PCRI’s Executive Director, Mark Scholz, MD, discusses coordinating with your doctor to distinguish prostate cancer pains from other pains, and how to go about alleviating the symptoms to restore quality of life.
0:09 Men who are diagnosed with prostate cancer are often concerned about pain. Although pain from prostate cancer does occur, it is much rarer than with other forms of cancer. More often, pain comes from something unrelated to prostate cancer, and it is a physician's job to work with you to find the source of pain and to relieve it to restore quality of life.
1:40 Men with undetectable PSAs or men who are newly diagnosed without metastases will almost certainly not experience any pain as a result of prostate cancer. If the PSA is 5-10 or higher, however, pain from cancer is possible, but it is still important to distinguish whether it is from the cancer or something else.
2:16 Pain from prostate cancer almost always shows up as issues with the bones. If it is a pain in the joints, then it is most likely arthritic pains since prostate cancer does not spread to the joints. Prostate cancer also does not spread to bones past the elbow or the knees since red marrow is not produced there. If you are experiencing enduring, progressive pain in the bones (in the expected areas) then the use of a scan can confirm whether or not the pain is from cancer. If the pain is the result of cancer, then it can be relieved with the use of beam radiation—although there is a limit to the number of spots that can be treated. There are also injectable forms of radiation, such as Xofigo, that can also reduce pain.
3:45 The most effective way to control pain from prostate cancer is to control the disease itself with whatever the best available therapy is (first and second generational hormone agents, chemotherapy).
4:25 If there is a confusing question about whether a painful spot is coming from cancer, then carefully going over your history with your doctor can help clarify the situation. If the pain subsides throughout the day or with certain activities, then it probably is not from cancer. Pain from cancer is progressive (meaning it gets worse and worse), persistent (it will not go away without treatment), and consistent (it is not relieved with certain activities or at certain times of the day).
5:07 The use of analgesics is an effective way to treat pain while waiting for the effects of a new treatment. Non-steroidals such as Motrin, Aleve, and Celebrex are typically effective and safe. If they are not effective, narcotic medications can also be used until the new treatment starts working.
5:58 Cortizone (Prednisone in doses of 20-30mg) is an effective analgesic that can also improve energy; however, it is unsafe to use for more than a few weeks.
6:23 Pain from prostate cancer is a rare occurrence, but if it happens then there are usually solutions to relieve the pain. If your doctor is not able to relieve the pain that you are experiencing, then it is worth being asked to be referred to a pain specialist.
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