What Are Signs & Symptoms of Prostate Cancer?

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Although early prostate cancer is often asymptomatic, meaning it has no symptoms, there are a number of signs and issues that can arise as a result of your prostate cancer as it progresses or as you receive treatment. Not all of the following symptoms are a direct result of the cancer itself or its spread, but rather, can develop after you undergo a prostate cancer-related procedure or treatment plan. The good news for many of these issues is that they are manageable or even treatable by medications, procedures, or lifestyle changes. Further, symptoms that arise after common prostate cancer treatments such as hormone therapy and even surgery are often reversible and resolve on their own after recovery.

Early prostate cancer

As mentioned above, early prostate cancer is often undetectable. The best way to detect early prostate cancer is by visiting your doctor regularly for prostate cancer screening. Your screening requirements are usually tailored to you and your specific needs or risk factors. Most men don’t begin to get screened for prostate cancer until later in life, and time periods between screens can be up to several years or more. The earliest signs of prostate cancer are typically related to a localized prostate cancer tumor pressing on the urethra (the tube that carries urine form the bladder through the penis and out of the body), and are therefore, usually related to urination. These include:

  • Painful urination or a burning feeling while urinating or ejaculating
  • Blood in the urine or semen
  • An increased need to urinate (often during the night)
  • Weak urine stream or interrupted urine stream
  • Difficulty in starting or stopping urinating
  • Leaking of urine or loss of bladder control

Many of these symptoms can be caused by a variety of different issues, including benign prostatic hyperplasia (BPH), which is the non-cancerous growth of the prostate gland as a man ages. These symptoms can also be caused by urinary tract infections, prostate gland infections, or trauma to the urinary or reproductive tract, all of which are treatable. It is important to talk to your provider if you notice these signs or symptoms, so they can help determine the cause. As prostate cancer progresses or is treated, many of the following symptoms can arise.1,2

Problems with normal urinary function

Although many examples of issues with urinary function were mentioned as signs of localized prostate cancer, these symptoms can be present at nearly any stage of your prostate cancer journey and can often fluctuate in their severity. Sometimes they may be due to your prostate cancer directly and to its growth, but other times, they may be caused by treatment options that you have undergone, including radiation therapy or surgery. Fortunately, these symptoms often reverse themselves after treatment, and tumors pressing on the urethra can be destroyed by using surgical techniques such as radical prostatectomy or transurethral resection of the prostate (TURP). These symptoms can also be managed further by medications, lifestyle changes, absorbent pads or bed guards, surgery and more. Your doctor will help you determine what treatment options are best for you.3-5

Erectile dysfunction

Erectile dysfunction is a common symptom that arises post-treatment, especially after surgery, hormone therapy, or radiation. Erectile dysfunction is defined as the inability to develop or maintain an erection. Similar to urinary symptoms, oftentimes erectile dysfunction that arises after treatment will subside within a few weeks to a year after treatment. If these symptoms do not subside, or are not subsiding fast enough to meet your quality of life needs, there are treatment options to combat ED, including medications, mechanical devices, or surgery.6,7

Pain in the hips, back, ribs, or groin

Pain in the hips, back, ribs, groin, or other parts of the body can arise as a result of prostate cancer that has spread (metastasized) to other parts of the body. This pain is often reported as feeling like a dull, toothache-like pain in an individual’s bones. Treatment for this kind of pain is typically palliative in nature, meaning it is not meant to cure the underlying prostate cancer, but rather, is meant to alleviate undesirable symptoms. These treatment options include radiation therapy, medications, and even surgical options.8-10

Lower extremity weakness or numbness

Neurological symptoms, such as weakness or numbness in the lower extremities, are often a result of prostate cancer that has spread to the spine and is pressing on nerves within the spinal cord. This is often referred to as metastatic spinal cord compression (MSCC). Losing the function of these nerves can lead to serious neurological deficits, including the loss of control of the bladder or bowels. Treatment for cancer that has spread to the spine or spinal cord is similar to treatment options for cancer that has spread to other bones, and the neurological deficits may or may not be reversible. Individuals with severe neurological complications may need to see an occupational or physical therapist and make lifestyle adjustments to combat these issues.11,12

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  1. American Cancer Society Recommendations for Prostate Cancer Early Detection. American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/early-detection/acs-recommendations.html. Published April 14, 2016. Accessed September 1, 2017.
  2. Prostate Problems. National Institute of Health. https://www.nia.nih.gov/health/prostate-problems. Published July 1, 2016. Accessed September 1, 2017.
  3. Mols F, Korfage IJ, et al. Bowel, urinary, and sexual problems among long-term prostate cancer survivors: A population-based study. International Journal of Radiation Oncology, Biology, Physics. Jan 2009; 73(1), 30-38.
  4. Urinary Dysfunction. Prostate Cancer Foundation. https://www.pcf.org/c/urinary-dysfunction/. Accessed September 1, 2017.
  5. Urinary Problems After Prostate Cancer Treatment. Prostate Cancer UK. https://prostatecanceruk.org/media/11857/urinary_problems-ifm.pdf. Published January 2017. Accessed September 1, 2017.
  6. Erectile Dysfunction. Prostate Cancer Foundation. https://www.pcf.org/c/erectile-dysfunction/. Accessed September 1, 2017.
  7. Dealing with Erectile Dysfunction. UCLA Health. http://urology.ucla.edu/dealing-with-erectile-dysfunction. Accessed September 1, 2017.
  8. Managing Pain in Advanced Prostate Cancer. Prostate Cancer UK. https://prostatecanceruk.org/prostate-information/advanced-prostate-cancer/managing-pain-in-advanced-prostate-cancer. Published May, 2017. Accessed September 1, 2017.
  9. Lishchyna N, Henderson S. Acute onset-low back pain and hip pain secondary to metastatic prostate cancer: A case report. Jounal of the Canadian Chiropractic Association. Mar 2004; 48(1), 5-12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1840035/. Accessed September 1, 2017.
  10. Bonneau, A. Management of bone metastases. Canadian Family Physician. Apr 2008; 54(4), 524-527. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2294085/.
  11. What is metastatic spinal cord compression (MSCC)? Prostate Cancer UK. https://prostatecanceruk.org/prostate-information/advanced-prostate-cancer/metastatic-spinal-cord-compression-mscc. Published February, 2015. Accessed September 1, 2017.
  12. Managing Bowel Issues After Prostate Cancer. Prostate Cancer Foundation of Australia. http://www.prostate.org.au/awareness/further-detailed-information/understanding-prostate-cancer-treatments-and-side-effects/understanding-bowel-disturbance/managing-bowel-issues-after-prostate-cancer-diagnosis/. Accessed September 1, 2017.
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Written by: Casey Hribar | Last reviewed: October 2017
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