Sadly, many men don't find out they have prostate cancer until the cancer has spread, making it more difficult to treat. This is because in the early stages, prostate cancer often doesn't have many symptoms. That's a problem because prostate cancer is the second most common kind of cancer in American men, after skin cancer.
The good news is, there are signs to be alert for. If you or a man in your life notices any of these changes, it's important to head to the doctor for a checkup sooner rather than later.
1. Difficulty urinating. This may take the form of feeling like you have to go and then nothing comes out, stopping mid-stream, or having to go more often. Another sign is difficulty stopping, which often takes the form of extended dribbling, or the feeling that you still have to go even when you're done. Because the prostate gland surrounds the urethra -- the tube that carries both urine and semen -- even a very small tumor in this location can interfere with urination or ejaculation. The prostate gland becomes enlarged in many men as they age, and this enlargement can cause similar urinary problems, as can benign inflammation of the prostate. So there may be no need to worry, but only a doctor can sort out one from the other.
2. Pain while urinating. Again, the problem may be a prostate tumor pressing on the urethra. However, pain while urinating is also a symptom of infection of the prostate, known as prostatitis, and of benign prostatic hyperplasia (BPH), which is non-cancerous enlargement of the prostate gland.
3. Blood in the urine. This sign is less common, but is a reason to go straight to the doctor. It doesn't have to be very much blood; all you might notice is a pinkish tint or smear. Some types of urinary tract infections can cause blood in the urine as well, but the doctor will need to perform tests to distinguish.
4. Difficulty getting or keeping an erection. Yes, this one's really hard to talk about. But if it's not happening when you want it to, or things get stuck "half-mast," it's time for a checkup. (Female partners need to tread delicately around this one, but if it's happening often enough to interfere with your sex life on a regular basis, find a moment to introduce the subject in a kind and non-threatening way.) A prostate tumor can prevent the blood flow increase to the penis that allows an erection to happen, or it can prevent the erection from sustaining to ejaculation. Enlargement of the prostate and BPH can also cause this, so don't panic, but do talk to your doctor.
5. Blood in the semen. This sign, like blood in the urine (#3) is often not described very clearly. It's not a large amount of blood, more like just enough to make semen pinkish or streaked, according to men with prostate cancer. Gals, you can help with this one too; if you notice an odd color to semen after sex, speak up.
6. Chronic constipation and other intestinal issues. The prostate gland is located below the bladder and in front of the rectum, so a tumor in this location can interfere with digestive functions. However, it's sort of a chicken-and-egg situation; chronic constipation can contribute to an enlarged prostate by putting pressure on the gland, as well as vice versa. Chronic constipation and intestinal problems can also be an early indicator of colon cancer. A good general rule is, if you're suffering from constipation, gas, or other intestinal symptoms that don't go away when you modify your diet, talk to the doctor.
7. Frequent pain in the lower back, hips, or upper thighs. The most common sites for prostate cancer to spread are the lower back, pelvis, and hips. Unexplained pain and tenderness in this area is a sign of trouble. One way to distinguish this type of pain from run-of-the-mill sciatica and lower back pain is that it may feel deeper and more like a dull ache. However, experts say any lower back or hip pain that doesn't go away is a reason to see the doctor.
8. Having to pee in the middle of the night. This is one of the sly symptoms that men diagnosed with prostate cancer say they now look back and remember. If you find yourself waking more than once a night urgently needing to go, a trip to the doctor and a PSA test is in order.
9. Leaking or dribbling urine. Here's one almost no one talks about, but we need to. It's basically the male version of urinary incontinence, which typically occurs on a small but still noticeable scale. Longer bathroom trips while you wait for the dribbling to stop or leakage on the way to the bathroom are the telltale signs. Women, if while doing the laundry you notice that his pants or jeans smell like pee, delicately suggest a visit to the doctor.
10. You're over 50 and have risk factors. Since early prostate cancer most often has no symptoms at all, men who are at risk need to talk to their doctors and have regular PSA tests and rectal exams (sorry!) whether they notice anything odd happening or not. Family history - especially a father who had prostate cancer -- being overweight, eating a high-fat diet, being of African-American descent, and smoking all increase your risk of prostate cancer. Another one many men don't know: If the women in your family have a history of breast cancer, you may carry faulty genes that increase your prostate cancer risk.