Three-Year Back Pain Masks Stage 4 Prostate Cancer
A 62-year-old man's three-year back pain turned out to be stage 4 prostate cancer that had spread to his spine, only discovered after he developed urinary problems. Doctors warn that early prostate cancer often has no symptoms, and bone pai
A man with chronic back pain for three years who could not find relief through orthopedic treatment was eventually diagnosed with stage 4 prostate cancer that had spread to his spine.
Early-stage prostate cancer typically shows no clear symptoms, leading many patients to discover the disease only after urinary problems or bone pain develops. According to a report, a 62-year-old factory owner underwent continuous orthopedic treatment for 2–3 years without finding the true cause of his pain.
Recently, when he developed urinary difficulties and weak urine flow, he consulted a urologist. Testing revealed stage 4 prostate cancer with cancer cells that had already metastasized to his spine. This revealed that his years of recurring back pain was not caused by bone or joint disease but by metastatic prostate cancer.
Dr. Gu Fangyu, Chief Director of Gujia Medical and the physician caring for this patient, explained that early-stage prostate cancer typically progresses slowly. Most patients have no symptoms at all. Even when urinary symptoms appear—such as weak urine flow, narrow stream, or frequent nighttime urination—patients often attribute these to aging or benign prostate enlargement, missing the opportunity for early detection.
This patient had a PSA value of approximately 10–11, which is higher than the reference range of 4–10 that doctors typically use as a benchmark. However, Dr. Gu noted that a high-precision MRI of the prostate was needed to identify suspicious lesions.
Dr. Gu stated that PSA is a widely used screening tool for prostate cancer that helps identify at-risk individuals. However, because PSA testing is highly sensitive, benign prostate enlargement or inflammation can also elevate PSA levels. Therefore, PSA results must be evaluated together with other diagnostic tests.
When abnormal PSA values are found, more accurate diagnostic methods are now available to help determine whether a patient needs a biopsy. The key to successfully treating prostate cancer is "early detection." Stage 1 and 2 prostate cancer, when treated promptly, has a high cure rate.
However, Dr. Gu noted that when cancer has spread to bone, lymph nodes, or other organs, treatment becomes more difficult, and the five-year survival rate may drop to approximately 30–50%.
In particular, bone is a common site for prostate cancer metastasis. Patients may experience prolonged lower back pain or hip bone pain but mistakenly attribute it to age-related degeneration or muscle and bone problems, potentially delaying diagnosis.
Taiwan's Department of Health and Welfare plans to launch a pilot prostate cancer screening program next year. Dr. Gu recommends that men aged 50 and older, as well as those aged 45 and older in high-risk groups—such as those with a family history of prostate cancer or BRCA gene mutations—should undergo regular screening.
If abnormal PSA levels are detected, there is no need to panic excessively. Patients should promptly seek a detailed evaluation from a urologist. If necessary, additional testing with PHI (Prostate Health Index) or high-resolution MRI may help identify clinically significant lesions early and improve the chances of receiving treatment at the optimal time.
