Prostate cancer usually does not cause symptoms in the early stages. Signs of prostate cancer can include frequent urination, weak or interrupted urine stream, painful ejaculation, blood in urine or semen, and erectile dysfunction as the disease progresses. It doesn’t necessarily mean you have prostate cancer if you have these symptoms. Other conditions that affect the prostate, such as benign prostatic hyperplasia (enlarged 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 in the male reproductive system. The prostate wraps around the urethra, a tube that empties urine from the bladder. A tumor can press on or constrict the urethra, causing frequent urination, urinary urgency, and difficulty urinating.
FREQUENT URINATION AND NOCTURIA
Frequent urination is the need to urinate more than usual. Most people don’t know how many times they urinate each day. People with prostate cancer may notice they are making more bathroom trips than normal. 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. Nocturia can be a symptom of prostate cancer, but there are many other causes, such as aging.
URINARY URGENCY
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 less common symptoms include painful ejaculation, blood in the urine or semen, and erectile dysfunction.
PAINFUL EJACULATION
Pain during or immediately after ejaculation can be a sign of prostate cancer. You may feel pain 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 in the semen (hematospermia) can occur when a tumor in the prostate gland presses on the urethra or surrounding glands and blood vessels. A tumor can irritate or block these structures, causing blood to appear in urine or semen.
SUDDEN ONSET ERECTILE DYSFUNCTION
Erectile dysfunction is when it is difficult to get or keep an erection. Aging is a common cause, but it is typically gradual in onset. Sudden onset erectile dysfunction, in contrast, 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
Other symptoms can occur if the cancer has metastasized (spread) outside of the prostate. Advanced symptoms include pain, swelling in the legs or feet, unintentional weight loss, and numbness and weakness.
PAIN IN THE BACK, HIPS, OR CHEST
The bones are almost always the first part of the body affected when prostate cancer spreads. 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. Fluid can build up and lead to swelling when cancer cells enter lymph nodes and block lymph drainage channels.
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. Fatigue is common in advanced prostate cancer and can also contribute to weight loss.
NUMBNESS AND WEAKNESS IN LIMBS
A tumor may compress the spinal cord and cause a range of symptoms when cancer spreads to the spine. Symptoms include numbness, tingling, and weakness in the arms and legs. Loss of control of the bladder and bowel may also occur. This can lead to incontinence (leaking urine or feces) or difficulty emptying the bladder or bowel.
WHEN TO SEE A HEALTHCARE PROVIDER
See a healthcare provider if you have prostate cancer symptoms. Not everyone who experiences these symptoms has prostate cancer. Other conditions that affect the prostate, such as benign prostatic hyperplasia (enlarged prostate), cause similar symptoms. A healthcare provider can investigate to determine the cause and provide treatment.
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. It’s important to make an appointment with a healthcare provider if you have prostate cancer symptoms. They can find and treat the cause.
