Symptoms & Diagnosis

Prostate Cancer Symptoms & Diagnosis

Early prostate cancer doesn’t typically cause any symptoms. In many men, the disease is first detected when their doctor finds signs during a routine check-up. Good screening tests have resulted in early diagnosis in about 80 percent of men with prostate cancer. According to the American Cancer Society, all of these men survive at least five years.

When it is diagnosed early, prostate cancer is curable. A biopsy, which is the only way to definitively diagnose the disease, is also useful for determining the grade and stage of the cancer.

Prostate Cancer Symptoms

More advanced cancers may be found as a result of the following symptoms:

  • Weak or interrupted flow of urine
  • Urinating often (especially at night)
  • Difficulty starting or stopping urination
  • Pain or burning during urination
  • Difficulty getting or sustaining an erection (impotence)
  • Painful ejaculation
  • Blood in the urine or semen
  • Frequent pain or stiffness in the lower back, hips, or upper thighs

Many of these symptoms are also seen with noncancerous diseases, including benign prostatic hyperplasia (BPH) and prostatitis (infection of the prostate). If you are experiencing any of these symptoms, call your doctor.

Prostate Cancer Diagnosis

For nearly 80 percent of men with prostate cancer, the disease is diagnosed early, in the local or regional stages. According to the American Cancer Society, the five-year survival rate for these men is 100 percent. Screening tests, including a digital rectal exam and prostate-specific antigen (PSA) test, are designed to detect signs of prostate cancer early. The only way to definitively diagnose prostate cancer is with a biopsy.

Prostate Biopsy

Whether cancer is suspected based on symptoms or screening results, the actual diagnosis is made with a prostate biopsy, a procedure in which samples of the prostate are removed and examined under a microscope. A core needle biopsy, the main method for diagnosing prostate cancer, is typically performed in a doctor’s office by a urologist. Using transrectal ultrasound (TRUS) and a local anesthetic, the doctor inserts a needle into the prostate through a probe in the rectum and takes about twelve samples of cells. The procedure typically takes no more than 5 to 10 minutes, and you should have very little discomfort.

Your biopsy samples will be sent to a lab to be examined by a pathologist. Getting results usually takes a few days.

  • If your biopsy reveals that you are cancer-free, you may still need to continue with routine screenings. Talk with your doctor about this.
  • If cancer cells are present, certain information available from the biopsy, such as the grade and stage of your cancer, helps your doctor determine the right treatment for you.

Risks of prostate biopsies include infection, as well as blood in the urine, stool, or semen. Antibiotics will be prescribed for your biopsy; however, in men without any prior urinary infections, the risk of infection is very low. Blood in the urine or stool is normal for up to two to three weeks after the biopsy and rarely requires any intervention. Blood in the semen (which may appear red or brown) is normal for two to three months. If you are on blood thinners, your urologist should provide specific guidelines for their use around the time of your biopsy.

Other Tests

Additional tests or imaging, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan, may be performed to check for cancer spread, though these are not required in all men with newly diagnosed prostate cancer.