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Signs and symptoms

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Symptoms, risk and screening
Are you over 50 years old, or have you been having urinary problems for some time now? This video is for you! Several diseases can affect your prostate, and it’s important to detect them early. Let’s take a closer look.

Overview

A “silent” cancer

Prostate cancer is often not accompanied by any symptoms; it is said to be “silent”. It is often discovered by chance, following a blood test or during a routine examination of the prostate. In this case, the doctor will have performed a rectal examination, noted induration, and will have sounded the alarm. This hardening is the most common clinical sign.

When the urethra is compressed there are similar symptoms

Symptoms begin to appear as the tumor increases and puts pressure on the urethra or when as the cancer advances. The symptoms are the same as for benign prostatic hypertrophy (BPH) because as the prostate grows older it increases in volume and compresses the urethra. Prostatitis can also cause symptoms similar to prostate cancer. However, as mentioned earlier, the majority of patients with prostate cancer will have no clinical symptoms.

After the age of 40, it is important that men make sure not to confuse BPH, prostatitis and prostate cancer. A doctor’s exam becomes more important to have peace of mind.

BPH or Enlarged Prostate

Illustration d’une hbp

The most common signs and symptoms

In the early stages of, there are no signs and symptoms. These appear when the enlarged prostate exerts pressure on the urethra and bladder. This can reduce the diameter of the urethra (compressing it) or irritating the bladder, which can cause changes in urinary habits and difficulty urinating. In some patients, symptoms may appear with minimal enlargement of the prostate.

BPH can cause the following symptoms:

  • More frequent urination (urinary frequency), especially at night
  • A strong or sudden urge to urinate (urinary urgency)
  • Difficulty starting or stopping the urine stream (called straining)
  • Weak or slow urine stream
  • Interrupted urine flow
  • Being unable to empty the bladder completely
  • Difficulty controlling the bladder (leaks)
  • Pain or a burning sensation during urination
  • Difficult or painful ejaculation
  • Blood in the urine or semen (rare)

Prostatitis or inflammation of the prostate

Illustration d’une prostatite

The most common signs and symptoms

Prostatitis can cause a wide range of symptoms that vary greatly from man to man. They may be similar to those caused by benign prostatic hypertrophy (BPH) and prostate cancer. On the other hand it differ in that there is an acute pain present in the pelvic area accompanied by a high fever and chills.

Prostatitis can be caused by an acute urinary tract infection (bacterial prostatitis) or by chronic inflammation / chronic sensitivity.

Prostatitis can cause the following symptoms:

  • More frequent urination (urinary frequency), especially at night
  • A strong or sudden urge to urinate (urinary urgency)
  • Difficulty starting or stopping the urine stream (called straining)
  • Weak or slow urine stream
  • Interrupted urine flow
  • Being unable to empty the bladder completely
  • Difficulty controlling the bladder (leaks)
  • Pain or a burning sensation during urination
  • Difficult or painful ejaculation
  • Blood in the urine or semen (rare)
  • Pain in the pelvis area (genitals, groin, lower abdomen or lower back)
  • Fever and chills if prostatitis is acute
  • Recurrent urinary tract infections

BPH and prostatitis do not equal prostate cancer. They are among the most common prostate diseases.

Localized cancer

Signs and symptoms of a localized cancer

stade 1 cancer prostate

It is quite common that because of its generally slow growth, especially in its early stages, prostate cancer may not cause any signs or symptoms. The onset of symptoms is linked to the growing size of the tumour developing in the tissues and surrounding organs.

The most common signs and symptoms

  • More frequent urination (urinary frequency), especially at night
  • A strong or sudden urge to urinate (urinary urgency)
  • Difficulty starting or stopping the urine stream (called straining)
  • Weak or slow urine stream
  • Interrupted urine flow
  • Being unable to empty the bladder completely
  • Difficulty controlling the bladder (leaks)
  • Pain or a burning sensation during urination
  • Difficult or painful ejaculation
  • Blood in the urine or semen (rare)

Advanced cancer

Signs and symptoms of advanced cancer

stade 4 cancer prostate

Signs and symptoms when spreading outside the prostate

After the cancer begins to grow in the prostate, it spreads to the pelvic lymph nodes. (These are not the lymph nodes in the groin, which are perceptible to the touch. The pelvic lymph nodes are located deep in the abdomen next to the prostate and cannot be seen or felt.) This is known as nodal metastasis. Nodal metastasis is not painful, although it sometimes causes edema (swelling) of the feet and ankles due to blocked circulation in the lymphatic system, a network of vessels that run along the veins and arteries transporting lymphatic fluid to fight infections.

