Nearly 200,000 American men will get a prostate cancer diagnosis this year. It’s the second most common cancer that affects males (skin cancer is first). For some men, the diagnosis will come as a surprise because they may have had no symptoms. Others will realize that certain problems they have experienced for months (or even years) were actually early signs of prostate cancer.

Men in their 60s are most at risk for prostate cancer, but any male can get it. Regardless of your age, it’s important to know the early warning signs of this disease. This type of cancer often grows slowly. A prompt diagnosis and treatment can make a significant difference in your health.

What are the early warning signs of prostate cancer?

You should contact your doctor if you experience new or unusual symptoms, especially if they persist for several weeks. These are the four most common warning signs of prostate cancer:

• problems urinating

• frequent or urgent urination

• increased bathrooms trips at night 

• blood in urine or semen

Problems urinating

The prostate is a small, walnut-shaped gland that surrounds the urethra. Urine flows through the urethra (a tube) to leave the body. Cancer can swell the prostate, which then squeezes and narrows the urethra. As a result, you may experience:

• burning sensation or pain when you urinate

• trouble starting to urinate (urinary hesitancy)

• urine stream that starts and stops

• weak urination

Frequent or urgent urination

An enlarged prostate can block or push against the bladder. If your bladder doesn’t empty completely, it will fill up faster. You’ll need to pee again sooner than usual. This need to pee may come on suddenly and urgently.

Increased bathroom trips at night

Getting up to relieve yourself several times in the night (a condition called nocturia) is another sign of prostate cancer. Your bladder has to work harder to push out urine when an enlarged prostate constricts the urethra. Over time, the bladder becomes weaker and loses its ability to hold urine through the night.

Blood in urine or semen

When an enlarged prostate presses on the urethra, it can irritate the bladder and the urethra, as well as the surrounding glands and blood vessels. These structures can get blocked. A blockage or irritation causes blood to seep out. Urine or semen may have a red, pink, or tea-colored appearance. Sometimes only a lab test can detect small amounts of blood.

What are signs of advanced prostate cancer?

Sometimes, prostate cancer goes undetected until it spreads outside the gland. This is known as metastatic, stage 4, or advanced prostate cancer. Prostate cancer tends to spread to the bones and the lymph nodes. Symptoms of metastatic prostate cancer vary depending on where in the body the cancer spreads.

Signs of advanced prostate cancer include:

• lower back, pelvic, hip, or chest pain

• loss of bladder or bowel control

• weakness or numbness in the legs or the feet

Is prostate cancer causing my symptoms?

Because prostate cancer symptoms can be easy to dismiss, it’s important to see your doctor for a checkup when you have concerns. In general, prostate cancer symptoms are characteristically:

• disruptive to daily life

• noticeably different from how you normally feel 

• persistent (for instance, occurring multiple times over several weeks)

Can other conditions cause prostate cancer symptoms?

As men get older, the prostate gland naturally gets larger. Other benign (noncancerous) conditions can affect the prostate and cause symptoms similar to prostate cancer. Tests can diagnose prostate cancer or rule it out.

Common noncancerous prostate problems include:

• Benign prostatic hyperplasia (BPH): Almost every male develops BPH at some point. This condition enlarges the prostate. The swollen gland squeezes the urethra, blocking the flow of urine and semen. BPH does not increase your risk of prostate cancer. There are medications to alleviate BPH. 

• Prostatitis: About half of all men will develop a form of prostatitis. A bacterial infection is often the cause. The infection inflames the prostate gland. It may also raise levels of prostate-specific antigens (PSAs) in the blood. Prostatitis doesn’t cause prostate cancer or increase cancer risk. Doctors often use antibiotics to treat prostatitis.

How is prostate cancer diagnosed?

Men who have few risk factors for prostate cancer typically get their first prostate screening at age 50.

Tests for prostate cancer include:

• Digital rectal exam (DRE): Your provider feels the prostate gland, which sits in front of the rectum. Unusual changes, such as bumps or hard areas, may indicate cancer.

• PSA blood test: A blood test checks for elevated levels of PSA, a protein made by the prostate gland. A higher-than-usual PSA level may indicate a number of problems, including prostate cancer, BPH, or prostatitis. 

• Biopsy: A biopsy is the only sure way to diagnose prostate cancer. Your doctor uses a thin needle to remove tissue or fluid from the prostate gland. A lab analyzes the biopsy samples for cancer cells.

How is prostate cancer managed or treated?

Prostate cancer is typically a slow-growing cancer. Some men never need treatment for prostate cancer. For men who do need treatment, the disease is highly curable.

Treatment options include:

• Active surveillance: no immediate treatment for slow-growing cancer that only affects the prostate gland

• Brachytherapy: a form of internal radiation that implants radioactive seeds near the tumor 

• External radiation therapy: a machine delivers strong X-ray beams directly to the tumor

• Systemic therapies: chemotherapy, hormone therapy, or immunotherapy to treat metastatic prostate cancer 

• Focal therapy: the use of extreme temperatures to destroy cancer cells

• Prostatectomy: surgical removal of the diseased prostate gland

From the community: “Mine was discovered relatively early after starting a low testosterone program. I did the usual blood tests and my PSA was 3.0, so there was no immediate concern. I started on Axiron (1 arm only) and went back for a follow up blood test after 1 month. My testosterone levels were still low, so my Dr said to try both arms. The results were what I was looking for - increased energy, sex drive and an improvement in ED, BUT,...

What my Dr did tell me from the start is that Low T treatments will not cause cancer but will "feed" it if its already there. Man was he correct on that one! I went back in 1 month after increasing the Axiron dosage with the traditional urinary warning signs - Weaker stream, interupted stream, incomplete emptying of my bladder, and urinary discomfort. He did another blood test and found my testosterone levels were right but my PSA went up to 3.5 in 1 month, so he did a free PSA test. This test revealed a 9% score, where 20-30% is normal for my age (56).” – Inspire member

Sources

• Key Statistics for Prostate Cancer. American Cancer Society. January 2020.

• Signs and Symptoms of Prostate Cancer. American Cancer Society. August 2019.

• Prostate Cancer Symptoms and Signs. American Society of Clinical Oncology. November 2019.

• Urinary Problems. Prostate Cancer News Today.

• Nocturia — Nighttime Trips to the Bathroom. The Simon Foundation for Continence. 

• Other Prostate Conditions (Related & Unrelated). Zero—The End of Prostate Cancer.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.