In short
Early prostate cancer usually causes no symptoms. When symptoms appear they are often urinary — needing to pee more often, especially at night, difficulty starting, or a weak, stop-start flow. These are more often caused by a harmless enlarged prostate, but blood in the urine or semen, or new back or hip pain, should always be checked by a GP.
One of the most important things to understand about prostate cancer is that, in its early and most treatable stages, it usually causes no symptoms whatsoever. The prostate sits below the bladder and surrounds the tube that carries urine, so symptoms tend only to appear once a growth is large enough to press on that tube — or once the cancer has spread.
This is exactly why the PSA blood test exists: it can pick up signs of a problem before any symptoms develop. It is also why urinary symptoms, while worth checking, are usually not caused by cancer at all.
What are urinary symptoms?
When prostate problems do cause symptoms, they are usually related to peeing, because the prostate surrounds the urethra. Things to look out for include:
- Needing to pee more often than usual, especially during the night
- Difficulty starting to pee, or having to strain
- A weak flow, or a flow that stops and starts
- A feeling that your bladder has not fully emptied
- A sudden or urgent need to pee
Why these symptoms are usually not cancer?
Most urinary symptoms in older men are caused by a non-cancerous condition called benign prostatic enlargement (BPH) — the prostate naturally getting bigger with age. While these symptoms are usually not due to cancer, they are still worth seeing a GP about, both to rule out cancer and because the symptoms themselves can often be treated and improved.
What is symptoms that need prompt attention?
Some symptoms are more concerning and should always be checked promptly. These include blood in the urine or semen, and new, unexplained pain in the back, hips, pelvis or bones that does not go away. Bone pain can sometimes be a sign that prostate cancer has spread, so it should not be ignored, particularly alongside other risk factors.
Whatever the likely cause, seeing a GP means the right tests can be arranged and any serious cause can be found early.
What are the key takeaways?
- Early prostate cancer usually causes no symptoms — this is why the PSA test is important for finding it early.
- Most urinary symptoms in older men are caused by a harmless enlarged prostate, not cancer.
- Urinary changes are still worth seeing a GP about, as they can be treated and cancer can be ruled out.
- Blood in the urine or semen, or new unexplained back, hip or pelvic pain, should always be checked promptly.
Care like this is out of reach for millions
The diagnosis, screening and treatment described here are routine in the UK. In Pakistan, Indonesia and Malaysia, poverty puts them out of reach — so a treatable cancer too often becomes a fatal one. World Aid Network funds treatment through locally-licensed oncologists for patients who cannot pay.
Frequently asked questions
Does prostate cancer always cause urinary symptoms?
No. Early prostate cancer often causes no symptoms at all. Urinary symptoms usually appear only when a growth presses on the tube that carries urine, and in older men these symptoms are far more often caused by a harmless enlarged prostate than by cancer.
Is needing to pee at night a sign of prostate cancer?
Needing to pee more often at night is a common urinary symptom that is usually caused by a non-cancerous enlarged prostate, not cancer. It is still worth seeing a GP, who can check the cause and discuss whether a PSA test is appropriate.
Can prostate cancer cause back pain?
New, persistent and unexplained pain in the back, hips or pelvis can occasionally be a sign that prostate cancer has spread to the bones. Back pain has many common causes, but if it is new, does not go away, or comes with other symptoms, see a GP.
This guide is general information, not medical advice. It was reviewed by the World Aid Network editorial team for accuracy against NHS and World Health Organization sources. Always speak to a GP or qualified clinician about your own health.