In more advanced stages of the disease, the cancerous cells usually migrate to the bones, particularly those of the pelvis and spinal column. This is known as bone metastasis.

If the metastases are large enough, the following symptoms may appear:

  • Pain in the lower back or hips
  • Numbness or paralysis of the lower limbs (at the spinal level, metastases can compress the spinal cord)
  • Edema (swelling) of the feet and ankles (lymph node metastases can cause poor lymphatic drainage of the lower limbs
  • Weight loss and general loss of condition (feeling of unwellness)
  • Constant fatigue and pallor (bone metastases can cause anemia)

Tests your doctor will administer based on these signs

If you have any unusual symptoms, it is important to consult your doctor to determine its cause. The doctor may then suggest you undergo a prostate-specific antigen (PSA) blood test and a rectal exam.

If your doctor believes that other tests should be done to confirm or deny that you have a prostate disorder, he will refer you to an urologist. The urologist will undoubtedly have you retake some of the tests that you have previously undergone. You may be asked to do another PSA test in the near future to see if your PSA rate increases over time and/or to confirm a temporary increase. Depending on the results, together you will decide on your future course of action, your treatment options, and resulting side effects.

We are here for you

You have questions or concerns? Don’t hesitate. Contact us at 1-855-899-2873 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, and those of your family or your loved ones. It’s simple and free, like all of our other services.

Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures, our section on available resources, the support that is offered to you, our events and ways to get involved to advance the cause.

 

Staying Informed

Pages of our site that might interest you
Want to know more? Just click on one of the links below.

The latest PROCURE news that might interest
Every week we publish a blog article. Here’s some we chose for you.

The medical content and editorial team at PROCURE
Our team is composed of urologists, and nurses certified in uro-oncology with a deep knowledge of prostate cancer and other diseases related to the genitourinary system. Meet our staff by clicking here.

Sources and references

Last medical and editorial review: September 2023
Written by PROCURE. © All rights reserved

Signs and symptoms

Signs and symptoms

A “silent” cancer

Most often, prostate cancer does not present any symptoms; it is said to be “silent.” It will be discovered by chance, following a blood test or during a routine prostate examination. Hence the importance of screening in middle-aged men.

In some cases, urinary symptoms may appear when the tumor grows and puts pressure on the urethra or when it is advanced. Other medical conditions can cause similar symptoms such as prostatitis or benign prostatic hyperplasia (BPH).

Get more information about potential warning signs on this page. If you have any questions or concerns, feel free to contact us at 1-855-899-2872 or via chat to speak with one of our healthcare professionals.specialized in uro-oncology.

Similar symptoms when the urethra is compressed

Symptoms begin to appear as the tumor increases and puts pressure on the urethra or when as the cancer advances. The symptoms are the same as for benign prostatic hypertrophy (BPH) because as the prostate grows older it increases in volume and compresses the urethra. Prostatitis can also cause symptoms similar to prostate cancer. However, as mentioned earlier, the majority of patients with prostate cancer will have no clinical symptoms.

After the age of 40, it is important that men make sure not to confuse BPH, prostatitis and prostate cancer. BPH and prostatitis do not equate to prostate cancer. They are among the most common prostate-related conditions. Therefore, a medical examination becomes more than important to clear up any doubts.

 

Tests your doctor will administer based on signs and symptoms

If you have any unusual symptoms, it is important to consult your doctor to determine its cause. The doctor may then suggest you undergo a prostate-specific antigen (PSA) blood test and a rectal exam.

If your doctor believes that further tests are necessary to confirm or rule out a prostate disorder, he will refer you to a urologist. The urologist may repeat some of the tests you have already undergone. You may be asked to undergo another PSA test in the near future to check if your PSA level is increasing over time and/or to confirm a temporary increase. Based on the results, you will decide together on the next steps.

BPH illustration

The most common signs and symptoms

n the early stages of BPH, there are no signs and symptoms. These appear when the enlarged prostate exerts pressure on the urethra and bladder. This can reduce the diameter of the urethra (compressing it) or irritating the bladder, which can cause changes in urinary habits and difficulty urinating. In some patients, symptoms may appear with minimal enlargement of the prostate.

