Prostate Cancer Symptoms and Diagnosis

Symptoms of prostate cancer

Prostate Cancer Symp-Diag header

Photo is of screening only.

Trouble passing urine
  • Frequent urge to pass urine, especially at night
  • Weak or interrupted urine stream
  • Pain or burning when passing urine
  • Blood in the urine or semen
  • Difficulty having an erection
  • Painful ejaculation
  • Nagging pain in the back, hips, pelvis or upper thighs 

It is important to note that not everyone with prostate cancer experiences symptoms. Prostate cancer is often detected by your doctor during a routine check-up or screening.   

Diagnosing prostate cancer

Digital rectal exam (DRE) and PSA (prostate-specific antigen)

DRE is a standard way to check the prostate. With a gloved and lubricated finger, your doctor feels the prostate from the rectum, feeling for lumps or anything unusual. It is always done in conjunction with the PSA blood test.
PSA is a protein made by the prostate gland that may be higher in men with prostate cancer. However, many other things can cause a high PSA level, including prostatitis and BPH, so don’t assume it is cancer. 
If your PSA level is mildly elevated, you and your doctor may choose to do PSA tests on a regular basis to watch for any changes. If you have a concerning rectal exam or a high PSA level, especially in conjunction with symptoms and/or risk factors, your doctor may recommend a biopsy.

Prostate biopsy

Your doctor will take small tissue samples from several areas of the prostate gland, which are then examined under a microscope. If cancer is present, the pathologist will give it a Gleason score ranging from 2 to 10. This describes how likely it is that a tumor will spread; the lower the number, the less aggressive the tumor is and the less likely it will spread.

Staging prostate cancer 

After prostate cancer has been diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. Treatment often depends on the stage of the cancer, which is based on the results of the PSA, the Gleason score and diagnostic tests including bone scan, MRI and CT scan. 

  • Stage I: cancer is found in the prostate only.
  • Stage II: cancer is more advanced than in stage I, but has not spread outside the prostate. 
  • Stage III: cancer has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles.
  • Stage IV: Cancer has spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder or pelvic wall, to nearby lymph nodes or to distant parts of the body. Prostate cancer often spreads to the bones.