Symptoms And Diagnosis Of Prostate Cancer
Most men with early prostate cancer don’t have any signs or symptoms. But there are some things that may mean you're more likely to get prostate cancer. You might hear these described as prostate cancer risk factors. Even if you don't have any of the symptoms that we talk about below, speak to your GP about prostate cancer if:
you are aged 50 or over
your father or brother has had prostate cancer
you are black.
Does prostate cancer have any symptoms?
Most men with early prostate cancer don’t have any signs or symptoms.
One reason for this is the way the cancer grows. You’ll usually only get early symptoms if the cancer grows near the tube you urinate through (the urethra) and presses against it, changing the way you urinate (wee). But because prostate cancer usually starts to grow in a different part (usually the outer part) of the prostate, early prostate cancer doesn’t often press on the urethra and cause symptoms.
If you do notice changes in the way you urinate, this is more likely to be a sign of a very common non-cancerous problem called an enlarged prostate, or another health problem. But it’s still a good idea to get it checked out. Possible changes include:
difficulty starting to urinate or emptying your bladder
a weak flow when you urinate
a feeling that your bladder hasn’t emptied properly
dribbling urine after you finish urinating
needing to urinate more often than usual, especially at night
a sudden need to urinate – you may sometimes leak urine before you get to the toilet.
If prostate cancer breaks out of the prostate (locally advanced prostate cancer) or spreads to other parts of the body (advanced prostate cancer), it can cause other symptoms, including:
back pain, hip pain or pelvis pain
problems getting or keeping an erection
blood in the urine or semen
unexplained weight loss.
These symptoms can all be caused by other health problems. But it’s still a good idea to tell your GP about any symptoms so they can find out what’s causing them and make sure you get the right treatment, if you need it.
How do you know if you have prostate cancer?
There’s no way of knowing if you have prostate cancer without visiting your doctor, as most men with early prostate cancer don’t have any symptoms. And if you do have symptoms they can be caused by other things.
And you can’t check for prostate cancer yourself.
You may want to speak to your GP if you're over 50 (or over 45 if you have a family history of prostate cancer or are a black man), even if you don't have any symptoms. These are all things that can increase your risk of prostate cancer. Your GP can give more information or tests if necessary.
No symptoms
Often prostate cancer grows slowly and doesn’t cause any symptoms for a long time, if at all.
Prostate urinary symptoms
Prostate cancer usually only causes symptoms when it has grown large enough to disturb your bladder or press on the tube that drains urine. These symptoms are called prostate urinary symptoms:
Passing urine more often, especially at night
Trouble starting or stopping the flow
A slow flow of urine
Pain when passing urine
Less common symptoms
Blood in the urine or semen
Feeling of not emptying your bladder fully
If the cancer has spread you may have other symptoms, such as bone pain.
Other conditions that can cause urinary symptoms
Benign prostatic hyperplasia (BPH)
BPH is when the prostate gland grows larger. BPH is common in middle aged and elderly men because the prostate gland often gets bigger as you get older. BPH is not cancerous but it may cause prostate urinary symptoms.
Prostatitis
Prostatitis means that the prostate gland has become inflamed. It can be caused by an infection in the prostate gland. It is not a form of prostate cancer. Symptoms can include pain in your testicles, pain when passing urine or an uncomfortable feeling when sitting down.
PSA tests and screening
Testing for cancer when you have no symptoms is called screening. There is no national screening programme in Ireland, as there’s little evidence that screening would reduce deaths from prostate cancer. It also could mean men having unnecessary treatment for very slow-growing prostate cancer, which could cause side-effects that affect their lives more than the cancer would.
If you’re worried
Talk to your GP about:
Your risk of prostate cancer – e.g. if you have close family members with prostate cancer.
The pros and cons of prostate cancer screening.
What the tests involve.
The decisions you might have to make if your PSA was raised.
How these decisions might affect your life. E.g. having treatment and getting side-effects.
Should I use a home PSA test kit?
Prostate problems are best diagnosed by your GP, who can take your medical history and carry out a physical examination, as well as doing the PSA test.
By attending your GP you can also discuss prostate cancer risk factors and talk about any concerns you may have about the test and its results when they are available.
Remember - your PSA level can be raised for other reasons; it doesn’t mean you have prostate cancer. It’s also possible to have cancer and a normal PSA level.
Diagnosing prostate cancer
Your family doctor (GP) will talk to you about your symptoms. He or she may do some tests. For example:
Digital rectal examination (DRE)
Inserting a gloved finger into your back passage to see if your prostate feels normal. It can be a little uncomfortable but it doesn’t take long.
PSA blood test
Checking the level of the prostate-specific antigen (PSA) protein in your blood.
Raised PSA can be a sign of prostate cancer or of a less serious condition, such as a urinary infection or a prostate infection. We have more information to help you understand PSA test results.
If you’re due to have a PSA test don’t ejaculate or exercise heavily for 48 hours beforehand. You probably won’t be able to have the test if you have a urinary tract infection or you’ve had a prostate biopsy in the previous 6 weeks. Talk to your doctor about this.