 

BPH can cause the following symptoms:

    • A frequent need to urinate during the day and night (frequent urination)
    • An urgent need to urinate
    • Difficulty starting or stopping urination
    • A weak or slow urine stream
    • An interrupted urine stream
    • A sensation of incomplete emptying of the bladder
    • Difficulty controlling the bladder (urinary leakage)
    • Pain or burning sensation when urinating
    • Difficult or painful ejaculation
    • Presence of blood in the urine or semen (rare)

Prostatitis illustration
The most common signs and symptoms

Prostatitis can cause a wide range of symptoms that vary greatly from man to man. They may be similar to those caused by benign prostatic hypertrophy (BPH) and prostate cancer. On the other hand it differ in that there is an acute pain present in the pelvic area accompanied by a high fever and chills.

Prostatitis can be caused by an acute urinary tract infection (bacterial prostatitis) or by chronic inflammation/chronic sensitivity.

 

Prostatitis can cause the following symptoms:

  • A need to urinate often during the day and night (frequent urination)
  • An urgent need to urinate
  • Difficulty starting or stopping urination
  • A weak or slow urine stream
  • An interrupted urine stream
  • A sensation of incomplete emptying of the bladder
  • Pain or burning sensation when urinating
  • Pain in the pelvic region (genitals, groin, lower abdomen, or lower back)
  • Difficult or painful ejaculation
  • Fever and chills if the prostatitis is acute
  • Recurrent urinary tract infections
  • Presence of blood in the urine or semen (rare)

Illustration tumor Signs and symptoms of a localized cancer

It is common for prostate cancer, especially in the early stages, to cause no symptoms due to its typically slow development. Symptoms may appear if the tumor grows and compresses your urethra, leading to changes in your urinary habits or other issues, or if your cancer is advanced. The tumor generally does not cause pain in the prostate itself.

But first and foremost, don’t panic! Since prostate cancer typically begins to develop in the part of the prostate closest to the rectum (the peripheral region of the prostate), it often does not press on the urethra, thus causing symptoms at an early stage.

As mentioned earlier, it is important to note that all these symptoms are usually caused by benign prostate enlargement that occurs with age and not by prostate cancer. They can also be caused by other problems related to the urinary tract, such as bacterial or infectious prostatitis, among others.

 

Cancer can cause the following symptoms (most often, there are no symptoms):

  • A frequent need to urinate during the day and night (frequent urination)
  • An urgent need to urinate
  • Difficulty starting or stopping urination
  • Weak or slow urine stream
  • Intermittent urine flow
  • Feeling of incomplete emptying of the bladder
  • Difficulty controlling bladder (urinary incontinence)
  • Pain or burning sensation when urinating
  • Difficult or painful ejaculation
  • Presence of blood in urine or semen (rare)

 Illustration advanced tumorLes signes et symptômes lorsqu’il se propage à l’extérieur de la prostate

After the cancer begins to grow in the prostate, it spreads to the pelvic lymph nodes. (These are not the lymph nodes in the groin, which are perceptible to the touch. The pelvic lymph nodes are located deep in the abdomen next to the prostate and cannot be seen or felt.) This is known as nodal metastasis. Nodal metastasis is not painful, although it sometimes causes edema (swelling) of the feet and ankles.

In more advanced stages of the disease, the cancerous cells usually migrate to the bones, particularly those of the pelvis and spinal column. This is known as bone metastasis.

 

If the metastases are large enough, the following symptoms may appear:

  • Pain in the lower back or hips
  • Numbness or paralysis of the lower limbs (at the spinal level, metastases can compress the spinal cord)
  • Edema (swelling) of the feet and ankles (lymph node metastases can cause poor lymphatic drainage of the lower limbs
  • Weight loss and general loss of condition (feeling of unwellness)
  • Constant fatigue and pallor (bone metastases can cause anemia)

If initial tests, like a prostate-specific antigen (PSA) blood test or digital rectal exam, indicate potential prostate cancer, your urologist may advise a prostate biopsy. This biopsy assesses the cancer’s progression rate and helps identify the most suitable treatment options.

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Sources and references
Last medical and editorial review: April 2024. See our web page validation committee and our collaborators by clicking here.

Discover our animated video!

Symptoms, risk and screening
Are you over 50 years old, or have you been having urinary problems for some time now? This video is for you! Several diseases can affect your prostate, and it’s important to detect them early. Let’s take a closer look. 

 

Anatomy

What is the prostate

Illustration de l’appareil de l’homme pour un cancer prostate

The prostate is a gland:

  • Located between the bladder and the penis, just in front of the rectum;
  • Formed of 2 lobes which surround the urethra, a canal that runs through the center of the prostate, from the bladder to the penis, letting urine and sperm flow out of the body;
  • The size of a walnut, which grows larger in size in your forties;
  • That has a soft, spongy texture to the touch like a small, ripe plum.

