10 Warning Signs of Prostate Cancer, According to Doctors

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BY THE TIME you reach your 50s, doctors say getting screened for prostate cancer is important. Don't wait until you start experiencing symptoms, because sometimes there aren't any.

Prostate cancer is slow-growing, and there are really no symptoms, especially early on, according to the American Cancer Society. By the time you do see symptoms, the cancer has likely reached an advanced stage.

“Men should be aware that prostate cancer is one of the most common cancers in men, but when caught early, it is often highly treatable,” says Daniel Spratt, M.D., a prostate cancer management expert and a professor in the Department of Radiation Oncology at the Case Western Reserve University School of Medicine.

Getting regular screenings and check-ups, knowing your risk factors for prostate cancer, and communicating with your doctor can help catch the disease early so you can get treated, Dr. Spratt says.

Following the American Urological Association guidelines, all men should be screened for prostate cancer once they turn 50, says Larry Lipshultz, M.D., a urology professor at the Baylor College of Medicine and Men’s Health urology adviser.

For men at a higher risk for prostate cancer, screening is recommended between ages 40 and 45. Those groups include Black men, people with a family history of the cancer, and those with a genetic predisposition, such as having the BRCA gene, Dr. Lipshultz says.

Screening involves getting a prostate-specific antigen, or PSA, blood test and a prostate exam, he says.

About one in eight men will be diagnosed with prostate cancer during their lifetime, and an estimated 288,300 new cases will emerge this year, according to the American Cancer Society. It’s more common in Black men and in all men over 65.

Here’s an overview of the most common signs of prostate cancer, why you should get regular screenings, and what screenings involve.

The Most Common Signs of Prostate Cancer

“Prostate cancer is one of those conditions that could easily be caught early,” says John Lynam, D.O., an osteopathic physician in Florida who specializes in urology. “Because of screening and testing, it has a high cure rate once caught early.”

This is especially important because there are no real early signs of prostate cancer, he says.

“Once prostate cancer causes symptoms, it is usually advanced and is often not curable at that point,” says Jonathan Shoag, M.D., a urologist and member of the Case Comprehensive Cancer Center Population and Cancer Prevention Program at Case Western Reserve University.

If there are warning signs of prostate cancer, they can include:

  • Blood in the urine or semen

  • Problems urinating—including feeling like you need to urinate more often or a slow or weak stream

  • Blocked urine

  • Loss of bladder or bowel control

  • Erectile dysfunction

  • Painful ejaculation

  • Pain in hips, back, ribs, or other areas

  • Weakness or numbness in the legs or feet

  • Fatigue

  • Unintentional weight loss

“Prostate cancer tends to spread to the bones, which can be painful, cause fractures, and limit mobility,” Dr. Shoag says.

Any time you notice any of these symptoms, visit your primary care doctor as soon as you can to get screened for prostate cancer, Dr. Lynam suggests.

Dr. Spratt says many prostate or urinary symptoms often have nothing to do with prostate cancer. So it’s important to rule out other potential health issues.

Why You Should Get Screened for Prostate Cancer

Instead of watching for signs of prostate cancer, which means it’s reached an advanced stage, Dr. Lynam suggests getting regular screenings to catch it early.

“The hope is catching the cancer when it is still asymptomatic and relatively easy to treat,” Dr. Shoag explains.

Most men should start getting screened when they reach 50, and Black men, people with a family history of prostate cancer, and others with a higher risk should get screened starting at 40.

You should get re-screened every two to four years, according to AUA.

What does prostate cancer screening involve?

Prostate cancer screening typically involves two tests, Dr. Spratt says.

One is a digital rectal exam, where doctors feel the prostate gland for abnormalities. “It’s a quick and painless procedure,” he adds.

The other is a PSA blood test, which measures the amount of a protein that’s produced by cancerous and noncancerous cells in the prostate. “Elevated PSA levels can be an indicator of prostate issues, including cancer,” Dr. Spratt.

Men without prostate cancer typically have PSA levels of under 4 nanograms per milliliter (ng/mL), according to the American Cancer Society. PSA levels between 4 and 10 suggest you could have about a 25 percent chance of prostate cancer, and levels over 10 signal that your chance of having the cancer is more than 50 percent.

Some have argued that a PSA test alone is enough to diagnose prostate cancer, Dr. Lipshultz says, but both are needed.

“You see somebody who has a normal PSA, and you do a prostate exam, and there’s cancer everywhere because it's so undifferentiated that it doesn’t make the PSA,” he explains.

Undifferentiated cancer cells typically don’t look or behave like the normal cells in tissues where they develop and may not produce much PSA.

Prostate cancer is one of the most curable diseases when caught early, Dr. Lynam says. In some cases, lower-grade prostate cancers can sometimes be safely monitored by your doctor without needing intervention.

“The most important message I can tell patients is to know your family history and get regular prostate cancer screening and checkups,” he says. “We are serious when we say early detection can save your life.”

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