Early Signs of Prostate Cancer
There are no warning signs of early prostate cancer. You can’t feel the growing tumor pushing against anything else, so there’s no pain. You can have the disease for years and not know it. That’s why regular prostate cancer screenings are so important.
If you’re a Black man, early screening for prostate cancer is particularly important as you’re 2.5 times more likely to die from prostate cancer than your non-Hispanic white peers. In a large study by JAMA Oncology, results pointed to factors such as access to quality health care as to why this may be the case.
If you’re nonbinary or gender expansive, you should still be aware of potential risks of prostate cancer, particularly for transgender women. Significant studies are lacking, but it is still possible to be diagnosed with prostate cancer. So screening, especially if you have symptoms or a family history of cancer, could be a helpful decision.
Symptoms of Prostate Cancer
Once a tumor causes your prostate gland to swell, or once cancer spreads beyond your prostate, you may have symptoms including:
- The need to pee often, especially at night
- Trouble starting or stopping a stream of urine
- A weak stream or one that starts and stops
- Leaking pee when you laugh or cough
- Not being able to pee standing up
- Pain or burning when you pee
- Pain or burning when you ejaculate
- Less fluid when you ejaculate
- Blood in your urine or semen
- Pressure or pain in your rectum
- Pain or stiffness in your lower back, hips, pelvis, or thighs
- New trouble getting an erection
These aren’t symptoms of the cancer itself. They happen because the cancer growth is blocking your prostate.
Symptoms of Advanced Prostate Cancer
Symptoms of advanced prostate cancer include:
- Dull, deep pain or stiffness in your pelvis, lower back, ribs, or upper thighs; pain in the bones of those areas
- Loss of weight and appetite
- Fatigue, nausea, or vomiting
- Swelling of your lower limbs
- Weakness or paralysis in your lower limbs, often with constipation
- Bowel problems
Other Prostate Conditions
These symptoms don’t always mean you have prostate cancer. Some other conditions may have similar signs.
Prostatitis. This is often a bacterial infection that causes inflammation of your prostate gland. At least half of men will have it at some point. Medications can treat it. Prostatitis symptoms include:
- Trouble peeing
- Burning, stinging, or pain when you pee
- An urgent need to pee often
- Chills and fever
- Lower back pain or body aches
- Pain in your lower belly or groin, or behind your scrotum
- Pressure or pain in your rectum
- Sexual problems
- Pain when you ejaculate
Benign prostatic hyperplasia (BPH). This is an enlarged prostate because of unusual cell growth that isn’t caused by cancer. Signs of BPH include:
- Trouble starting a urine stream
- Peeing often, especially at night
- Feeling like your bladder hasn’t fully emptied after you pee
- A strong or sudden urge to pee
- Weak or slow urine stream
- A urine stream that stops and starts several times while you pee
- Pushing or straining to start a urine stream
Bladder infection. Your bladder holds your urine. The organ is located directly above your prostate. Some bladder cancer symptoms can overlap with those for prostate cancer. They may include:
- Blood in your urine
- Pain or burning feeling while you urinate
- An urgent or frequent need to urinate, even if your bladder isn’t full
- Waking up at night to urinate
Erectile dysfunction. This condition makes it hard for you to get or keep an erection. It’s also called impotence. The main signs of erectile dysfunction is not being able to get an erection or to keep it long enough to have sex.
Urinary tract infection (UTI). This can happen when bacteria grow in your bladder or kidneys. Some infections are caused by BPH blocking the flow of urine out of your bladder. Doctors treat them with antibiotics. UTI symptoms include:
- Needing to pee more than usual or more often
- A strong urge to pee
- Pain, discomfort, or burning when you pee
- Pain, pressure, or tenderness in your lower belly, side, or upper back
- Urine that looks cloudy or smells bad
- Fever
- Chills
- Nausea and vomiting
Managing Prostate Cancer Pain
Back pain. This can happen if your prostate cancer spreads to bones in your back. It can make it difficult to walk. Over time, pain in this area can spread to other parts of your body.
Nerve pain. If prostate cancer presses on a nerve in your body, you can feel this type of pain. The feeling can be described as shooting, burning, or tingling. Nerve pain can also cause an area to feel numb.
Lymphedema. If your prostate cancer spreads to your lymph nodes, it can cause lymphedema. This condition is caused by a blockage in your lymphatic system, which is part of your immune system. Fluids can build up and cause areas in your body to swell if your lymphatic system is blocked. Lymphedema pain from prostate cancer can affect your legs, but can also affect areas including the penis or scrotum. Affected areas are described as feeling achy, tight, or heavy.
To help manage prostate cancer pain, you can:
- Keep a pain diary to show your doctor
- Take pain-relieving drugs like bisphosphonates
- Start treatment such as pain-relieving radiotherapy
- Undergo surgery to damaged bone
- Try complementary therapies, like acupuncture, reflexology, or aromatherapy
Managing Other Prostate Cancer Symptoms
Other prostate cancer symptoms can include:
Loss of libido (sex drive). Side effects of drug treatments for prostate cancer can cause a loss of interest in sex and erection problems. A common treatment for prostate cancer is hormone therapy, which is used to slow your body down from making testosterone, the male hormone. Your doctor may recommend you do hormone therapy off and on to lessen the side effects of these medications.
To manage a loss of libido with prostate cancer, you can:
- Ask your doctor about breaks with your hormone therapy treatment, or only restart treatment when your prostate-specific antigen (PSA) levels begin to rise
- Talk to your doctor about drug treatment for erection problems
- Seek advice from a sex counselor or therapist
- Talk with your partner about loss of libido
- Keep a healthy diet and stay active
Depression. News of cancer can be understandably difficult for you and your loved ones. Following a prostate cancer diagnosis, it isn’t unusual for you to experience depression and other emotional side effects. Because stress is often another side effect of depression, depression in cancer patients has been linked to shorter survival times.
To manage the effects of depression, it can be helpful to:
- Join a support group for those with prostate cancer or in recovery
- Talk to your doctor about changes in your mood and feelings
- Talk to loved ones about what you are experiencing
- Try to remain active
Cognitive impairment, or mental functions. The use of hormone therapy in prostate cancer patients can increase the risk of cognitive impairment. This is because lowered levels of testosterone, the male sex hormone, can affect concentation, thinking, and memory. You may forget a thought mid-sentence, have trouble remembering conversations, or struggle with complex decision-making, like handling bills or taking medications.
To manage your thinking and memory, you can try to:
- Talk with your doctor about changes in your cognitive ability
- Keep a journal to help with daily reminders
- Use sticky notes to keep track of tasks
- Repeat information back to people to ensure you fully understand what they said
- Work on puzzles, like crossword or Sudoku, to keep your mind active
When to See Your Doctor About Prostate Cancer Symptoms
Talk to your doctor if:
- You have trouble urinating or find that urination is painful or different from usual. Your doctor should check your prostate gland to see whether it is enlarged, inflamed with an infection, or cancerous.
- You have pain that doesn’t go away in your lower back, pelvis, upper thighbones, or other bones.
- You lose weight for no clear reason.
- You have swelling in your legs.
- You have weakness in your legs or a hard time walking, especially if you also have constipation.
