Prostate cancer often grows slowly. Symptoms may not develop for many years. Men with early prostate cancer may not have any symptoms, as these only happen when the cancer is large enough to press on the urethra. The prostate can also become enlarged due to a condition called benign prostatic hyperplasia (BPH), which is non-cancerous.
The symptoms of benign (non-cancerous) enlargement of the prostate and prostate cancer are similar. They can include:
- difficulty peeing – for example, a weak flow or having to strain to start peeing
- needing to pee more often than usual, especially at night
- feeling like you have not completely emptied your bladder after peeing
- an urgent need to pee
- blood in the pee or semen
- rarely, pain when peeing or ejaculating.
If you have any of these symptoms, it is important to have them checked by your doctor.
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Prostate cancer may spread to bones such as the spine, pelvis, thigh bone (femur) or ribs. It may affect different areas of the bones rather than only one area.
The first sign of a secondary cancer in the bones is usually an ache in the bone. This is often in the hips or in the back. The pain gradually gets worse over a few weeks. You may have pain during the day but also at night, making it difficult to sleep. You usually need to take painkillers to help you. Other types of pain not caused by cancer may feel different. For example, pain from arthritis is often worse early in the morning and is not there all the time.
A secondary cancer in the bone may gradually make the bone weaker. Pain and weakness can make getting around difficult. Bones that are very weak may break (fracture) more easily. There are treatments you can have to help strengthen the bones and reduce pain.
You can find out more about the physical impacts of cancer and its treatments.
Spinal cord compression
If the bones in the spine have cancer in them, the cancer may press on the spinal cord. This is called spinal cord compression.
It usually affects your legs and may cause:
- numbness or tingling in your legs.
Spinal cord compression is not common. But if you notice these symptoms, you should contact your doctors straight away – even at the weekend or during a holiday period. If you cannot contact your GP or cancer doctor, you should go to the nearest emergency department (A&E).
We have more information about spinal cord compression.
Prostate cancer can sometimes spread from the bone into the bone marrow. Bone marrow is the spongy material in the centre of our bones where our blood cells are made. This includes red blood cells, which carry oxygen around the body. If the bone marrow cannot produce enough red blood cells, you may become anaemic. This can make you feel very tired and breathless, and you may look very pale.
Prostate cancer can sometimes spread to other parts of the body, such as the lymph nodes, lungs, or liver. If you notice any new symptoms that last for 2 weeks or more, you should talk to your cancer specialist.
It is important to remember that any of the symptoms mentioned here can be caused by problems other than cancer.
Below is a sample of the sources used in our prostate cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
European Association of Urologists. Guidelines on Prostate Cancer. 2016.
European Society for Medical Oncology. Cancer of the prostate: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 2015.
National Institute for Health and Care Excellence (NICE). Prostate cancer overview. Available from: pathways.nice.org.uk/pathways/prostate-cancer (accessed from March 2017 to November 2017).
National Institute for Health and Care Excellence (NICE). Surveillance report 2016. Prostate cancer: diagnosis and management (2014). NICE guideline CG175. 2016.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editors, Dr Jim Barber, Consultant Clinical Oncologist and Dr Lisa Pickering, Consultant Medical Oncologist.
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