By anatomical disposition, the prostate surrounds the first part of the urethra. Most patients with prostatic pathology claim low urinary suffering, without a specific area. The prostate cancer is also subject to this relation, but the impact of the urinary symptoms sparked by prostate cancer on the patient’s quality if life is variable. In most cases, the establishing of a diagnosis in due time is delayed.



The clinical manifestations of prostate cancer are, in most cases, similar to those of benign hypertrophy in the prostate. The urinary symptoms dominate the clinical panel, which, in some cases, can favor errors in diagnosis. What are the symptoms of the patient? - The patients could claim often urination during the day and the night, difficulty when urinating, difficult initiation of the urination, interrupted urinary jet, impossibility of urination.



The loss of urine in the blood may occur as single symptom in prostate cancer patients and it has nothing characteristic suggesting the existence of prostatic neoplasia. Urinary incontinence can complete the clinical panel of the prostate cancer in cases of local neoplasia invasion of the external urethral sphincter. The loss of blood in the sperm can be a sign of prostate cancer, but is a seldom symptom.

There are situations in which the first symptom is renal insufficiency, accompanied by bilateral lumbar pain. Patients of medium age with major erectile dysfunction, with impotence, need to know that this can be caused by the invasion of the neurovascular bandelets. Wide bone metastasis, aside from pain, spontaneous fractures, can also produce severe anemia, through the invasion of the bone marrow.

Metastases in the internal ganglion groups can lead to an increase in the lymph node’s volume and the occurrence of urethral blockage, sometimes bilaterally. There is also a connection between high fever and advanced prostate cancer. Respiratory symptoms, dry coughing, sometimes accompanied by dyspnea and fever, can be due to the prostate cancer when there are pulmonary metastases. Prostate cancer can lead to the almost complete obstruction of the rectal lumen, which is clinically visible through constipation and sometimes rectal bleeding. High fever and prostate cancer have been shown to be connected in rare cases.

Investigation protocol - For prostate cancer, investigations need to contain, aside from a rectal digital examination, the level of prostate specific antigens in the blood. The protocol also needs to include image testing. Diagnosis is only confirmed following a transrectal ecography and a prostatic bioptic puncture. What the patient needs to know before examination - Transrectal puncture is performed after prior preparations, which include:
-therapy with antibiotics (for protection against potential infection complications);
-an enema on the morning of the examination;
-interruption of antiaggregant medication if need be. For example aspirin;
-on the day of examination, the patient will not eat anything and will only drink fluids.



The main therapeutic options in prostate cancer - Curative treatment is achieved through the complete removal of the prostate (radical prostatectomy), cryogenic surgery, brachytherapy  (method of radiotherapy that consists of radioactive implants, within or near the tumor) which may or may not be accompanied by hormone therapy. Palliative treatment consists of estrogen therapy, the removal of the testes and chemotherapy.