June 29, 2021

What Are the 5 Warning Signs Of Prostate Cancer?

Prostate cancer is the most common type of cancer that affects men in the United States, next to non-melanoma skin cancer. Knowing how to spot early signs of prostate cancer can help you determine whether it may be time to see your doctor for an examination.

Continue reading to learn more about the causes and early warning signs of prostate cancer and how this cancer can be effectively treated.


What Is Prostate Cancer?

Prostate cancer is the uncontrolled growth of cells in the prostate gland. This male gland is about the size of a walnut but may be significantly larger in older men. It is located below the bladder, in front of the rectum, and around the urethra, and produces and stores part of the fluid in semen.

Almost all prostate cancers diagnosed after biopsy are diagnosed as adenocarcinoma of the prostate. The more rare types would be a small cell carcinoma, neuroendocrine tumor, transitional cell carcinoma, or a sarcoma. All are pretty rare in the prostate.

Many cases of prostate cancer develop slowly over time and do not spread outside the prostate gland. However, cases that are more aggressive and that spread outside the prostate gland may be life-threatening. Detecting prostate cancer and treating it early can greatly reduce the risk of mortality, especially when this cancer is treated while it remains confined to the prostate gland.


What Causes Prostate Cancer?

The exact cause of prostate cancer remains unknown. This cancer begins when cells in the prostate experience change in their DNA that causes them to grow and multiply faster than normal cells. These abnormal cells can eventually form a tumor that affects nearby tissues and organs. In aggressive cases of prostate cancer, these abnormal cells can separate from the tumor and spread to other organs and parts of the body.

man with pain in private area at doctor's appointmentAdenocarcinoma happens when the prostatic tissue rapidly replicates.  This leads to benign prostatic hypertrophy, then possibly prostate cancer. This happens often after age 60-65.   Benign prostatic hypertrophy can often lead to frequent urination and incontinence.

Certain factors may increase your risk of developing prostate cancer. These risk factors include:

  • Being 50 years of age or older
  • Having a family history of prostate cancer, breast cancer, and/or ovarian cancer
  • Being overweight or obese
  • Having a high-fat diet
  • Being black or African American

The younger you are diagnosed, often times, the more aggressive the disease. (Usually age 40-45 years old) African American and Caribbean descent men are at a higher risk. The reasons for this is currently unknown. A first degree relative with a history of prostate cancer can put a man at a higher risk. Any man that has any pre-existing conditions, such as hypertension, diabetes, or high cholesterol is at a higher risk due to the chronic inflammation process.


What are the 5 Warning Signs of Prostate Cancer?

Many men with early-stage prostate cancer may not have any signs or symptoms. However, you should make an appointment with your doctor as soon as possible if you experience any of the following five warning signs.

1. Pain or Burning Sensation When Urinating

Painful urination is also known as dysuria. This symptom tends to be more common in older men than in younger men. Dysuria is characterized by feelings of discomfort, pain, and/or burning when urinating. Dysuria may also be a sign of other medical conditions, including a urinary tract infection or sexually transmitted infection, which is why it’s important to see your doctor for a proper diagnosis.

man standing at toilet

2. Frequent Urges to Urinate at Night

Having a frequent urge to urinate repeatedly in the middle of the night is known as nocturia. The most common causes of nocturia are a urinary tract infection or bladder infection, though it may also be an early warning sign of prostate cancer.

3. Difficulty Starting or Stopping Urination

Urination should be an automatic bodily process that occurs easily. However, having difficulty with starting urination or stopping urination could indicate prostate cancer. You may also have difficulty maintaining the flow of urine, even if you feel a strong urge to urinate. Other potential causes of this symptom include an enlarged prostate, nerve damage, or cancer affecting the urethra or bladder.


4. Blood in Urine or Semen

Blood in the urine that you can see is known as gross hematuria. Gross hematuria usually isn’t painful but can be alarming when you see it in your urine stream. Your urine may be pink or red or resemble the color of soda depending on the amount of red blood cells in your urine stream. Other potential causes of gross hematuria include urinary tract infection, kidney infection, and kidney stones.

Blood in the semen may indicate prostate cancer, given how the prostate gland produces part of the fluid in the semen. The presence of a tumor in the prostate gland can rupture blood vessel walls to cause blood to appear in semen. Other potential causes of blood in the semen include recent prostate biopsy, inflammation in the testicles, and sexually transmitted infections.

5. Sudden Erectile Dysfunction

Erectile dysfunction is the inability to achieve or maintain an erection. Erectile dysfunction can be caused by a wide range of medical conditions, though it may be an early sign of prostate cancer if it occurs with other early warning signs. This sexual dysfunction may also be caused by chronic conditions, including heart disease, stress, and high blood pressure.

I assess every patient for changes in their urinary pattern like incontinence, frequency, changes in flow, pain, and nocturia. If changes present, I will always review history of a prostate-specific antigen (PSA), recheck a urinalysis and do a digital rectal examination (DRE) if warranted.  If there is a question of a prostate infection, a DRE is often not a needed exam. It will cause more pain and possibly make an infection worse. I will monitor the PSA closely and make sure that I watch for doubling time. If this increases, I will make sure to refer the patient to an urologist.


Can Women Get Prostate Cancer?

Women do not have a prostate gland, therefore, they cannot develop the prostate cancer that affects men. However, some people refer to a woman’s Skene’s glands as the female prostate.

Women do not have a prostate.   They do not need to worry about prostate cancer. We do appropriate screenings for female patients.

