What Are the Symptoms of Prostate Cancer?

Does early prostate cancer cause symptoms?

Usually, no — and that's the most important thing to understand about this disease.

Early prostate cancer grows silently. Most men who are diagnosed have no symptoms at all. Their cancer is found because of a screening test — a PSA blood test or a prostate exam — not because something felt wrong.

This is exactly why I talk so much about early detection. By the time prostate cancer causes symptoms you can feel, it's often further along. The goal is to find it before that happens, when it's most curable.

What urinary symptoms do people confuse with prostate cancer?

As prostate cancer grows, it can press on the urethra and cause urinary changes: trouble starting urination, a weak or interrupted stream, needing to go more often (especially at night), or feeling like the bladder doesn't fully empty.

But here's what I tell my patients: these symptoms are far more often caused by BPH — benign prostatic hyperplasia, a non-cancerous enlargement of the prostate that happens to most men as they age. BPH is extremely common and usually not dangerous, though it can be bothersome.

So urinary symptoms deserve attention, but they usually point to BPH, not cancer. That's another reason screening matters — you can't tell the difference by symptoms alone.

What are the symptoms of advanced prostate cancer?

When prostate cancer spreads beyond the prostate, the symptoms change — and they're harder to ignore.

Blood in the urine or semen can occur. If the cancer reaches the bones — most often the back, hips, or pelvis — it can cause a deep, persistent ache that doesn't go away with rest. Some men develop erectile dysfunction, unexplained weight loss, or a fatigue that sleep doesn't fix.

I want to be clear about something: these are not early warning signs. None of them means you caught it early. They can also be caused by other conditions entirely. But new, persistent symptoms like these deserve a prompt call to your doctor — not watchful waiting at home.

The bottom line: don't wait for symptoms to get checked — the most curable prostate cancer is the kind you can't feel. And if something new or persistent does show up, get it evaluated promptly.

By Chad Ellimoottil, MD — urologist at Michigan Medicine specializing in prostate cancer detection.

Disclaimer: This information is for general educational purposes only and is not medical advice. Please consult a qualified healthcare professional about any medical condition, diagnosis, or treatment decision.