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Prostate cancer and back pain

Chronic back pain can sometimes be a symptom of advanced prostate cancer. However, there are many other possible causes of back pain.

The prostate is a walnut-sized gland that sits below the bladder and wraps around the urethra. This gland is part of the male reproductive system and is involved in the production of semen.

According to the American Cancer Society (ACS), prostate cancer is the second most common type of cancer among American males, affecting 1 in 9 over the course of their lifetimes.

The outlook for people with prostate cancer is encouraging, particularly when doctors diagnose it early. For all stages of prostate cancer, the ACS report 5- and 10-year relative survival rates of 99 percent and 98 percent, respectively.

However, prostate cancer is still a leading cause of cancer death, so regular screenings and prompt attention to possible symptoms are very important.

In this article, we look at the link between back pain and prostate cancer. We also describe other causes of back pain and explore prostate cancer in detail, including its symptoms, risk factors, diagnosis, testing, and treatment.

Can back pain be a symptom of prostate cancer?

man in kitchen holding his lower back
Prostate cancer cells may spread to a person’s bones.

There can be a connection between back pain and prostate cancer, but back pain alone is not necessarily a sign of the disease.

In advanced prostate cancer, cancer cells spread beyond the prostate to other parts of the body. These cells usually spread to the bones first, and doctors refer to this as bone metastasis.

If prostate cancer spreads to the bones, it most often reaches the spine, ribs, and hips. This occurs in stage 4 prostate cancer, and it can cause pain. According to ZERO, an advocacy group, bone metastases will affect more than 60 percent of men with advanced prostate cancer.

Individuals with chronic back pain that has no obvious cause should see a physician for an evaluation.


Other causes of back pain

Back pain, particularly in the short term, is a very common medical complaint. Possible causes can include:

  • strains, sprains, and overexertion
  • injuries
  • damaged, ruptured, or deteriorating discs in the spine
  • spinal stenosis
  • pressure on the spinal nerves
  • sciatica
  • abnormalities of the spine, such as scoliosis
  • arthritis and other inflammatory diseases
  • kidney stones
  • infections
  • abdominal aortic aneurysms


Other symptoms of prostate cancer

Prostate cancer usually has no early warning signs. Because of this, many doctors and health authorities recommend screening men at risk.

When prostate cancer does cause symptoms, they may include:

  • a frequent, urgent need to urinate
  • nocturia, or needing to urinate frequently during the night
  • reduced urine flow
  • trouble starting or stopping the flow of urine
  • pain with urination or ejaculation
  • blood in the urine or semen

However, these can also be symptoms of other conditions, including:

  • benign prostatic hyperplasia, which is enlargement of the prostate and very common in older men
  • prostatitis, which is inflammation of the prostate

Neither of these conditions involves cancer, but it is still important to see a doctor for evaluation and treatment.


Risk factors for prostate cancer

group of friends eating pizza
An unhealthful diet may be a risk factor for prostate cancer.

One of the most significant risk factors is aging. According to the ACS, this type of cancer is rare among males aged under 40 years. The average age at diagnosis is around 66 years old.

Another risk factor is ethnicity, but doctors do not understand why. The ACS state that prostate cancer is more common in African-American males and in those from the Caribbean with African descendants.

The disease is less common in Asian-American and Hispanic, or Latino, males than in non-Hispanic whites.

Having a family member with the disease may also increase a person’s chances of developing it.

Other risk factors may include:

  • an unhealthful diet
  • obesity
  • exposure to certain chemicals

When to see a doctor

Prostate cancer often causes no symptoms in the early stages. According to the National Cancer Institute, prostate-specific antigen (PSA) screening is the most common method of detecting this cancer in the United States.

The U.S. Preventive Services Task Force recommend that males ages 55–69 discuss the risks and benefits of prostate cancer screening with their doctors.

People who have regular back pain and are concerned about the risk of prostate cancer should also speak to their doctors.

Anyone who has already been diagnosed with prostate cancer and who begins to experience chronic back pain should see a doctor as soon as possible. Unexplained back pain can indicate that the cancer has spread.


When to have PSA tests

The prostate gland produces a protein called PSA. Levels of this protein increase when the prostate is dealing with irritation, swelling, or the growth of cancerous cells.

High levels of PSA in the blood do not necessarily mean that an individual has prostate cancer, but they can suggest that further tests are necessary.

The Prostate Cancer Research Institute (PCRI) recommend that most men start having PSA tests at the age of 45.

Males with a higher risk of developing the disease, including those who are African-American or who have a family history of prostate cancer, should start undergoing these tests at age 40.

Diagnosis

If PSA tests indicate prostate cancer, a doctor will usually order further tests.

The PCRI suggest that people with high PSA levels should consider undergoing 3T multiparametric MRI scanning. This creates images of the prostate, and it can help doctors identify potential areas of cancerous activity.

The next step is usually a needle biopsy, in which a healthcare professional takes a sample of the prostate for examination in a laboratory.

Doctors can diagnose bone metastases using a bone scan or other imaging tests.

A bone scan involves injecting a small amount of radioactive dye into a person’s vein. The healthcare professional then scans the body with a special camera, and the dye helps reveal bone damage that may result from cancer.


Treatment

man holding packet of tablets
A person can take over-the-counter medication to help relieve back pain symptoms.

There are a variety of treatment options for people with prostate cancer and back pain.

Doctors often suggest watchful waiting, or no treatment, in the early stages of the disease. For other people, they may recommend a prostatectomy, which involves removing the prostate and some of the surrounding tissue.

Another treatment option is radiation therapy, which consists of using targeted radiation beams to kill the cancer cells.

For people with bone metastases, a doctor may inject radioactive drugs called radiopharmaceuticals. These drugs specifically target and kill cancer cells in the bones. Radiopharmaceuticals can relieve bone pain and help a person live longer.

Doctors may also prescribe medicines to prevent complications from bone metastases.

To help keep the bones strong, a person may also need to take calcium and vitamin supplements.

Common treatments for symptoms of back pain include:

  • using heat packs or cold packs
  • gentle stretching and low impact activities
  • strengthening exercises
  • physical therapy
  • over-the-counter or prescription pain medication


Takeaway

Prostate cancer is common among males in the U.S. It usually progresses slowly and responds well to treatment. Most people who receive a diagnosis of prostate cancer do not die from it.

Back pain can sometimes occur with advanced prostate cancer. However, back pain on its own does not necessarily indicate that a person has the disease. This pain is a common medical complaint, and there are many possible causes.

Anyone experiencing back pain and who is about the risk of prostate cancer should consider speaking to a doctor.

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