What are the symptoms of prostate cancer?

Changes in urination can include needing to go more often, waking at night to urinate, waiting for the stream to start, stopping and starting, or feeling that the bladder has not emptied. These symptoms can happen when the prostate presses on the urethra, but an enlarged prostate or infection can cause the same pattern.

Early prostate cancer may cause no noticeable symptoms. In more advanced disease, cancer-related bone pain may affect the back, hips, pelvis, or other areas. Blood in urine should always be assessed, even when it is a small amount or appears only once.

Arrange an appointment for new, persistent, or worsening urinary symptoms, visible blood in urine, or unexplained bone pain. Keep a short record of fluid intake, daytime and night-time urination, stream changes, pain, and medicines. Assessment may include an examination, urine testing, blood tests, and discussion of prostate-specific antigen testing.

A diagnosis is not made from symptoms alone. If cancer is confirmed, treatment choices depend on the tumour findings and personal health. They may include active monitoring, surgery, radiotherapy, brachytherapy, or treatments aimed at cancer that has reached bone or other sites.

Seek urgent help if you cannot pass urine, have severe lower abdominal pain, heavy blood or clots in urine, fever with urinary symptoms, or sudden severe back pain with leg weakness or numbness. These problems can threaten bladder function or signal pressure on nerves.

Ask what may be causing the urinary change, which tests are appropriate, and whether a urology referral is needed. If cancer is diagnosed, ask how its grade and stage affect choices such as prostate removal surgery, radiotherapy, or brachytherapy.