Signs and Symptoms

Prostate cancer is a slow growing disease that may not present any symptoms in its early stages. Signs and symptoms will present themselves once the tumour begins to increase in size and affect the surrounding tissues and organs. The most common symptoms of prostate cancer are:1

  • Frequent urination
  • Intense need to urinate
  • Difficulty in starting or stopping the urine flow
  • Slow or intermittent urine flow
  • Inability to urinate
  • Burning or pain during urination
  • Feeling of not having completely emptied the bladder after urination
  • Difficulty in getting an erection
  • Painful ejaculation
  • Blood in the urine or semen (less common)

Benign or non-cancerous conditions can also cause these symptoms. Benign prostatic hyperplasia (BPH) is an increase in the size of the prostate caused by an increase in cellular growth that occurs naturally with age. 

Prostatitis is caused by the inflammation or an infection of the prostate. The enlarged prostate can put pressure on the urethra or bladder blocking urine flow which in turn can cause urinary or sexual problems. 

When cancer has advanced and invaded surrounding tissues and organs, other symptoms may appear:2

  • Bone pain (particularly in the back, hips, thighs, pelvis, and neck)
  • Weight loss
  • Fatigue and loss of general condition
  • Low red blood cell count (anemia)
  • Weakness or numbness in the legs or feet
  • Loss of bladder or bowel control
  • Swelling of the feet and ankles (due to metastasized lymph nodes caused by poor lymphatic drainage)

Cancer cells have the potential to spread from the prostate to other parts of the body where they can grow into new tumours or metastasis. Most cases of prostate cancer metastasis occur in the lymph nodes and the bones. Understanding the usual progression of cancer helps the doctor to predict its probable course involving treatment options, drug treatment and further care.3

The most common sites where prostate cancer spreads to are: 

  • Bladder
  • Urethra
  • Ejaculatory ducts (the ducts that run from the seminal vesicles to the part of the urethra that passes through the prostate)
  • Seminal vesicles (the glands on each side of the prostate)
  • Rectum
  • Pelvic wall
  • Lymph nodes in the pelvis
  • Lymph nodes outside the pelvis
  • Bones
  • Lungs
  • Liver
  • Brain

These symptoms are not always present which is why it’s important to get routine checkups if you: 

  • Will be turning 50 years old
  • Are over the age of 50 and you haven’t talked about prostate cancer with your doctor
  • Have a family history of prostate cancer
  • Are of african ancestry
  • Are experiencing any of the symptoms listed above