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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

Prostate cancer symptoms

Prostate cancer is the most common cancer in men after skin cancer, so it’s important to understand the basics of the disease, as well as the risk factors.

The prostate is a small gland in the male reproductive system. It’s essential in producing fluid that enriches semen, but it may cause issues as men age. 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 (DRE) and prostate-specific androgen (PSA) tests are vital

Early prostate cancer symptoms

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
  • Erectile dysfunction
  • Painful ejaculation

Advanced prostate cancer symptoms

Men with advanced prostate cancer may experience additional symptoms. That’s because the cancer has spread from the prostate to other parts of the body, such as the bones or lymph nodes.

A wide range of treatment options are available for managing advanced cancer. These treatments kill cancer cells, but they may also help patients manage pain.

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 persists or leads to fractures

Recurrent prostate cancer symptoms

Prostate cancer that returns after treatment is considered recurrent. When it returns to the area around the prostate, the disease is classified as a local recurrence. If the cancer is found in another part of the body, the recurrent cancer is considered metastatic. If the cancer metastasizes (or spreads) outside the prostate, it most likely develops in bones first. Metastatic prostate cancer most often spreads to the liver, bones and lungs.

After initial treatment for prostate cancer, PSA levels are expected to drop dramatically. The first sign of recurrent prostate cancer may be a rise in the PSA level. Other symptoms of recurrent cancer may depend on whether and where the cancer has spread. Symptoms include:

  • Blood in the urine
  • Difficulty urinating
  • Lower back pain
  • Fatigue
  • Difficulty breathing
  • Jaundice

Patients should discuss any symptoms with their doctor and ask about scheduling regular PSA tests after treatment.

Testing options for prostate cancer

There is no one age for prostate cancer testing, but the American Cancer Society (ACS) makes recommendations about screenings. According to the ACS, patients in any of these groups should consider asking their doctor about testing:

  • Men age 50 or older who have an average risk of prostate cancer and a life expectancy of at least 10 more years
  • Men age 45 or older with a high risk, including African-American men and those with a first-degree relative (brother or father) who had prostate cancer before age 65
  • Men age 40 or older who have a higher risk, such as more than one first-degree relative diagnosed with prostate cancer at an early age