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Prostate Cancer Symptoms and Types

Prostate cancer is a common cancer in men. Many men with prostate cancer feel well at first and have no symptoms. When symptoms do appear, they can be easy to miss or mistaken for other prostate problems. 

Symptoms can also vary based on where the tumor is located, how large it is and whether the cancer has spread. Read on to understand what might be happening in your body and when to see a health care specialist.

Why early prostate cancer often has no symptoms

Early prostate cancer usually doesn’t cause any symptoms. One reason for this is where the prostate is located. The prostate is deep in the pelvis, below the bladder and in front of the rectum. Small tumors in this area can grow without pressing on nearby organs or nerves.

Many prostate cancers also grow slowly. These slow-growing tumors might not cause noticeable signs for years. Because of this, prostate cancer is often found through screening tests, like a PSA blood test, before any symptoms appear.

That’s why screening is important. Even if you feel healthy, screening can help find prostate cancer early, when treatment options are often more effective and are less invasive.

Early signs and symptoms of prostate cancer

When prostate cancer causes symptoms, they usually relate to urination or sexual function. These symptoms might start mild and get worse over time.

Urinary symptoms

The prostate surrounds the urethra, the tube that carries urine out of the body. Changes in the prostate can make it hard to urinate or pee. 

Early signs can include:

  • Starting to pee is difficult
  • The urine stream is weak or stops and starts
  • It feels like the bladder is not emptying completely
  • Having to pee more often
  • Waking up at night to pee
  • A sudden need to pee 
  • Mild pelvic pressure or discomfort 

These symptoms are common and do not always mean cancer. Still, ongoing changes should be checked by your health care provider.

Sexual and reproductive symptoms

Prostate cancer can change your sexual health and ability to have children. You might have trouble getting or keeping an erection, pain during ejaculation or less semen than usual.

Sexual changes can happen for many reasons, like age or other health problems. If these changes are new or they are getting worse, talk to your provider.

Blood-related symptoms

Blood in body fluids can be a sign that something is wrong in the prostate or nearby tissues. Watch for:

  • Blood in urine
  • Blood in semen

Blood may appear pink, red or brown. Even if it happens only once, talk to your provider. 

When urinary symptoms may not be cancer

Many prostate symptoms are caused by non-cancerous conditions, including:

  • Benign prostatic hyperplasia (BPH): An enlarged prostate that commonly causes urinary frequency and a weak urine stream.
  • Prostatitis: Inflammation or infection of the prostate that can cause pain, burning or flu-like symptoms.
  • Overactive bladder: A condition that leads to frequent or urgent urination.

If symptoms are mild and stable, your provider may recommend monitoring. You should seek care sooner if symptoms worsen, affect daily life or appear suddenly. 

Symptoms of advanced or growing prostate cancer

When prostate cancer spreads beyond the prostate, it is called advanced or metastatic prostate cancer. 

When cancer spreads to the lymph nodes, you might experience:

  • Swelling of the legs and feet
  • Groin pain or pressure

When cancer spreads to the bones, you might experience:

  • Ongoing pain in the hips, back, spine and ribs
  • Pain that gets worse with activity or at night
  • Weak bones or fractures
  • Numbness or weakness in the legs (when the spine is affected)

Other symptoms:

  • Unexplained weight loss
  • Extreme fatigue
  • Loss of appetite
  • General weakness
  • Trouble controlling bladder or bowel function 

Make an appointment if you have any symptoms that worry you.

Types of prostate cancer

Not all prostate cancers are the same. The type of prostate cancer helps your care team understand how it may behave and how it should be treated.

Adenocarcinoma

More than 95% of prostate cancers are adenocarcinoma. This type of cancer begins in the gland cells that make prostate fluid. 

Adenocarcinoma can grow slowly or more quickly, depending on the cancer’s grade and stage. The two main subtypes are acinar adenocarcinoma and ductal adenocarcinoma.   

Small cell prostate cancer

Small cell prostate cancer is a rare and aggressive type of cancer. It grows quickly and can spread early to other parts of the body. This kind of cancer often does not raise PSA levels, making it harder to detect through routine screening. Symptoms may come on suddenly and get worse fast.

Neuroendocrine prostate cancer

Neuroendocrine prostate cancer is a rare type of prostate cancer. It has some things in common with small cell cancer and can happen after hormone treatment for prostate cancer.

Since it acts differently from regular prostate cancer, it often needs special treatment.

Transitional cell (urothelial) cancer

This type of cancer starts in the lining of the urethra near the prostate. It is less common and may cause urinary symptoms early on. 

Sarcomas and other rare types

Very rare types of prostate cancer include sarcomas and lymphomas. These cancers begin in immune cells and/or the tissue that connects organs, not in the gland cells. Because these cancers are so rare, they are usually treated at special cancer centers that have experience with rare prostate tumors.

How prostate cancer type affects treatment

The type of prostate cancer you have helps guide your treatment plan. Some cancers grow slowly and may be monitored with active surveillance. Others may need prompt treatment. 

Your care team considers:

  • Cancer type
  • Grade (how aggressive the cancer looks under a microscope)
  • Stage (how far the cancer has spread)
  • PSA level
  • Your age, health and personal preferences

At Banner MD Anderson, your case is reviewed by a multidisciplinary team to ensure your care plan fits your specific cancer. 

Learn more about diagnosis, grading and staging prostate cancer.

See a Banner MD Anderson specialist

Our specialists work together to deliver advanced diagnostics, personalized treatment options and supportive care every stage.

Whether you are monitoring symptoms, looking into treatments or getting a second opinion, you don’t have to face prostate cancer alone.

Where to go next

Request an appointment