Prostate cancer is the most common non-skin type of malignant tumor in the United States, diagnosed in more than 175,000 men every year. It occurs when the cells in the prostate, which under normal circumstances naturally divide and die, start to grow out of control. The prostate gland is found in men’s bodies below the bladder, near the rectum and surrounding the urethra. This gland is responsible for the production of a fluid that joins the sperm and is expelled during ejaculation in the form of semen.

Patients who suffer from prostate cancer experience alterations in both the reproductive and urinary systems, with symptoms such as a need to urinate frequently, especially at night; difficulty starting urination or holding back urine; weak or interrupted flow of urine; painful or burning urination; difficulty in having an erection; painful ejaculation; blood in urine or semen; as well as frequent pain or stiffness in the lower back, hips, or upper thighs.

Pain as Symptom of Prostate Cancer

Early diagnosis of prostate cancer is very difficult since the symptoms of the disease usually do not manifest until advanced stages. Pain is one of these symptoms and it can be experienced very differently from patient to patient. In earlier stages of prostate cancer, pain can occur during urination or ejaculation, which is related to the blockage caused by cancer growth in the prostate. The tumors start to pressure the nearby organs and tissues, causing the pain. In more advanced cases, the pain may spread to the pelvis, lower back, ribs, or upper thighs, and in the bones of those areas.

“Approximately 70% to 85% of patients with advanced prostate cancer have associated clinically apparent bone metastases, while another 20% to 25% have metastatic liver lesions,” explain the authors of the study “Pain Management in Patients With Advanced Prostate Cancer.” “In addition to pelvic pain associated with primary tumor extension, these metastatic lesions cause pain that ranges from mild to very severe and may require extensive, highly individualized pain management. Pain is perhaps the one aspect of cancer that patients fear most, and effective pain control is a critical issue for patients and often a challenge for clinicians.”

Management of Prostate Cancer Pain

The same study reveals that pain has a major impact on numerous dimensions of patients’ quality of life. “Patients with poorly controlled pain experience significant physical effects, such as decreased strength, limited mobility, and difficulty sleeping. In terms of psychological effects, patients with pain have increases in fear, anxiety, and depression and a decrease in their overall enjoyment of life. Socially, pain has an effect on the patient’s ability to form and maintain relationships with others and also places an increased burden on caregivers.” However, there are treatment options for the management of pain in patients with prostate cancer.

Pharmacologic management of pain usually start with nonsteroidal anti-inflammatory drugs (NSAIDs), and opioid analgesics, while step-two drugs include codeine, dihydrocodeine, hydrocodone, oxycodone, and propoxyphene. Step-three drugs are usually opioids like morphine, hydromorphone, oxycodone, and fentanyl. For a small percentage of people who can’t take oral medication, transdermal fentanyl or rectal morphine suppositories are also options. Adjuvant medication may be used to increase the efficacy of opioids or to treat pain of a different etiology, and it includes tricyclic antidepressants, anticonvulsants and corticosteroids. Local therapy may consist of palliative radiation, multimodal chemotherapy or physical therapy, while systemic therapies refers to the use of bisphosphonates.

Note: Prostate Cancer News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.