Introduction
Prostate cancer is one of the most commonly diagnosed cancers in men in the UK. The prostate is a small gland located below the bladder, and its primary function is to produce fluid that forms part of semen. While some prostate cancers grow slowly and may never cause problems, others are more aggressive and require treatment. Early detection is associated with better outcomes, making it important to understand potential signs and discuss screening with your doctor. As Mr Alan Doherty, Consultant Urologist, states, “Recognising potential signs of prostate cancer, and more importantly, understanding the role of screening even without symptoms, can lead to timely intervention and better outcomes.”
However, it is important to remember that prostate cancer does not always produce obvious symptoms in its early stages, which means some men only learn they have the condition after a routine blood test or check-up.
Symptoms of prostate cancer
It’s essential to understand that early-stage prostate cancer is often asymptomatic. This means it frequently causes no noticeable symptoms. Many men with early, treatable prostate cancer feel perfectly healthy. This is why relying on symptoms alone is unreliable for detecting the disease.
Symptoms can develop as prostate cancer progresses, but these symptoms are far more commonly caused by non-cancerous conditions like benign prostatic hyperplasia (BPH). However, if you experience any of the following, it’s important to see a doctor to determine the cause:
Urinary changes
Some men report difficulties in starting or maintaining a steady stream of urine, needing to urinate more frequently (especially at night), or feeling that the bladder does not empty fully. Occasional pain or discomfort during urination can also occur, however, these issues are more commonly associated with benign prostate conditions.
Blood in urine or semen
The presence of blood, known medically as haematuria or haemospermia when present in semen, can be alarming. While blood in urine or semen may be linked to infections or other benign causes, it always merits further assessment by a medical professional.
Pelvic or lower back pain
Some individuals complain of persistent aches or stiffness in the lower back, hips, or upper thighs. Although this can be explained by muscle strain or other benign conditions, it may in rare cases suggest prostate cancer that is affecting nearby areas.
Erectile difficulties
Early-stage prostate cancer does not typically cause erectile dysfunction; however, any new or persistent erection problem should prompt a consultation with your GP or urologist to rule out underlying conditions.
Discuss Prostate Cancer Screening with Your Doctor
Given that prostate cancer can be asymptomatic in its initial stages, many men consider screening options such as a PSA (Prostate Specific Antigen) blood test or digital rectal examination (DRE). The decision to undergo screening should be made after a thorough discussion with your doctor about the potential benefits and risks, taking into account your age, family history, ethnicity, and overall health. There’s no “one-size-fits-all” answer.
- PSA test: This involves a simple blood test to measure the level of prostate-specific antigen. Elevated levels might indicate prostate cancer, but they can also be influenced by other conditions such as benign enlargement or infection.
- Digital rectal examination (DRE): This allows a clinician to feel for irregularities in the prostate’s shape or texture.
Risk Factors for Developing Prostate Cancer
- Age: Risk increases significantly after age 50.
- Family History: Having a father or brother with prostate cancer more than doubles a man’s risk.
- Ethnicity: Black men have a significantly higher risk of developing prostate cancer and are more likely to develop it at a younger age.
- Genetics: Certain inherited gene mutations can increase risk.
A discussion with your GP about screening is particularly valuable if you have one or more of these risk factors. Together, you can balance the potential advantages of early detection against the possibility of unnecessary anxiety or medical intervention.
Other Medical Conditions May Mimic Prostate Cancer Symptoms
The symptoms listed above are much more likely to be caused by non-cancerous conditions, including:
- Benign Prostatic Hyperplasia (BPH): A very common, non-cancerous enlargement of the prostate.
- Prostatitis: Inflammation or infection of the prostate gland.
- Urinary Tract Infection (UTI): An infection in the urinary system.
If you are dealing with urinary or pelvic symptoms, try not to panic. Instead, schedule a visit with your doctor, who may suggest tests—such as urine analyses, ultrasound scans, or PSA checks—to help determine the cause.
