What are the top 5 warning signs of prostate cancer?

Prostate cancer is a type of cancer that develops in the prostate, a small walnut-shaped gland in the male reproductive system. It is the second most common cancer among males in the U.S.

Most people with stage I prostate cancer don’t show any symptoms. “For prostate cancer to cause symptoms, it may be at an advanced stage when it becomes harder to cure,” says urologic oncologist Lisly Chéry, M.D. “That’s why prostate cancer screening is so important.”

We spoke with Chéry to learn more about prostate cancer symptoms, screening guidelines and how to lower your risk of developing prostate cancer.

Symptoms of prostate cancer

The top 5 early warning signs of prostate cancer may include:

Blood in urine

If your urine is pink or red, you should see a primary care doctor or urologist.

“This is a ‘do not pass go’ moment,” says Chéry. “Even if there is no pain or it only happens one time, get evaluated to see what’s going on if you have blood in your urine.”

Difficulty urinating

Urinary retention is when you have difficulty urinating or completely emptying your bladder.

“The urethra, or the tube you urinate from, runs through the prostate,” says Chéry. “As prostate cancer grows, it can cause that tube to collapse and make it so the bladder cannot get urine past it. Sometimes, it requires insertion of a catheter to go inside the bladder to remove the urine.”

Pelvic pain

Pain or a sensation in the pelvis can be a sign of advanced prostate cancer.

“As prostate cancer grows, it can start to invade the muscles in the pelvis or rectal wall,” says Chéry. “This can give you the sensation that you’re sitting on a ball because the prostate may be inflamed.”

Frequent urination

You may wake up several times during the night to use the bathroom or go more often during the day.

Weak urine stream

This can include difficulty starting or maintaining a flow of urine.

Other, less common signs include:

Bone pain

Pain in your bones and joints can be an indication that the prostate cancer has metastasized, or spread, to your bones.

Blood in semen

Blood in the semen is rare, but you should see a doctor if it occurs.

Painful or burning urination

You may experience pain or a burning sensation when urinating.

Difficulty holding back urine

This happens when you unintentionally pass urine.

Erectile dysfunction

You may have difficulty having or maintaining an erection.

“It’s very common for men to have problems with their prostate, especially as they age,” says Chéry. “It’s important to know that these symptoms aren’t always associated with prostate cancer.”

Discuss prostate cancer screening with your doctor

If prostate cancer is caught early, it’s easier to treat and cure.

It’s recommended to speak with your primary care physician or urologist about prostate cancer screening at age 45. Men at high risk for prostate cancer can have those discussions as early as age 40.

Risk factors for developing prostate cancer include:

• Age: The average age of diagnosis in the U.S. is 66. It’s uncommon in men under age 50.
• Race: African American men or men of African descent have nearly double the risk of prostate cancer than white men.
• Hereditary cancer syndromes: Certain genetic mutations, like BRCA1 and BRCA2, can increase the risk of prostate cancer.
• Family history: Your risk is higher when a close blood relative (e.g., father or brother) has or had prostate cancer.

A prostate-specific antigen (PSA) screening test is the most common way to detect prostate cancer. PSA is a protein found in the blood in the prostate. If your PSA levels are elevated, it could mean you have prostate cancer – but not always.

“Your PSA can go up for many reasons,” says Chéry. “Just because your PSA is elevated, it doesn’t necessarily mean you have cancer. Your doctor will examine you to figure out what’s going on.”

Prostate cancer screening can also include a digital rectal exam.

“The prostate is positioned right in front of the rectum and the back of the prostate is where cancer most often forms,” explains Chéry. “During a digital rectal exam, a doctor will insert a gloved finger into your rectum to feel for any abnormalities in your prostate.”

You cannot check yourself for prostate cancer, so getting screened for prostate cancer is the best method of detection.

“Knowing your PSA level and staying on top of it year after year has shown to be beneficial in preventing death from prostate cancer,” says Chéry. “If you develop prostate cancer and catch it early, you’ll have more treatment options and a better chance of getting cured. Don’t wait until prostate cancer finds you; find it first by staying on top of your screenings.”

Other medical conditions may mimic prostate cancer symptoms

As men get older, the front of the prostate (where the urethra runs through) will grow. Symptoms caused by this growth may mimic the symptoms of prostate cancer and cause your PSA levels to go up. But most of the time, these conditions will not be prostate cancer.

Two common prostate-related problems are:

• Benign prostatic hyperplasia (BPH): a non-cancerous growth in the prostate, also known as an enlarged prostate
• Prostatitis: an infection of the prostate associated with inflammation that can cause fever, pelvic pain and frequent urination   

Be sure to see a doctor if you experience any new or strange symptoms. These non-cancerous conditions can usually be treated with medication.

Lower your risk of prostate cancer

Data shows that following a healthy diet such as the Mediterranean diet may help lower your risk of developing prostate cancer. It can also reduce the risk of recurrence if you already have prostate cancer.

The Mediterranean diet is high in vegetables, whole grains, fruits, legumes and healthy fats. Seeds and nuts are also included.

“Studies show that this type of diet can also lower your risk of heart disease and stroke,” says Chéry. “It’s like a double bang for your buck in that it reduces your risk for prostate cancer and is also good for your heart.”

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