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In most cases, prostate cancer symptoms are not apparent in the early stages of the disease. The symptoms of prostate cancer may be different for each man, and any one of these symptoms may be caused by other conditions. As a result, routine screenings in the form of digital rectal exams and prostate-specific androgen (PSA) tests are important.
Early warning signs of prostate cancer
Because of the proximity of the prostate gland to the bladder and urethra, prostate cancer may be accompanied by a variety of urinary symptoms, especially in the early stages. Depending on its size and location, a tumor may press on and constrict the urethra, inhibiting the flow of urine. Some early prostate cancer signs include:
Burning or pain during urination
Difficulty urinating, or trouble starting and stopping while urinating
More frequent urges to urinate at night
Loss of bladder control
Decreased flow or velocity of urine stream
Blood in urine (hematuria)
Blood in semen
Difficulty getting an erection (erectile dysfunction)
Prostate cancer may spread (metastasize) and form tumors in nearby organs or bones. If the cancer spreads to the spine, it may press on the spinal nerves. Signs of metastatic prostate cancer may include:
Swelling in legs or pelvic area
Numbness or pain in the hips, legs or feet
Bone pain that doesn’t go away, or leads to fractures
The symptoms of prostate cancer often differ from patient to patient. The most common first sign of recurrent prostate cancer is a rise in the PSA level in the blood, making regular PSA tests all the more important in measuring the progress of treatment and checking for signs of recurrence. It is important to report new signs or symptoms to your doctor.
Prostate specific antigen test
A prostate-specific antigen (PSA) test measures the level of PSA in the blood. The prostate gland produces PSA, a protein that at an elevated level may be a sign of prostate cancer. A high PSA reading also may indicate noncancerous conditions such as inflammation of the prostate (prostatitis) and enlargement of the prostate (benign prostatic hyperplasia).
Men who have symptoms associated with prostate cancer may have a PSA test along with a digital rectum exam (DRE). These symptoms include burning or pain during urination, loss of bladder control, painful ejaculation, and swelling in legs or pelvic area. For the test, a clinician takes a sample of your blood and sends it to a lab for analysis.
In the past, a PSA reading of 4 ng/mL and below was considered normal. Men with a reading above 4 ng/mL were considered likely to have prostate cancer and would have a biopsy to confirm the cancer’s presence. According to the National Cancer Institute, research has found that men with prostate cancer can have a low PSA level, while men without prostate cancer can have a high level. One in four men with an elevated PSA level actually has prostate cancer. However, an increase in PSA level over time may indicate a prostate tumor.
The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer, beginning at age 50. Men with one or more risk factors for prostate cancer should consult with their physician about whether to start routine screening earlier.
Symptoms of enlarged prostate can include:
A weak or slow urinary stream.
A feeling of incomplete bladder emptying.
Difficulty starting urination.
Urgency to urinate.
Getting up frequently at night to urinate.
A urinary stream that starts and stops.
Straining to urinate.
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