The prostate is made of:

  • Gland cells that secrete liquids for ejaculation;
  • Muscle cells that participate in the evacuation of your sperm during ejaculation;
  • Fiber cells that maintain the structure of the gland.

Around the prostate, we find:

  • The seminal vesicles, glands that produce sperm and that are located on either side of the prostate;
  • The vas deferens, the tube that carries sperm from the testicle to the seminal vesicles;
  • The nerve bundles that control your bladder and erectile function and that are located on either side of your prostate.

Structure

Three main zones of the prostate

Illustration des 3 zones de la prostate de l’homme cancer prostate

Peripheral zone

  • The peripheral zone is the largest area of the prostate. It can easily be felt by the doctor during a digital rectal exam (DRE).
  • Most prostate cancers start in the peripheral zone.

Transition zone

  • This is the area located in the middle of the prostate, between the peripheral and central areas. It surrounds your urethra that runs through the prostate.
  • With age, the transitional area increases in size until it becomes the largest portion of your prostate. This is called benign prostatic hyperplasia (BPH) or enlarged prostate.

Central zone

  • It is the part of the prostate that is farthest from the rectum. This is why prostate tumors located in this area can not be felt by the doctor during a digital rectal examination.
  • If the doctor is in doubt, the following information will help decide if additional investigation is necessary:
    • Your PSA level
    • Your age and family history
    • Your ethnic origin

Fonction

In short

Illustration d’une prostate saine cancer prostate

Your fertility and natural fertilization

  • It produces … a prostatic fluid rich in enzymes, proteins and minerals that nourishes and protects your spermatozoa.
  • It makes … a protein (APS) that is used to liquefy your sperm to facilitate the mobility of your spermatozoa.
  • It allows … ejaculation by contracting.
  • It promotes … fertility through its enzymes facilitating the penetration of sperm through the cervix.
  • It is not related to the mechanism of erection. Therefore, the origin of erectile dysfunction lies elsewhere.

Additional details

Exocrine Function

The prostate is made up of thousands of tiny fluid-producing glands. Specifically, the prostate is an exocrine gland. Exocrine glands are so-called because they secrete through ducts to the outside of the body (or into a cavity that communicates with the outside). Sweat glands are another example of an exocrine gland.

The fluid that the prostate gland produces forms part of semen, the fluid that carries sperm during orgasm. This fluid, produced in the prostate, is stored with sperm in the seminal vesicles. When the male climaxes, muscular contractions cause the prostate to secrete this fluid into the urethra, where it is expelled from the body through the penis.

Urine Flow

The prostate wraps itself around the urethra as it passes from the bladder to the penis. Prostatic changes can affect urine flow. Increasing the size of the prostate or muscle tone may impede the flow of urine due to the close anatomical relationship between the urethra and the prostate.

Prostate Specific Antigen (PSA)

The prostate also produces a protein called prostate-specific antigen (PSA). PSA is released with the ejaculatory fluid and can also be traced in the bloodstream. The testing of PSA levels in the blood is used to detect prostate cancer. The level of PSA in the blood is usually measured in nanograms of PSA per milliliter of blood (ng/mL).

A raised PSA level

Usually, a PSA rate of less than 4 nanograms per milliliter of blood is normal, but age should also be taken into consideration as PSA levels gradually increase with age. A rise in PSA concentration may indicate the presence of:

  • An enlarged prostate (benign prostatic hyperplasia)
  • An inflammation or infection of the prostate (prostatitis)
  • A prostate cancer

Your doctor will have you undergo other tests to determine the exact cause of the increase in your PSA.

We are here for you

You have questions or concerns? Don’t hesitate. Contact us at 1-855-899-2873 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, and those of your family or your loved ones. It’s simple and free, like all of our other services.

Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures, our section on available resources, the support that is offered to you, our events and ways to get involved to advance the cause..

 

Staying Informed

Pages that might interest you
Want to know more? Just click on one of the links below.

The latest PROCURE news that might interest you
Every week we publish a blog article. Here are some for you.

The medical content and editorial team at PROCURE
Our team is composed of urologists, and nurses certified in uro-oncology with a deep knowledge of prostate cancer and other diseases related to the genitourinary system. Meet our staff by clicking here.

Sources and references

Last medical and editorial review: September 2023
Written by PROCURE. © All rights reserved

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