In its early stages, prostate cancer can have no noticeable symptoms, and many men feel completely well. It is often only detected through blood tests or routine check-ups, which is why it’s so important to understand the risks and know when to take action.
Common early signs of prostate cancer are related to changes to urination or sexual health, which can include: difficulty starting urination, a weak urine stream, pain or burning sensation during urination or ejaculation and the need to urinate more often. Unexplained pain in the lower back, hips, or pelvis can indicate more advanced prostate cancer.
Experiencing these symptoms does not automatically mean you have prostate cancer; they can be caused by benign conditions like an enlarged prostate.
However, it’s important to have symptoms checked, as generally, the earlier prostate cancer is diagnosed, the more effective the treatment options.
In this article, we’ll look more closely at the symptoms of prostate cancer, who is most at risk and discuss what to do if you have concerns.
Helpful resources and support for prostate cancer
What is Prostate Cancer?
Prostate cancer is the most common cancer among men in the UK, with over 52,000 men diagnosed each year.
The disease originates in the prostate gland, a small organ in the male reproductive system located just below the bladder and in front of the rectum.
Prostate cancer starts when cells in the prostate gland begin to grow and divide in an uncontrolled way, forming abnormal cells that can gradually develop into a tumour.
Can prostate cancer go undetected?
Prostate cancer can go undetected for many years, sometimes decades. Most prostate cancers grow slowly and may remain confined to the prostate without causing symptoms or health problems.
Men cannot self-check for prostate cancer. Many cases are diagnosed during routine testing for another reason, during GP check-ups or in blood tests. That’s why regular health checks are essential, especially for men over 50.
While blood tests can indicate prostate cancer, it’s not always the case. The main blood marker associated with prostate disease is PSA (prostate-specific antigen). PSA levels can be low even when prostate cancer is present, which means the condition may not always be identified through blood testing alone.
How is prostate cancer diagnosed in the UK?
In the UK, there is no national prostate cancer screening process. Instead, the NHS supports an informed approach, encouraging men to contact a GP in the first instance. Men aged 50 and over, those from a Black ethnic background, or those with a family history of prostate cancer are advised to speak to their GP if they have concerns or would like to consider testing.
During this discussion, your GP will ask you about your general health and medical history, and will likely perform a digital rectal exam (DRE) and arrange a PSA blood test. If these findings suggest further investigation is required, your GP will refer you to a specialist for additional tests.
Early detection through PSA tests and rectal exams significantly improves the chances of being cured, as most early-stage prostate cancers can be treated effectively.
Are symptoms of prostate cancer always obvious?
Symptoms of prostate cancer are not always obvious, especially in the early stages.
Early prostate cancer is often described as a “silent” condition because many men experience no warning signs at all. This is why being aware of your personal risk and discussing screening with a healthcare professional can be important, even if you feel well.
How long can I have prostate cancer without knowing?
Prostate cancer often develops slowly, so it’s possible to have the disease for many years without knowing. Indeed, some men live their whole lives without the disease ever causing problems.
Prostate cancer may not cause symptoms until the cells grow large enough to press on the urethra (the tube that carries urine from the bladder out of the body).
This highlights the value of regular health checks and open conversations with your GP, particularly if you are over 50.
What happens if prostate cancer is not caught early?
In some cases, prostate cancer can grow beyond the prostate gland. This may involve nearby tissues or lymph nodes within the pelvis, which is known as locally advanced prostate cancer. If the cancer spreads to more distant parts of the body, such as the bones, it is described as metastatic prostate cancer. In these cases, treatment becomes more complex.
It’s important to remember that not all prostate cancers behave this way, and many grow slowly, which is why individual assessment and monitoring are important.
Key early symptoms of prostate cancer
Early prostate cancer often develops in the outer part of the prostate, which may delay the onset of symptoms. Many men with early prostate cancer will have no symptoms at all. When symptoms do appear, they are most often linked to changes in urinary habits and sexual health.
It’s important to remember that many of the symptoms listed here are common in other, non-cancerous prostate conditions, such as an enlarged prostate. Symptoms can also mimic non-cancerous conditions such as benign prostatic hyperplasia (often the cause of an enlarged prostate) or prostatitis (an inflammation or infection).
But persistent or worsening changes should always be checked by a healthcare professional.
Urinary changes and bladder control
The prostate gland surrounds the tube that carries urine (urethra) from the bladder, hence why changes in urinary symptoms can often be an early indicator.
These may include:
- Needing to urinate more often or urgently, especially at night
- Difficulty starting urination
- A slow or interrupted urine stream
- Dribbling after finishing
- A feeling that the bladder is not completely empty
- Burning or pain during urination or ejaculation
- Blood in urine or semen
It is advisable to discuss persistent changes in urinary habits with a GP or another healthcare professional.
