Updated on March 28, 2024.
Prostate cancer, which occurs when cells in the prostate gland start to grow irregularly, is the second most common cancer among men in the United States, behind only skin cancer. One out of every nine men will be diagnosed with the cancer during their lifetime, according to the American Cancer Society (ACS).
The good news is that most people with prostate cancer will not die as a result of the disease. Still, it is a potentially serious illness that could require monitoring or treatment. That’s why it’s important to become familiar with symptoms that may warrant a call to your healthcare provider (HCP).
What are the symptoms of prostate cancer?
The prostate is a small gland located below the bladder that helps make semen. Prostate cancer typically doesn’t have noticeable symptoms at first. “There are no clear symptoms associated with early or organ-confined prostate cancer [cancer that stays within the prostate gland],” says John McGill, MD, a urologist in Georgia. Cancers at this stage are usually discovered as a result of screening.
Once symptoms do appear, it means the cancer is already at an advanced stage.
“In advanced prostate cancer, men may develop bone pain, blood in the urine, or obstruction of the bladder or ureters, the thin tubes that drain urine from the kidneys,” says Dr. McGill. Other prostate cancer symptoms may include frequent urination, foot or leg numbness, and problems with erections.
Why can symptoms be confusing?
The later symptoms of prostate cancer aren’t necessarily unique to the disease. Many other conditions have similar warning signs, making it challenging to diagnose.
Some of the symptoms that could suggest other illnesses include:
- Bone pain: “Differentiating bone pain from general aches and pains can be quite difficult,” says McGill. “This is one reason why bone pain by itself does not necessarily mean a person has advanced prostate cancer.”
- Bloody urine: Hematuria, or blood in the urine, may indicate advanced prostate cancer, but it can also indicate conditions like kidney stones (pebble-like pieces of material in the kidneys that can block urine flow), urinary tract infections, or iregular growths in the kidneys, ureters, or bladder.
- Urination problems: Trouble urinating is more likely a sign of benign prostatic hyperplasia (enlarged prostate), a non-cancerous condition caused by the growth of prostate cells and increased size of the prostate with age, according to the ACS.
If you experience any of these symptoms or combination of these symptoms, see your HCP right away, regardless of the recommended age for screening. Your HCP will advise what tests you might need to determine a diagnosis.
How is prostate cancer diagnosed?
Certain tests can help detect prostate cancer, even in early stages. These include the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE, when a healthcare provide examines the prostate by using gloves and lubricant, and gently sliding their index finger into the rectum). If these show irregularities, a prostate biopsy—a procedure that involves removing small samples of the prostate to examine under a microscope—may be recommended.
But prostate cancer diagnosis can be complicated, says McGill. Early screenings like the PSA test and DRE may not be completely accurate. They may produce false-positive results, which suggest cancer when it isn’t present. They may also produce false-negative results, indicating that a patient doesn’t have cancer when they really do.
Sometimes, when elevated PSA levels and a biopsy signal prostate cancer, a patient may have treatment like radiation or surgery. But in very-low-risk and low-risk cases, this treatment might be unnecessary, as the disease may progress so slowly that it would never cause significant problems. In fact, because both radiation and surgery have side effects of their own, treatment for very-low-risk and low-risk prostate cancer may affect quality of life more than the cancer itself.
The main points about prostate health
McGill says staying up to date with urology (which treats diseases of the urinary tract and male reproductive tract) and other healthcare appointments is the best way to check in the health of your prostate. This may involve prostate cancer screening, for which recommendations vary by age and risk.
- For average-risk men between ages 55 and 69, the United States Preventive Services Task Force (USPSTF) recommends discussing the risks and benefits of screening with a clinician. The decision to be screened is up to the individual. Routine screening is not recommended for average-risk men aged 70 and older.
- Those at increased risk, who include African American men and people with a first-degree family history of early prostate cancer (parent or sibling), should begin this conversation sooner, according to the ACS.
Always report new, severe, or unusual symptoms to an HCP, even if you are outside the recommended ages for screening.
