Is it prostate cancer or something else?

Prostate cancer symptoms or something else?

Prostate cancer is the most common cancer in men in the UK¹, but many of its symptoms are also signs of less serious problems. Men's health specialist Dr Jeff Foster, a GP at H3Health, explains that in the early stages of prostate cancer, it's especially difficult to tell the difference between prostate cancer and benign prostatic hyperplasia (BPH), also called prostate gland enlargement.

While prostate cancer can be life-threatening, BPH is a treatable prostate disease that doesn't lead to cancer. Although prostate cancer is much more serious, the doctor explains that the same principle applies to the two conditions:

"In both cases, something in the prostate gland - which helps produce semen, gets larger and squashes the urethra, the tube through which you urinate, which causes problems while peeing. This is the principle of every prostate disease, and it means that they each have many of the same symptoms."

Here is an overview of each condition:

The prostate and nearby organs

Problems when you pee

Early stage prostate cancer symptoms are caused by the extra pressure placed on your urethra. As BPH and other prostate problems can also squeeze this tube, the following symptoms could be a sign of any of them. The only way to know for sure is to get checked out by your doctor.

Urinary incontinence

Having urinary incontinence means you can't always control when you pee, and you may regularly leak and dribble. It could also mean that you experience urgency incontinence, where you feel a very sudden and intense urge to pee and only have a few seconds to get to a toilet before urine from the bladder is released.

Needing to urinate more frequently

Problems with peeing and needing to pee more frequently can become a constant disruption in your life. Night-time is one of the most obvious times you may notice an increase. According to Dr Foster, it's common for people with prostate problems to visit the toilet three or four times a night.

Difficulty passing urine

Although your number of toilet trips may go up, once you're in front of the bowl you may find peeing difficult. For example, you may find it hard to release urine, notice that your flow has become much weaker, or frequently find that your bladder doesn't feel empty after peeing.

The speed of symptoms

You'll need to see a doctor to test if the symptoms mentioned indicate prostate cancer or something else. Dr Foster says you should take notice of how quickly these symptoms develop. If they come on suddenly, and quickly become more severe, this is one possible indicator that your urinary problems could be cancerous. Other benign prostate conditions like BPH will develop much more gradually.

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Enlarged prostate

The prostate gland commonly becomes larger in older men. Women do not have a prostate gland. This prostate gland enlargement is also called benign prostatic hypertrophy (or hyperplasia). It can cause problems with passing urine. Symptoms are often mild. Without treatment, symptoms do not always become worse and may even improve over time. If symptoms become troublesome or distressing they can be improved by medicines or surgery.

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Advanced prostate cancer symptoms

Advanced prostate cancer - also called metastatic prostate cancer - means the cancer has spread beyond your prostate gland. As the cancer begins to affect your lymph nodes and other parts of your body, you may notice other symptoms.

You have a better chance of recovering from prostate cancer the earlier it's caught, so if you experience any of the following advanced prostate cancer symptoms listed, you should see your doctor as soon as possible - especially if you also have problems when you pee.

These signs can also be caused by other, less serious issues - but don't self-diagnose, the tests performed by your doctor are the only way to know for sure.

Finding blood in the urine or semen

Prostate cancer is one possible explanation for finding blood in your urine (haematuria) or in your semen (haematospermia). However, there are several conditions that could cause this, including urinary tract infections (UTIs) and other enlarged prostate problems such as prostatitis.

Feeling pain in your pelvis, hips, or back

Advanced prostate cancer may spread to your bones, known as bone metastasis, and as a result, your bones may become painful. You're more likely to feel this in your back, pelvis, and hip bones, due to their close proximity to your prostate, which sits just beneath your bladder.

Erectile dysfunction

Erectile dysfunction means you repeatedly find it difficult to get or keep an erection. This has several possible causes, ranging from physical health issues, such as hormone changes, to mental health issues - such as anxiety and depression. Erectile dysfunction affects around 40% of men at age 40 and around 70% age 70³, and as a symptom on its own it's unlikely to be a sign of prostate cancer. However, it can be seen as a symptom in advanced prostate cancer but other symptoms would usually be present too.

Unexplained weight loss

Unintentional weight loss isn't usually one of the first prostate cancer symptoms people notice. However, if you find you've lost weight without any changes in your lifestyle, and you're experiencing any other symptoms previously listed, it's worth getting tested. Weight loss tends to be a sign of advanced prostate cancer, due in part to the increased activity of cancer cells in the body - the more cancer cells there are, the more energy they use up.

Further reading

1. Prostate Cancer UK: About prostate cancer.

2. Urology Health: Benign prostatic hyperplasia (BPH).

3. Feldman et al: Impotence and its medical and psychosocial correlates - results of the Massachusetts male aging study.