Common Prostate Cancer Emergencies

Most people do not think of prostate cancer as an illness that can result in emergencies. However, there are a few ways prostate cancer could necessitate an urgent trip to the hospital.

Emergency staff rushing patient on gurney in hospital

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Emergency Situations Caused by Prostate Cancer

Prostate cancer is usually a disease that develops and grows over a number of years rather than days or weeks. Consequently, many people don't think of prostate cancer as an illness that can result in emergencies. Unfortunately, as with other cancers, these trips to the emergency for care are all too common. What are some of the most common emergency situations?

Urinary Retention

Because the prostate is situated just below the outlet of the bladder, urinary symptoms are the most common symptoms of an enlarged prostate (whether due to prostate cancer or BPH, benign prostatic hypertrophy).

If the outlet of the bladder becomes completely obstructed by an enlarged prostate, however, then no urine is able to pass from the bladder to the urethra and then out of the body. This results in what is called acute urinary retention.

Untreated Urinary Retention

If this obstruction does not diminish relatively quickly, the bladder will completely fill with urine and can cause extreme abdominal pain.

If it is not relieved for many hours, pressure will build up within the urinary system. This pressure will be transmitted upstream to the kidneys, which can then become infected or damaged (possibly irreversibly). Kidney failure and death can result if the kidneys are not treated appropriately in this situation.

Acute urinary retention is an emergency and a complete inability to urinate should prompt a trip to the emergency room.

Typically, if the obstruction has not been present for long enough to damage the kidneys, the blockage can be relieved by simply placing a catheter into the bladder. Long-term treatment of urinary obstruction is usually accomplished with medication that shrinks the prostate or surgery to remove the tissue causing the blockage.

Spinal Cord Compression

Prostate cancer is known to have a tendency to metastasize (spread) to bone. In particular, the spine is a common place of spread when prostate cancer has moved outside of the pelvis.

One of the primary functions of the human spine is to protect the spinal cord. The spinal cord acts as the main pathway of information from the brain to the rest of the body. Prostate cancer, if it has metastasized to the spine, can cause compression of the spinal cord.

If the cord is compressed for too long (sometimes as little as a few hours), then it can suffer irreversible damage and cause permanent disability.

Most of the symptoms of cord compression are vague and non-specific. Lower back pain, pain shooting down the legs, burning or tingling in the hands or feet, and loss of sensation are common symptoms of cord compression. Additionally, loss of urinary or bowel control can be caused by cord compression.

Spinal cord compression is typically treated with some combination of steroids to reduce swelling, radiation to shrink the tumor, and surgery to remove the tumor.

Bottom Line

A known history of prostate cancer, especially if it has metastasized, should prompt a visit to the emergency room (or at least a call to your physician) if you notice any of these symptoms.

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By Matthew Schmitz, MD
Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families.