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 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)

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)

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.