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Is It Prostate Cancer or Something Else?

Symptoms can be misleading. Find out what to watch for—and when.

Medically reviewed in April 2021

Prostate cancer, which occurs when cells in the prostate gland start to grow uncontrollably, is the second most common cancer among American men. And according to the American Cancer Society, one out of nine men will be diagnosed with the cancer during their lifetime. The statistics sound alarming, but the fact is that most men with prostate cancer don’t die from it. Still, that doesn’t make it any less serious of a disease, which is why it’s important to become familiar with symptoms that may warrant a call to your healthcare provider.

We talked to John McGill, MD, of Southeastern Urology Associates and Coliseum Medical Centers in Macon, Georgia, to learn more about symptoms and how the cancer is diagnosed.

What are the symptoms?
“There are no clear symptoms associated with early or organ-confined prostate cancer,” says Dr. McGill. Unfortunately, once symptoms do appear, the cancer is already at an advanced stage. “In advanced prostate cancer, men may develop bone pain, blood in the urine or obstruction of the bladder or ureters, which drain urine from the kidneys,” says McGill. Other prostate cancer symptoms may include frequent urination, foot or leg numbness and erectile dysfunction.

Why are symptoms confusing?
What’s most vexing about prostate cancer is that the symptoms aren’t unique to the disease, making it challenging to diagnose. Here’s a breakdown of some symptoms that could suggest something else:

  • Bone pain: “Differentiating bone pain from general aches and pains can be quite difficult,” says McGill. “This is one reason why bone pain by itself does not necessarily mean a person has advanced prostate cancer.” 
  • Bloody urine: Hematuria, or blood in the urine, may indicate advanced prostate cancer, but it can also indicate conditions like kidney stones, urinary tract infections or abnormal growths in the kidneys, ureters or bladder.
  • Urination problems:  According to the American Cancer Society, trouble urinating is more likely a sign of benign prostatic a non-cancerous condition related to prostate growth.

How is it diagnosed? 
Certain screenings may detect prostate cancer in its early stages. Even for those without symptoms, prostate-specific antigen (PSA) blood tests and digital rectal exams (DRE) may help find the cancer while it’s easier to treat. If these tests show any abnormalities, a prostate biopsy—a procedure that involves removing small samples of the prostate to examine under a microscope—may be recommended.

But prostate cancer diagnosis can be complicated, says McGill. Early screenings like the PSA and DRE tests may not be completely accurate. They may produce false-positive results—positive results even when cancer isn’t present—or false-negative results, indicating that a man doesn’t have cancer when he does. Sometimes, elevated PSA levels signal positive results for prostate cancer so men have biopsies, followed by radiation or surgery. But many times prostate cancer progresses so slowly that it would never cause problems, and these procedures have side effect risks of their own.

The bottom line?
McGill says staying up-to-date with your regular urologist and general practitioner appointments is the best way to keep your prostate health in check. The American Urological Association strongly recommends that men ages 55 to 69 discuss the risks and benefits of PSA screenings, ultimately with shared decision-making with their physician,” he says.  And men at increased risk, such as those with a family history of the disease and African Americans should report any symptoms to their healthcare provider, even if they are outside of the recommended ages for screening.

McGill says staying up-to-date with your regular urologist and general practitioner appointments is the best way to keep your prostate health in check. Starting at age 50, men at average risk for prostate cancer should make an informed decision about when to be screened with their healthcare team, taking into account the potential risks and benefits.

Men at increased risk, such as those with a first-degree family history of the disease and African American men, should start these conversations at age 45. If you have a brother or father who was diagnosed with the disease at an early age, talk to your doctor by age 40. Of course, men should report any symptoms to their healthcare provider, even if they are outside of the recommended ages for screening.

Article sources open article sources

American Cancer Society. “Cancer Facts for Men.” May 27, 2020.
American Cancer Society. “Key Statistics for Prostate Cancer.” January 21, 2021.
American Cancer Society. “Signs and Symptoms of Prostate Cancer.” August 1, 2019.
Centers for Disease Control and Prevention. “How Is Prostate Cancer Diagnosed?” August 18, 2020.
American Cancer Society. “Can Prostate Cancer Be Found Early?” August 1, 2019.
American Urological Association. “Patient Access to PSA Testing.”
American Cancer Society. “American Cancer Society Recommendations for Prostate Cancer Early Detection.” November 17, 2020.

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