Prostate cancer often shows no symptoms until the advanced stages. A few symptoms of prostate cancer include painful or burning urination, difficulty emptying the bladder, and persistent pain in the back, hips, or pelvis.

Aside from skin cancer, prostate cancer is the second most common cancer in males. It occurs when cells in the prostate mutate and grow at an abnormal rate.

The National Cancer Institute (NCI) estimates there were 268,490 new cases in 2022. Due to regular screening, prostate cancer has a 5-year relative survival rate of 96.8%

This article covers the symptoms of prostate cancer and when a person should get screened.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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According to the American Cancer Society (ACS), early prostate cancer does not cause symptoms.

As the tumor develops and grows, it presses against nearby structures, such as the spine or urethra, which can cause symptoms. At this point, the cancer is more advanced.

This means that screening is important to detect cancer early. The ACS recommends that males aged 50 and over should receive regular screening.

Most symptoms of prostate cancer occur when the disease has progressed to a later stage.

People may experience different symptoms of prostate cancer. Some people do not have symptoms at all. Others might experience blood in their semen or a change in sexual function, such as erectile dysfunction or painful ejaculation.

Other symptoms may include:

  • a painful or burning sensation during urination
  • difficulty initiating urination
  • trouble emptying the bladder completely
  • frequent urination, especially at night
  • persistent pain in the back, hips, or pelvis
  • a weak or interrupted flow of urine

It is important to remember that other conditions are more likely to cause many of these symptoms. For example, difficulty urinating can develop due to a benign tumor called prostatic hyperplasia.

Despite this, a person should contact a doctor if they experience symptoms of prostate cancer.

In the United States, the ACS recommends prostate cancer screening for:

  • males aged 50, who have an average risk of prostate cancer and expect to live more than 10 years
  • males aged 45, who have a high risk of developing prostate cancer
  • males aged 40, who have a very high risk of developing prostate cancer

A person may have a high risk of prostate cancer if they have a first-degree relative who received a prostate cancer diagnosis at age 65 or younger.

A person may have a very high risk of prostate cancer if they have more than one first-degree relative who had prostate cancer at an early age.

There are two main types of screening for prostate cancer: a digital rectal exam (DRE) and a prostate-specific antigen (PSA) blood test.

Medicare will cover PSA blood tests and DRE tests once a year for those aged 50 and over.

DRE

A digital rectal exam involves a doctor inserting a gloved and lubricated finger into the rectum to physically feel the prostate for potentially cancerous lumps.

Although it can be uncomfortable for some people, especially those with hemorrhoids, it is not typically painful. It also does not take very long and requires no sedation or invasive surgery.

It can be useful in detecting prostate cancer in people whose blood tests come back within the normal range.

PSA blood test

Prostate-specific antigen is a protein made by cells in the prostate gland.

There is no industry-wide standard that indicates a person definitively has prostate cancer. However, this blood test can determine if further testing is necessary.

The ACS notes that most males who do not have prostate cancer have PSA levels under 4 nanograms per milliliter (ng/ml) of blood.

A PSA level of 4–10 ng/ml is a borderline range for prostate cancer. This means that people with this level have about a 1 in 4 chance of having the condition.

A PSA level of over 10 ng/ml means that the risk of having prostate cancer is over 50%.

If a person receives a high result on their PSA blood test, doctors may refer them to a specialist called a urologist for further testing. They may also recommend a DRE.

It is important to note that a PSA test is not always accurate. It can be a good screening tool, but healthcare professionals do not consider it to be an absolute diagnostic tool.

The only way to definitively diagnose prostate cancer is through a biopsy, where a doctor removes a small sample of cells from the prostate and exams them in a laboratory.

Some symptoms of prostate cancer may be subtle and unnoticeable until the disease advances.

People should speak with a doctor if they notice any of the prostate cancer symptoms. They should also make sure they attend regular screenings.

Most times, early prostate cancer does not cause symptoms. Symptoms typically appear once the cancer advances.

Symptoms can include:

  • painful urination
  • difficulty urinating
  • difficulty completely emptying the bladder
  • frequent urination
  • pain in the back, hips, or pelvis
  • interrupted or weak urine flow

People should contact a doctor if they experience any of these symptoms. It is also important to attend regular screenings to detect cancer early.