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The problem with trying to diagnose prostate cancer early is that the symptoms of early prostate cancer are similar to those caused by benign (non-cancerous) prostate enlargement known as Benign Prostatic Hypertrophy or BPH. In fact BPH often causes more symptoms than prostate cancer and is very common in men as they get older. Many men diagnosed with prostate cancer will also have BPH. However many men who have BPH will not have prostate cancer at all.

These early prostate cancer symptoms are mainly due to obstruction of the flow of urine out of the bladder. As the prostate enlarges it makes the tube running from the bladder which carries urine out of the body narrow. This can make it difficult to pee normally.

1. Hesitancy * difficulty with starting to pee
2. Weak Stream * the stream or flow of urine is not as fast and hard as it used to be
3. Straining * you need to push the urine out
4. Prolonged Urination * it takes you longer to pee even small amounts
5. Feeling of Incomplete Emptying * the bladder still feels like there is some urine left in it after you have just emptied it.
6. Urinary Retention * the inability to empty the bladder at all

Other Symptoms are due to irritation of the bladder by the enlarged prostate. Again these symptoms are the same for BPH as they are for prostate cancer.

1. Urgency * when you need to go, you need to go now, it's difficult to hold on
2. Frequency * you need to pee more often
3. Nocturia * you need to get up in the night to pee
4. Urge Incontinence * where you suddenly need to pee and can*t hold on so you have an accident if you can*t get to a toilet in time

If you have any of these symptoms it is worth going to see your GP to talk about them. Firstly there are many treatments that can help with the symptoms plus the doctor can check that they are due to BPH and not to prostate cancer which could need urgent treatment. If you have these symptoms the doctor may want you to have a PSA blood test or a DRE.

IMPORTANT ADVANCED PROSTATE CANCER SYMPTOMS

When prostate cancer has spread outside of the prostate gland it can give symptoms from the areas it has spread to. Sometimes these are the first indication that something is wrong and the cancer is diagnosed late. They can also occur whilst a patient is being followed up (seen in clinic regularly) following treatment for prostate cancer and indicate that the cancer has progressed despite any treatment.

Where cancer invades locally around the prostate gland it can affect the nerves which supply the penis. This can lead to problems getting and sustaining an erection. It could also cause painful ejaculation or blood in the semen. There are many other causes of problems with erections (erectile dysfunction) and you should speak to you doctor about any concerns you have. There are many effective treatments available for this or it may be a sign of something more serious which needs investigating further.

Locally advanced prostate cancer can also cause pain in the pelvis or sometimes felt around the anus (back passage). This pain may be quite severe and is often persistent. Most often men would require strong pain killers from the doctor for this type of pain.

The most common site of secondary spread is the bones. This is usually felt as pain which is persistent and felt in the same place in the bones for a period of time. Sometimes this pain stops you from sleeping properly or affects the way in which you can move around and get on with daily life. There may be just one site or several bones affected at the same time.

The cancer in the bones will also cause them to be more brittle and easier to break or fracture with even minor injuries. If one of the bones in the spine collapses from being affected by cancer it can cause pressure on the spinal cord. This is the bit of the body which sends messages from the brain to the arms and legs to tell them to move and carries messages back about sensation and temperature. If the spinal cord is squashed it can cause numbness in the arms or legs and difficulty moving them. It may also affect the way you open your bowels or urinate, and is often associated with pain in the back. Cancer secondaries in the bones may also cause a high calcium level in the blood which can make you feel nauseous, sleepy, confused, constipated and have abdominal pains.

Remember there are many reasons why (especially elderly) men can get aches and pains in their bones (arthritis etc) but if you are worried you should tell you doctor. They may be able to reassure you or may want to arrange for you to have a bone scan (see earlier). This obviously helps to assess what form of treatment would be most appropriate.

When cancer is more advanced it may start to cause weight loss and a general deterioration in health. If it has spread beyond the bones to other areas of the body it could cause symptoms there e.g. cause breathlessness if spread to the lungs, cause headaches if spread to the brain.