Prostate Cancer Symptoms

July 1, 2024

This page was reviewed under our medical and editorial policy by Wesley Yip, M.D., assistant professor, Division of Urology and Urologic Oncology, Department of Surgery, City of Hope^® Cancer Center Duarte

Prostate cancer is typically a slow-growing disease, but not always. Men usually have no symptoms when the cancer is in its early stages. While prostate cancer is often diagnosed through screenings such as digital rectal exams (DREs) and prostate-specific antigen (PSA) blood tests, sometimes the patient’s symptoms offer doctors diagnostic clues as well.

Signs of Prostate Cancer

Prostate cancer signs are objective indicators of disease that health professionals observe through exams or testing. By comparison, symptoms of prostate cancer are what the patient feels or experiences.

Men with prostate cancer may experience the symptoms listed below.

Urination issues: The prostate gland is a male reproductive organ. Located just below the bladder, it encircles the urethra, the tube that carries urine from the bladder through the penis. If cancer cells invade prostate tissues and a tumor begins to grow, it may press against the urethra and cause issues, such as straining to urinate or interrupted flow.

Blood in the urine or semen: A prostate tumor may irritate the urethra, causing blood in the urine or semen (since the urethra also carries semen out of the prostate gland).

Pain: When prostate cancer spreads (metastasizes) to the bones, men may experience pain in areas where it is present. For instance, back pain may be a symptom of prostate cancer that has spread to the spine, and chest pain may indicate it has spread to the ribs.

Leg or foot numbness: If prostate cancer has spread to the spine, the tumor may press on spinal nerves and cause numbness or weakness in the legs and feet.

Incontinence: Similar to its effects on the legs and feet, prostate cancer that has spread to the spine may result in a loss of bladder or bowel control.

Fatigue: Cancer-related fatigue may be caused by the buildup of certain toxins in the body or hormonal or protein changes that cause men to feel tired and worn out.

Weight loss: There are a variety of reasons for cancer-related weight loss, including increased metabolism and a loss of appetite from factors such as pain and fatigue.

Erectile dysfunction: Prostate cancer may cause prostate enlargement (prostate hypertrophy) that may lead to erectile dysfunction (ED), characterized by difficulty getting or maintaining an erection.

Problems with urination or blood in the urine or semen may be early signs of prostate cancer. The remaining signs and symptoms may be indications that the cancer has spread beyond the prostate gland. Men should tell their doctor about these symptoms right away so tests may be ordered to determine whether they are related to prostate cancer or to other common health conditions, such as benign prostate hypertrophy and prostatitis, which cause similar symptoms.

Men who choose to undergo prostate cancer screening may show a possible sign of cancer in PSA screening test results.

Prostate-specific antigen (PSA) is a protein produced by normal and cancerous cells in the prostate, so high levels or levels that trend upward over time may indicate prostate cancer or other noncancerous prostate conditions. Elevated PSA levels do not always mean cancer, but doctors may monitor these men more closely, look for rising levels in repeated tests or combine the results with other symptom information to guide further testing and treatment.

Symptoms of Recurrent Prostate Cancer

Recurrent prostate cancer means cancer has returned after tests found that no more cancer was detected after treatment. Similar to the initial diagnosis, recurrent prostate cancer may have no symptoms, which is why men are encouraged to follow through with regular follow-up care. For instance, a doctor may suggest regular PSA testing to check the blood for elevated levels of PSA.

Elevated PSA levels are often the first sign that the cancer is back.

If recurrent prostate cancer symptoms do appear, men may experience:

• Urination problems
• Bone pain
• Unexpected weight loss

Doctors will provide patients with a detailed list of symptoms to watch for after prostate cancer treatment has been completed, and men should let their doctor know if they experience these or any other symptoms that may indicate cancer has recurred.

Keep in mind that sometimes prostate cancer treatments cause side effects that are similar to those of the disease itself, such as urination issues and erectile dysfunction. The patient’s cancer care team will guide him through managing his symptoms and offer recommendations for advanced testing to help pinpoint any underlying causes.