Signs and Symptoms of Prostate Cancer

Prostate cancer is a disease in which abnormal cells grow uncontrollably in the prostate gland, forming a tumor. In the early stages of the disease, prostate cancer usually does not cause symptoms. As the disease progresses, symptoms of prostate cancer can include frequent urination, weak or interrupted urine stream, painful ejaculation, blood in urine or semen, erectile dysfunction, and pain in the back, groin, or chest. 

If you have these symptoms, it doesn’t necessarily mean you have prostate cancer. Other conditions that affect the prostate, such as benign prostatic hyperplasia (enlarged prostate) and prostatitis (inflammation of the prostate) cause similar symptoms.

Common Symptoms

The prostate is a walnut-sized gland located in the lower pelvis in front of the rectum and just below the bladder. The prostate wraps around the urethra, a tube that empties urine from the bladder. When a tumor presses on or constricts the urethra, it can cause some of the more common symptoms of prostate cancer:

Frequent Urination 

Frequent urination is the need to urinate more than usual. Most people don’t know how many times they urinate each day, but people with prostate cancer may notice they are making more bathroom trips than normal. 

Nocturia (Excessive Nighttime Urination)

Nocturia, or excessive nighttime urination, is when you wake up more than once a night to urinate. The body slows down urine production at night, which allows most people to sleep between six to eight hours without waking to use the bathroom. Though nocturia can be a symptom of prostate cancer, there are many other causes, including aging. 

Urinary Urgency 

Along with frequent urination, prostate cancer can cause a sudden, overwhelming need to urinate right away. Urinary urgency can make it difficult to “hold it,” and may be accompanied by discomfort in the bladder or urinary tract. 

Difficulty Urinating 

Having trouble urinating, known as urinary hesitancy, can include problems with starting the stream of urine, a weak or slow stream, or a stream that frequently starts and stops. Feeling like the bladder is not completely emptied and dribbling (leaking) urine are also possible signs of prostate cancer.

Less Common Symptoms

Other symptoms of prostate cancer may also occur. These include:

Painful Ejaculation 

Pain during or immediately after ejaculation can be a sign of prostate cancer. This may be felt in the penis, testes, rectum, or lower abdomen. Painful ejaculations range from mild discomfort to excruciating and may last a few seconds or longer.

Blood in the Urine or Semen 

Blood in the urine (hematuria) or blood in the semen (hematospermia) can occur when a tumor in the prostate gland presses on the urethra or surrounding glands and blood vessels. This can irritate or block these structures, causing blood to appear in urine or semen.

Sudden Onset Erectile Dysfunction 

Erectile dysfunction (ED) is when it is difficult to get or keep an erection. Aging is a common cause of ED, but is typically gradual in onset. Sudden onset erectile dysfunction may be a sign of prostate cancer. This can occur when a tumor compresses or damages nerves that control blood flow to the penis.

Advanced Stage Symptoms 

If cancer has metastasized (spread) outside of the prostate, other symptoms can occur. These include:

Pain in the Back, Hips, or Chest

When prostate cancer spreads, the bones are almost always the first part of the body affected. This is known as bone metastases. Cancer can spread to any area of the body, but the back, hips, and ribs are the most common sites of bone metastases. 

Swelling in the Legs or Feet

Swelling in the legs and feet may occur when prostate cancer spreads to the lymph nodes in the pelvis. The lymph nodes are part of the lymphatic system, which collects excess fluid from body tissues and organs, filters it, and returns it back to the bloodstream. When cancer cells enter lymph nodes and block lymph drainage channels, fluid can build up and lead to swelling. 

Unintentional Weight Loss

Unintentional weight loss is often a sign of advanced prostate cancer. Cancer cells demand a lot of the body’s energy supply, causing the body to burn more calories than normal. Loss of appetite and fatigue common in advanced prostate cancer can also contribute to weight loss. 

Numbness and Weakness in Limbs

When cancer spreads to the spine, the tumor may compress the spinal cord and cause a range of symptoms, such as numbness, tingling, and weakness in the arms and legs. Loss of control of the bladder and bowel may also occur, which can lead to incontinence (leaking urine or feces) or difficulty emptying the bladder or bowel. 

When to See a Healthcare Professional

If you have any symptoms of prostate cancer, see your healthcare provider. Not everyone who experiences these symptoms has prostate cancer. Other conditions that affect the prostate, such as benign prostatic hyperplasia (enlarged prostate) and prostatitis (inflammation of the prostate), cause similar symptoms. Your healthcare provider can investigate to determine the cause and provide treatment.

A Quick Review

Prostate cancer is a slow-growing disease that does not usually cause symptoms in the early stages. More advanced prostate cancer may cause symptoms such as frequent urination, a weak urine stream, erectile dysfunction, and blood in the urine or semen. Other prostate conditions, such as an enlarged prostate, cause similar symptoms. 

If you have symptoms of prostate cancer, it’s important to make an appointment with your healthcare provider so they can find and treat the cause.