Lower back and hip pain x 2 years

[utheta]

I am a 38 yo overweight black male with 2 year hx of lower back pain and hip pain in addition to HTN controlled with Benicar. Recently began feeling as if my urine stream has decreased and had a CXR done for work recently which found right middle lobe atelectasis or possible pneumonia. I don't feel sick (no fever, night sweats, or hemoptysis). Ocassional bright red blood on tissue paper I think are hemorrhoid related. If I sit for a long time there is pain in the hip area when I walk. One heterosexual partner for 3 years (protected and unprotected sex). HIV test negative in 2004 and partners HIV test was also negative at this time.  After I urinate, there are 1-2 spots of urine on underwear (is this considered dribbling).  I don't smoke, drink 1-2 drinks per month, no drug activity. In addition to the above listed complaints. As an African American approaching 40, I am concerned about Prostate Cancer.  Can you please tell me if this could be metastatic prostate cancer ?

[Kevin Pho, MD]

I can't tell whether its cancer over the internet.  

However, I would further investigate the prostate given the changes in the urinary stream.  A digital rectal exam should be done to feel the prostate, and blood test for PSA can be done to help evaluate for cancer.  If the PSA is elevated, a prostate biopsy should be done to rule out cancer.  

I would further investigate the blood on the tissue paper with a lower endoscopy to ensure it isn't anything more than hemorrhoids.  

These options should be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Rocky Mount]

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