The Skene’s glands are the two small ducts located in front of the vaginal wall and along both sides of the urethra. These glands are not the same as prostate glands in men, though they function similarly in how they drain fluids into the urethra.

Cancer in the Skene’s glands is extremely rare and accounts for an estimated 0.003% of female cancers that originate in the urinary tract and genitals. The primary symptom of this cancer is bleeding out of the urethra. Make an appointment with your doctor as soon as possible if you are female and experience abnormal bleeding from your vagina or urethra.


How Can Prostate Cancer Be Treated?

Prostate cancer can be treated in a number of different ways depending on factors such as the severity of cancer and the rate at which it is growing.man discussing treatment options with doctor

In my 20 years of oncology experience, I have seen many changes on the front of prostate cancer.  All treatment forms depend on the aggressiveness of the disease and the patient’s current health status.  Radiation often plays a big part in treatment of prostate cancer. This comes in many forms—external beam radiation, prostate seed implants, proton therapy, high intensity focused ultrasound, and chemotherapy. In some cases for advanced disease, radioactive isotopes can be administered to make the patient more comfortable.

Low-grade prostate cancer may not require treatment, especially if you aren’t experiencing any symptoms. In these instances, a doctor may recommend active surveillance, which involves closely monitoring symptoms and undergoing regular blood testing, rectal exams, and prostate biopsies.

Other treatments for prostate cancer include hormone therapy, freezing or heating the prostate tissue, surgery, radiation therapy, chemotherapy, immunotherapy, and targeted drug therapy. Your doctor can recommend the best prostate cancer treatment for you based on your unique condition.

Hormone Therapy

Hormone therapy involves the use of medications that prevent your body from producing testosterone or prevent testosterone from reaching your cancer cells. The abnormal cells in prostate cancer need testosterone to grow, which is why preventing testosterone from reaching these cells may help destroy the cancer.

Freezing Or Heating

Prostate tissue can be frozen using cryoablation or cryotherapy, which uses a cold gas to freeze and destroy the cancerous prostate tissues. Prostate tissue can also be heated and destroyed using high-intensity focused ultrasound energy.



Surgery may be performed to remove the prostate gland, especially if the cancer is confined to only the prostate gland. Surgery may also be used as hormone therapy to remove the testicles and significantly reduce your testosterone levels.

Radiation and Chemotherapy

Radiation therapy can destroy cancer cells in the prostate using high-powered energy, while chemotherapy can destroy rapidly growing cells using one or more medications. Radiation and chemotherapy may be used to treat advanced prostate cancer that has spread to other parts of the body.


Immunotherapy helps your body identify and attack cancer cells. One form of immunotherapy involves taking a sample of immune cells from your body and using genetic engineering to change them into cancer-fighting cells that destroy prostate cancer. Other forms of immunotherapy involve using drugs that train your immune system to destroy cancer.

Targeted Drug Therapy

Targeted therapy uses drugs that interact with specific components of prostate cancer cells to destroy cancer. For example, some men with prostate cancer have a mutation in one of the BRCA genes (BRCA1 and BRCA2). These men may be given medications that specifically target cells with these genes to destroy their cancer.

I believe in taking a full assessment of the patient’s lifestyle, family, beliefs, and disease state before helping anyone make a decision on what treatment would be right for them and their family. Cancer is a family disease.

What Is the Prostate Cancer Survival Rate?

Prostate cancer can be successfully treated when caught early on. The survival rate for this cancer depends on the stage of cancer.

According to the American Cancer Society, men with localized and regional prostate cancer have a nearly 100% 5-year relative survival rate. This means that men with prostate cancer are nearly 100% as likely as men without cancer to live for at least five years following their diagnosis. Localized cancer is cancer confined to the prostate, while regional cancer is cancer that has spread outside the prostate to nearby tissues or lymph nodes.

The 5-year relative survival rate for distant prostate cancer is 30%. Distant prostate cancer is aggressive cancer that has spread to other parts of the body far from the prostate, such as the liver or lungs.


Can Prostate Cancer Be Prevented?

You may be able to prevent prostate cancer by practicing a series of healthy lifestyle behaviors that reduce your risk of developing this condition. For example, a high-fat diet is a known risk factor for prostate cancer, therefore, consuming less fat may help you avoid prostate cancer.

There is not a “fool proof method” to prevent prostate cancer. Keeping any chronic illness you might have such as diabetes, hypertension, high cholesterol, high salt diet, or high sugar diet under control. Maintain a healthy exercise program.  Make sure to do a self-exam and include scrotum and pelvic lymph node exam. You should report any abnormal findings.

Here’s how to prevent prostate cancer using healthy lifestyle behaviors:

  • Maintain a healthy weight, as being overweight or obese can increase your risk for prostate cancer.
  • Eat healthy, whole foods such as fruits, vegetables, nuts, seeds, and fish, as foods such as these are loaded with vitamins and other nutrients that help you maintain good overall health.
  • Exercise regularly, as exercise can help you maintain a healthy weight, regulate hormones, and prevent obesity.

If you know you are going to have a prostate-specific antigen (PSA) lab test done, make sure not to ejaculate 48 hours prior.  Semen that is released during sexual activity can possibly cause the PSA to be falsely elevated.  If you are doing watchful waiting, in other words monitoring PSA due to an elevation, this is important to follow for accurate results.   In my oncology days, I would always advise patients to do this, and I still do. Many of them say they have never heard of this policy, but I feel it is a little more accurate.


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Posted in: Cancer, Men's Health