What Are the Early Signs of Prostate Cancer and When Should You Be Screened?
October 30, 2024 By: Cancer Services Team
Content medically reviewed by Casey Liveringhouse, MD
While all men are at risk for prostate cancer, the disease is rare in men younger than 40. But as your age increases, so does your risk. Being aware of the early signs of prostate cancer can help you know when it’s time to talk with your primary care provider.
“In many cases, prostate cancer does not cause symptoms in early stages, which is why it is also important to discuss screening options with your provider,” said Casey Liveringhouse, MD, hematologist and oncologist at Essentia Health. “However, when symptoms do appear, getting them checked out right away can lead to early diagnosis and better outcomes.”
Understanding Prostate Cancer
The prostate gland lies below the bladder and in front of the rectum. It is about the size of a walnut in younger men, but it grows as men age. The prostate gland is part of the male reproductive system.
The most common cancer in men after skin cancer, prostate cancer usually grows slowly. Most prostate cancers are adenocarcinomas, a type of cancer which begin in the gland cells. In the case of prostate cancer, this type of cancer develops in the glands that make the fluid that combines with sperm to make semen.
Because a prostate cancer mass doesn’t put pressure on any organs or tissues, it can sometimes be present for years before any symptoms appear.
Early Signs of Prostate Cancer
If possible warning signs of prostate cancer do appear, make an appointment with your health care provider right away.
Urinary symptoms are some of the most common signs, including –
- Blood in the urine or semen
- A frequent need to urinate, sometimes urgently and especially at night
- Pain or burning when urinating
- A slow or weak flow of urine
- Trouble holding back or starting urinating
More advanced prostate cancer can cause additional symptoms, such as –
- Bone pain in the hips, spine, ribs, or other areas if cancer has spread to the bones
- Erectile dysfunction (ED), or trouble getting an erection
- Fatigue
- Loss of bladder or bowel control
- Numbness or weakness in the legs or feet
- Weight loss
“Keep in mind these symptoms can be signs of other conditions, so having them does not mean you have cancer,” said Dr. Liveringhouse. “For example, problems with urination are often caused by a condition called benign prostatic hyperplasia, or BPH, which is an enlarged prostate. Your provider can determine the cause of your symptoms and whether additional testing may be necessary.”
How Is Prostate Cancer Diagnosed?
If your provider suspects prostate cancer, he or she will do exams and tests to confirm a diagnosis. Your provider will ask you for details on your symptoms and how long you have had them. You will also likely have a physical exam.
Following a physical exam, your provider may order tests, including a prostate-specific antigen (PSA) blood test. The prostate gland makes PSA, a protein in blood and semen. Higher PSA levels might indicate cancer.
If you have a high PSA level or other potential signs of prostate cancer, the next step will likely be a prostate biopsy. Usually done in a urologist’s office, a prostate biopsy only takes about 10 minutes.
Should You Be Screened for Prostate Cancer?
Because prostate cancer may not cause symptoms, it is often detected through screening. This is done through PSA blood tests. However, screening may not be right for everyone.
“All men should discuss the pros and cons with their health care provider to make an informed decision on whether to be screened based on their personal risk factors,” Dr. Liveringhouse said.
In addition to older age, the following risk factors make it more likely to develop prostate cancer –
- Being African American
- Having a first-degree relative (father or brother) who has been diagnosed with prostate cancer, especially if diagnosis was at a younger age
- Having certain inherited gene mutations
The American Cancer Society recommends that men have a conversation with their provider about screening at the following times –
- Age 50 for men at average risk who are expected to live at least 10 more years
- Age 45 for men at high risk, which includes African Americans and men who have a father or brother diagnosed before age 65
- Age 40 for men at very high risk, which includes men with more than one first-degree family member diagnosed at a young age
“The best things you can do are to be aware of possible symptoms and talk to your provider about whether screening is right for you,” Dr. Liveringhouse said. “By being proactive, you can make the right decisions for your health.”