Prostate cancer is the fifth leading cause of cancer death among men. One of the main reasons for this poor prognosis is the slow progression of symptoms. Often, warning signs appear only after the tumor has grown and began to put pressure on nearby tissues and organs. Although the disease rarely spreads to the skin, cases have been reported.
In 2018, researchers writing in the journal Hindawi reported the case of a 56-year-old man who presented to his clinic with a month-long history of skin problems.
The patient has purple nodules with a diameter of approximately 1.5 cm on the upper right cheek.
The purpuric nodule was solitary and asymptomatic, having “a firm consistency, central ulceration, and slightly raised margins surrounded by hematoma crusts.”
Initially, the patient reported no other unusual symptoms, but claimed to have lost approximately eight kilograms in weight over the previous 20 months.
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On questioning, the patient also admitted that he had had urinary symptoms a year earlier, including urge to urinate and urinary retention, but said that these symptoms disappeared spontaneously.
Unfortunately, the patient died eight months after being diagnosed with metastatic prostate cancer due to disseminated disease.
Because the skin is an unusual site for prostate cancer to metastasize, its presence is associated with a poor prognosis.
The authors explained: “Various manifestations of skin metastases resulting from internal malignancies have been reported and described as diagnostic problems for clinicians.”
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In one literature review from the PubMed database, scientists found 59 articles documenting 31 cases of this diagnosis.
However, only in 15% of cases, skin lesions helped establish the initial diagnosis of prostate cancer.
In advanced cases of prostate cancer or metastatic prostate cancer, when symptoms are most likely, patients tend to experience urinary retention and bone pain.
In a recent case study, a prostate cancer patient named Alan Kerr highlighted the importance of PSA tests for early diagnosis.
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In 2019, Alan went on holiday to Tenerife when he fell ill with gastroenteritis.
During a vacation visit with a general practitioner, he had his blood tested, which showed that he had an elevated prostate-specific antigen (PSA) level of 5.5 ng/mL.
Autopsy studies show that one in three men over 50 have cancer cells in their prostate, but when the PSA level exceeds 3 ng/mL, this may indicate an underlying problem.
After waiting 24 months to have his PSA checked again in 2021, Alan’s test result showed that he had risen from 5.5 ng/mL to 7.7 ng/mL.
So he was sent to the hospital for more tests when he was officially diagnosed with prostate cancer at the age of 65.
“They checked my prostate and said the edges were hard to touch. Then I had an MRI and a biopsy when I was diagnosed with prostate cancer at the age of 65,” he said.
The diagnosis showed that Alan had slow-growing cancer cells, as well as a small number of medium-growing ones, which required immediate treatment.
“Despite the fact that I had a delay of about a year, I was still lucky to catch her early,” commented Alan.
Prostate cancer in most cases begins to develop at the age of 50 and reaches its peak incidence between the ages of 60 and 70, so it is recommended that men get more PSA tests as they grow older.