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)
- Painful ejaculation
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.
Learn more about the PSA test and other laboratory tests
Advanced prostate cancer symptoms
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.
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 nearby lymph nodes 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
Talk to your doctor about symptoms you may be experiencing and about scheduling regular PSA tests after your treatment.
Diagnosing and treating prostate cancer
Several tests may be used to diagnose prostate cancer. Once a diagnosis is determined, an array of treatment options may be available to treat the disease. Tools and procedures used to diagnose prostate cancer include:
Digital rectal examination (DRE): This typically is one of the first tests to determine the presence of prostate cancer. During a DRE, which is often performed as part of a regular physical examination, a doctor feels the prostate for lumps or unusual growths.
Biopsy: During this procedure, a tissue sample is removed and examined for the presence of cancer cells.
Imaging tests: Ultrasound, MRI, CT scan and prostascint scan may be used to help determine the size and stage of the cancer.
Advanced genomic testing: This test looks for abnormalities in the cancer’s DNA.
Learn more about diagnostic procedures for prostate cancer
Treatment options of prostate cancer
In most cases, prostate cancer is diagnosed before the cancer has spread to distant organs or bones. And because prostate cancer cells often grow slowly, many men may not need immediate treatment. In these cases, patients may be candidates for active surveillance. Patients under active surveillance may receive regular PSA tests, biopsies and other exams to determine if the cancer is growing.
Other treatment options for prostate cancer include:
- Surgery
- Chemotherapy
- Radiation therapy
- Hormone therapy
- Immunotherapy
- Clinical trials
Patients with prostate cancer may experience symptoms of the disease or side effects of treatment that may impact their quality of life. An integrative model of care is designed to help each patient manage the side effects of treatment, to preserve the patient’s quality of life and help prevent delays in the treatment regimen.
Integrative care services for prostate cancer patients may include:
- Pain management
- Nutritional support
- Mind-body support
- Spiritual support
GET EXPERT ADVICE AND CARE
Understanding when symptoms are a sign of something serious and either diagnosing the disease or confirming a previous diagnosis requires expertise from specialists trained and experienced in treating prostate cancer. At CancerCenter.com, our nurse advocates can connect you with prostate cancer experts that treat all stages of the disease.