screening for prostate cancer in Sweden, but the number of PSA tests performed is high.