Erectile dysfunction
Difficulty getting or maintaining an erection can sometimes be associated with prostate cancer, but it is far more commonly linked to other causes, including stress, medication, cardiovascular health, or ageing.
If erectile dysfunction is new, persistent, or occurs alongside urinary symptoms, it’s advisable to discuss it with a doctor.
Unexplained weight loss
Weight loss is not usually an early sign of prostate cancer, but it should be assessed by a healthcare professional when it is unexplained. When weight loss is linked to prostate cancer, it may suggest a more advanced disease and is often accompanied by other symptoms such as fatigue or pain.
Bone pain
Bone pain – most commonly felt in the lower back, hips, or pelvis, and worsening at night – can sometimes be a sign of advanced prostate cancer. When cancer cells have spread beyond the prostate to the bones, it is classed as metastatic prostate cancer and can make the condition more challenging to treat.
When should I get checked if I’m worried about prostate cancer signs?
You should speak to your GP if you notice persistent or worsening changes in urination, blood in urine or semen, ongoing erectile dysfunction, or unexplained pain in the lower back, hips, or pelvis.
This is particularly important if you are over 50, especially if you have additional risk factors such as a history of prostate cancer, ovarian cancer or breast cancer in your family, or if you come from a Black ethnic background.
Even if symptoms turn out to be benign, having them checked can be highly reassuring.
If prostate cancer is considered a risk, you will be referred for further diagnostic tests, such as a prostate biopsy or MRI scans.
If, following these tests, your doctors diagnose prostate cancer, they will create a personalised treatment plan. This may include surgery, radiotherapy, hormone therapy, or a combination of treatments, depending on the type and stage of the cancer.
Who is at higher risk of prostate cancer?
Prostate cancer is more common in men aged 50 and over. Studies have shown that Black men have a higher risk of developing prostate cancer compared to men of other races, partly due to genetic factors. Risk is also higher in men of Black African or Caribbean heritage and in those with a close family history of prostate cancer, particularly if a father or brother was diagnosed at a younger age.
Certain inherited genes, such as BRCA1 or BRCA2, and conditions like Lynch syndrome can also increase risk. Lifestyle factors may play a role, but age, ethnicity, and family history remain the most significant.
Prevention
Although there is no certain way to prevent prostate cancer, you can lower your risk by maintaining a healthy weight through balanced eating and regular physical activity.
Some evidence suggests that a Mediterranean-style diet, rich in vegetables, fruits, whole grains, legumes, healthy fats, seeds and nuts, may be associated with a lower risk of certain cancers, including prostate cancer. Simple habits like walking, cycling, or other forms of exercise can also make a difference.
It’s also important for you to talk freely to your GP about your concerns, especially if there is a family history of prostate cancer.
Supporting your wellbeing after a prostate cancer diagnosis
Receiving a prostate cancer diagnosis can be a difficult experience, and it’s normal to feel worry, anxiety, or even depression. Talking openly with a GP, specialist nurse, or another healthcare professional about how you are feeling can be an important first step in getting the right support.
Many men also find comfort in connecting with others who have had a similar diagnosis, whether through local support groups or online communities. Staying physically active where possible, practising relaxation techniques such as meditation or gentle breathing exercises, and leaning on family and friends can all help support your emotional wellbeing.
Concerned about prostate cancer symptoms?
If you’re concerned about prostate cancer symptoms, the most important next step is to speak with your GP. Many prostate-related symptoms are not caused by cancer, but only proper assessment can determine the cause.
If prostate cancer is diagnosed, your specialist team will discuss the treatment options that may be appropriate for you, taking into account the type and stage of the cancer, your general health, and your personal priorities. Treatment may involve surgery, radiotherapy, hormone therapy, or a combination of approaches.
It’s important to remember that early-stage prostate cancer can often be treated effectively, with medication sometimes prescribed to help manage common side effects related to urinary or sexual function.
Radiotherapy options for prostate cancer
Traditional photon radiotherapy is a common and effective prostate cancer treatment, using X-rays to target prostate cancer cells.
Proton beam therapy (PBT) is an advanced type of radiation therapy which uses protons rather than X-rays. This allows radiation to be delivered more precisely, stopping at the tumour and reducing the dose to nearby healthy tissue and organs such as the bladder and bowel. For selected prostate cancer patients, this may reduce the risk of common side effects such as erectile dysfunction and urinary incontinence. Learn more about proton beam therapy for prostate cancer.
Proton beam therapy is limited in availability in the UK and is most often accessed privately. Proton International London (PIL) is a private, UK-based provider of proton beam therapy. Our experienced team of healthcare professionals is happy to answer your questions about private treatment at our clinic, based at University College London Hospital (UCLH).
Contact us or start a referral for private treatment.
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