How to Lower Your Risk of Prostate Cancer
While some risk factors can’t be changed, there’s limited evidence that certain lifestyle choices might help reduce risk:
- Maintain a balanced diet: A diet rich in fruits, vegetables, and whole grains, and low in red and processed meats, may be beneficial. However, the evidence for specific dietary recommendations is not conclusive.
- Stay active: Moderate exercise helps manage weight and can support overall wellness. This might include brisk walking, swimming, or light resistance training.
- Regular check-ups: If you have risk factors or are over 50, attending regular health assessments can ensure any changes are detected early.
Bear in mind that healthy living is not a guarantee, but it can contribute to better general health and potentially reduce the chance of aggressive disease.
Treatment Options if You Have Been Diagnosed Early
When prostate cancer is detected at an early stage, you may have a wider range of treatments available, and in many cases, the likelihood of good long-term outcomes improves.
- Active surveillance: This involves closely monitoring the prostate cancer without taking immediate action, often used when tumours are very small or slow-growing. You will undergo regular PSA tests, DREs, and periodic imaging or biopsies to check for any changes.
- Focal therapy: This approach targets only the affected area of the prostate, aiming to preserve healthy tissue while eradicating the tumour. It can lower the risk of side effects such as incontinence or erectile dysfunction.
- Surgery (prostatectomy): A surgeon removes the entire prostate gland and sometimes surrounding tissues. This is a common choice for men with localised but significant prostate cancer.
- Radiotherapy: This can be given externally (external beam radiotherapy) or internally (brachytherapy). Radiation is aimed at cancer cells to shrink or destroy them, often with success in early-stage disease.
Additional treatments, such as hormone therapy or chemotherapy, may be relevant depending on the tumour’s grade, stage, and whether there are signs of more advanced disease. A discussion with a multidisciplinary team—urologists, oncologists, and specialist nurses—helps ensure you receive tailored recommendations.
For those uncertain about their diagnosis or treatment plan, seeking a second opinion can provide additional insights and reassurance.
Frequently Asked Questions
What are the early symptoms of prostate cancer?
Most men with early-stage prostate cancer have no symptoms at all. This is why relying on symptoms to detect prostate cancer is unreliable. Symptoms like difficulty urinating, frequent urination, or blood in the urine or semen are much more often caused by non-cancerous conditions like an enlarged prostate (BPH) or infections. However, if you experience any of these symptoms, see a doctor to determine the cause. The best way to detect prostate cancer early is through a discussion with your doctor about PSA testing and DRE, even if you feel perfectly well.
What are the symptoms of stage 1 prostate cancer?
Stage 1 prostate cancer is typically asymptomatic. It’s usually detected through screening (PSA test and/or DRE), not because of symptoms. The symptoms often associated with prostate cancer (urinary problems, etc.) are more likely to occur in later stages or, more commonly, are due to non-cancerous conditions.
What is the number one symptom of prostate cancer?
There is no single “number one” symptom of prostate cancer, especially in its early stages. Many men have no symptoms at all. While urinary problems are often associated with prostate cancer, they are far more commonly caused by benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate. The best approach is to discuss screening with your doctor, not to wait for symptoms.
Do you feel ill with prostate cancer?
Early-stage prostate cancer usually does not cause you to feel generally ill. Men with early prostate cancer typically feel perfectly healthy. Symptoms like fatigue, weight loss, or bone pain are more associated with advanced prostate cancer that has spread beyond the prostate.
References
- PSA testing: advice for men without symptoms by the UK Government
- NHS: Prostate cancer – Symptoms
- Mayo Clinic: Prostate cancer – Symptoms and causes
- Prostate Cancer UK: What are the signs and symptoms of prostate cancer?
Note: This article is for informational purposes only and should not replace professional medical advice. Consult a healthcare provider for personalised recommendations.
