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Is Stage IV Cancer In Bladder (or Anus For That Matter) The Only Option For Such Symptoms?

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Posted on Mon, 16 Dec 2024
Question: Hi there

I fear I am dying from bladder cancer. I am 52 year old male, nonsmoker, computer programmer. I am 77 kilograms (up 2 in the last year).

I have a history of somatoform problems. I had bladder problems (frequency, testicular pain) some 20 years ago and 10 years ago I had anal pain and testicular pain for a few months. Doctor then found nothing.

My problems started after I had some weird viral infection 3 months ago. Maybe it was covid, as I lost smell for 2 days, but I didn’t go to test myself. At the middle of ilness after bowel movement I was having anal pain. This continued on and off for like 2.5 months, some days were better some worse, and I never had anal pain at night. Sometimes with anal pain I also have testicular pain, more on the left where I have a 1 cm spermatocele (for 30 years now) and varicocele (also since my puberty).

Now for 10 days I have new symptoms. I get too many times frequent urge to urinate. When my bladder is a little full, my testacle has more pain and I have to go to pee. I still have rectal pain, but much less, like the pain is shifting from rectum to urinary tract.

So I have rectal pain, testicle pain, pain at the tip of the penis, urinary frequency. The most is when I am sitting, walking makes pain better, but urinary urgency and some weird feeling at my penis is still there. At night most of the problems dissapear (maybe I feel tip of the penis at night).

I am worried because my urine color is like XXXXXXX of a white person, not so much yellow. I do not remember if that is normal or not. It is not dark brown, more like very light brown and certanly not red or pink. Sometimes it is more yellow and sometimes a little orange.

I am constantly in a half aroused state, but not pleasantly aroused. I have good erection because of that and in semen there is nothing wrong to be seen, all white.

When I pee, it doesn’t hurt or burn, the scrotum has some burning pain (like testicle pain) and I have perineum pain and anal burning dull pain. It feels like mild urinary infection meets prostatistis meets anal inflamation. I fear I had cancer somewhere in the pelvis that now spread over the whole area. What else could spread and last for months? :-(

It would be logical to have anal cancer (although I do not feel anything wrong when I put olive oil inside my anus) because it started the first. But I am most scared now of bladder cancer because of the “incident” I had 2.5 years ago, when I didn’t have any symptoms…

2.5 years ago I was on a routine check at 50 years old and there was blood in urine, 4-10 RBC instead of 0-3 and 1 on Haemoglobin instead of 0… For a male having blood in urine without other syptoms is suspect of cancer I heard.

I did another urine test 1 week later and there was no blood. I did ultrasound with full bladder and kidneys and what they could see with ultrasound was ok. I never had cystoscopy, I fear the procedure so much. I did another urine test a year ago (1.5 years later) and it was ok. I did another one 6 months ago and the Haemoglobin was again 1 and the RB was 0-3 (normal). They told me this is not significant as the dipstick has much false positives and I was running 10km evening before the test.

But now I am thinking… can this blood 2.5 years ago be from the bladder cancer that has now made me symptoms and attacked anus, testicles…? Is there any other explanation for my symptoms?

I will be going to the lab to have complete blood and urine workup now again, but becaue of my symptoms I am so scared to go because I fear I will have blood in urine and blood markers will be all wrong. I am in a terrible physical state right now.

Is stage IV cancer in bladder (or anus for that matter) the only option for such symptoms? I know stage 1-3 do not make pain, so it has to be stage IV. I get some relief from the pain sitting on toilet, from hot baths or hot water and at night when I am sleeping…

Yours scared
XXXXXXX
doctor
Answered by Dr. Chakravarthy Mazumdar (7 hours later)
Brief Answer:
No Cancer of Bladder at all .You have Chronic Non Bacterial Prostatitis.

Detailed Answer:
Hello
Thanks for query .

Based on the facts that you have narrated the pain in perineal region ,testicle associated with frequency for urination that you have since last 2 years is strongly suggestive of what is called as Non Bacterial Prostatitis which is very common at this age .

Presence of few RBC (4-6) is not of any significance and is not indication of cancer of bladder as suspected by you .Caner of Bladder always presents with gross painless hematuria.(Frank Dark Blood in urine). Few RBC in urine signifies mild UTI .

Consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Serum PSA.
4) Microscopic Examination and Culture of urethral discharge collected after Digital Rectal Examination (DRE).
5) Semen Examination and Semen culture.

Please do remember that Chronic Non Bacterial Prostatitis takes long time to get cured hence one has to have patience .

Doing prostate massage everyday through rectum does help to reduce the congestion of prostate and gives relief.

.Further treatment will depend upon result of these tests and final diagnosis.

Hope I have answered your query ,please feel free to ask if you have more questions, I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 2087 Questions

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Is Stage IV Cancer In Bladder (or Anus For That Matter) The Only Option For Such Symptoms?

Brief Answer: No Cancer of Bladder at all .You have Chronic Non Bacterial Prostatitis. Detailed Answer: Hello Thanks for query . Based on the facts that you have narrated the pain in perineal region ,testicle associated with frequency for urination that you have since last 2 years is strongly suggestive of what is called as Non Bacterial Prostatitis which is very common at this age . Presence of few RBC (4-6) is not of any significance and is not indication of cancer of bladder as suspected by you .Caner of Bladder always presents with gross painless hematuria.(Frank Dark Blood in urine). Few RBC in urine signifies mild UTI . Consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis. 1) Urine routine and culture. 2) Ultrasound scanning of abdomen and pelvis 3) Serum PSA. 4) Microscopic Examination and Culture of urethral discharge collected after Digital Rectal Examination (DRE). 5) Semen Examination and Semen culture. Please do remember that Chronic Non Bacterial Prostatitis takes long time to get cured hence one has to have patience . Doing prostate massage everyday through rectum does help to reduce the congestion of prostate and gives relief. .Further treatment will depend upon result of these tests and final diagnosis. Hope I have answered your query ,please feel free to ask if you have more questions, I shall be happy to help you Thanks and Regards. Dr.Patil.