Prostate Cancer Symptoms: 5 Common Signs to Watch for

Prostate cancer is one of the most common cancers, but early on it usually doesn’t cause symptoms. So many people find out they have prostate cancer through routine screening, such as a prostate-specific antigen (PSA) test or a digital rectal exam.

But some people do notice changes in their body or urinary habits. These symptoms can happen as the tumor grows — or, in more advanced cases, if the cancer spreads to other parts of the body. Here are five symptoms you shouldn’t overlook.

1. Trouble urinating

A tumor in the prostate can press on the urethra. The urethra is the tube that carries urine from the bladder out of the body. 

This pressure can partially block the flow of urine and make it harder to urinate. You may notice symptoms like:

• Straining to start urinating

• A weak urine stream

• Urine that starts and stops

This pressure can also make it harder to fully empty your bladder. This may lead to:

• Needing to urinate more often

• Waking up at night to urinate

• A sudden urge to urinate

• Feeling like your bladder isn’t fully empty after you go

2. Blood in urine or semen

A tumor in the prostate can press on nearby structures like the bladder and parts of the body that make semen. This pressure leads to irritation and bleeding. The blood then gets mixed into urine and semen as these fluids travel through these structures and out of the body.

This can show up as blood in the urine or semen.

Blood may not look red when mixed with urine or semen. Urine or semen may appear pink, red, or even brown, and the color change can be subtle or more noticeable.

3. Erectile dysfunction (ED)

Erectile dysfunction (ED) isn’t a common sign of prostate cancer, especially early prostate cancer. But sometimes, the tumor can grow large enough that it also starts to press down on smaller, nearby structures like blood vessels and nerves that control the penis. 

Compressed blood vessels and nerves don’t work properly. Nerves can’t properly send signals to the penis, and blood vessels can’t deliver enough blood to the penis. Without these two things, people can have trouble achieving and maintaining an erection. 

4. Bone and joint pain

Bone and joint pain can be signs of advanced prostate cancer. If prostate cancer spreads (metastasizes), it often travels to the bone. This can lead to constant, nagging pain in bones and joints. 

Most of the time, prostate cancer grows very slowly. So it’s not common for people to experience bone and joint pain as a first sign of prostate cancer. In fact, only about 5% of people have widespread prostate cancer when they’re first diagnosed. 

5. Weakness and fatigue

Cancer cells can grow quickly. To fuel their growth, they use a lot of the body’s energy and nutrients. People may feel tired and overly fatigued if they have prostate cancer. They may also experience weight loss for the same reason. 

What can cause prostate cancer?

Experts aren’t sure exactly what causes prostate cancer, but it’s likely the result of a combination of things like:

• Genetics: A person’s genes likely play a role in whether they develop prostate cancer. Studies show that prostate cancer can run in families. 

• Age: People are also more likely to develop prostate cancer as they get older. How a person’s genes respond to the aging process likely plays a role too.

• Lifestyle: Being exposed to certain things throughout your lifetime can also raise your risk of developing prostate cancer. There’s data showing that people who smoke are more likely to develop prostate cancer. 

• Diet: Eating a high-fat and meat-based diet can also raise the chances of developing prostate cancer. 

What to do if you’re experiencing symptoms of prostate cancer

Talk with your healthcare team if you’re having symptoms that could be a sign of prostate cancer. They can check for other common causes of these symptoms. And they can help you figure out if you may need more testing.

Many of the symptoms of prostate cancer are subtle and overlap with other conditions. In fact, a symptom like frequent urination is more likely to be caused by conditions that aren’t as serious as prostate cancer. Benign prostatic hyperplasia (BPH), for example, can cause a slow urine stream as the prostate grows bigger with age. Similarly, infections of the urinary tract or prostate can cause difficulty urinating, frequent urination, and bloody urine.

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Written by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Brandon R. Mancini, MD, MBA, FACRO

Brandon R. Mancini, MD, MBA, FACRO, serves as medical director at BAMF Health in Grand Rapids, MI, in the emerging field of theranostics. His clinical focus is treating people with metastatic prostate and neuroendocrine cancers.

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