Managing pain due to prostate cancer

What is prostate cancer?

Prostate cancer forms in the prostate gland. The prostate gland is found in men, below the bladder and in front of the rectum; it makes and stores semen. Prostate cancer can range from slow-growing, which can be treated fairly simply, to a very aggressive type that calls for a mix of different treatments.

What are the symptoms of prostate cancer?

In its early stages, prostate cancer may not have any symptoms. It’s usually diagnosed by a PSA (prostate specific antigen) blood test, a rectal exam, and an ultrasound. When prostate cancer gets worse, symptoms can include:

  • A dull pain in the lower pelvic area
  • Problems starting or stopping urination
  • Pain during urination
  • Frequent urination, especially at night
  • A feeling that your bladder does not empty all the way
  • Blood in the urine or semen
  • Painful ejaculation
  • Frequent pain in your lower back, hips, or upper thighs

How prostate cancer is treated

Treatment depends on the stage of the cancer (how advanced it is), the type of cancer cell that’s involved, and the age of the patient. For some cases of early-stage, slow-growing tumors, treatment may not be needed right away. Instead, a doctor keeps an eye on the condition over time.

Some prostate cancer treatments include:

Surgery
Surgery for prostate cancer usually means taking out the whole prostate gland. This treatment may sometimes make it hard for the person to urinate or have an erection. Newer techniques include a procedure where the prostate can be removed using robotic (laparoscopic) surgery instead: Operating tools can reach into the prostate area through tiny incisions in the skin. Even though this operation is more complicated for the surgeon, it’s easier on the patient’s body, often has fewer lasting bad effects, and there is a faster recovery time.

Radiation
Radiation therapy (high-energy rays to destroy cancer cells) may be sometimes be used instead of surgery. Sometimes radiation is used after surgery, too, to kill any cancer cells that may be left.
When prostate cancer is found early, one treatment option involves tiny pellets packed with radioactive material (radioactive seeds) that may be put into the prostate gland. These seeds give off radiation over a certain period of time. Using seeds may be easier for the patient than going through daily radiation treatments.

Hormone therapy
This treatment uses medication to keep male hormones (like testosterone) from helping cancer cells to grow, when cancer has spread past the prostate, or has come back after treatment.

Chemotherapy
Chemotherapy uses strong medications to kill cancer cells. This treatment is usually tried on advanced or fast-growing prostate cancers, when hormone therapy, radiation, and surgery haven’t worked.

Prostate cancer pain

Managing pain from prostate cancer
Most prostate cancers don’t cause pain at first. However, it’s possible for pain to occur anytime from diagnosis until treatment, and it may last for a while. When prostate cancer metastasizes (spreads) to the bones, it can cause a deep aching feeling, usually from the bone breaking down. Some bones may even fracture.

A prostate tumor can cause pain in the pelvic area. This pain may be bad enough for the patient to need oral or IV (intravenous) pain medication, before the tumor is treated with surgery, radiation, or chemotherapy.

Managing pain from prostate cancer treatment
There are times when cancer treatments, such as surgery, can cause pain or discomfort. Talk with your surgical and anesthesia teams to learn what your pain management choices are after surgery. Some options include oral or IV pain medications, or drugs that are placed into the space around the spinal cord; this is called an epidural. Sometimes patients can give the pain medication to themselves instead, through a special patient-controlled analgesia (PCA) system.

Surgery, radiation therapy and some kinds of chemotherapy may cause neuropathic (nerve) pain, This type of pain can give burning, shooting, or stabbing feelings, sometimes with numbness or tingling. There are many different medications that can help this kind of pain.

When you’re in pain

Your comfort is an important part of cancer care. With so many medications and treatments on hand to take care of cancer pain, no cancer patient should have to live with untreated pain. Don’t hesitate to tell your doctor or nurse if you’re hurting. While the treatment may not be 100% successful, it can still make a difference.

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References

National Cancer Institute. (2008). Pain Control. Retrieved 7/1/08 from www.cancer.gov.

National Cancer Institute. (2005). What you need to know about prostate cancer. Retrieved 7/1/08 from www.cancer.gov.