Recognising the early signs of prostate cancer can help men seek medical advice sooner and determine whether further investigation is needed. The early signs of prostate cancer most commonly involve changes in urination. However, in many cases prostate cancer causes no symptoms at all in its earliest stages, which is why awareness of risk factors and proactive testing are essential.
Prostate cancer is the most common cancer affecting men in the UK. It can be confined to the prostate (localised prostate cancer), have spread to surrounding tissues (locally advanced prostate cancer), or spread to other parts of the body (metastatic prostate cancer). Many men find themselves searching for what the early signs of prostate cancer are, particularly if they begin noticing changes in their urinary habits or general health.
Professor Prasanna Sooriakumaran (Prof PS) is an internationally recognised prostate cancer surgeon based in London who has dedicated his career to diagnosing and treating men with prostate cancer. If you are concerned about potential early signs of prostate cancer, consulting an experienced specialist can provide timely reassurance and, where needed, a clear path to diagnosis.
You can arrange a consultation with Prof PS here.
What Are the Early Signs of Prostate Cancer?
One of the most common questions men ask is what the early signs of prostate cancer are. In many cases, the first symptoms men notice relate to changes in urination. This is because the prostate gland surrounds the urethra, the tube that carries urine from the bladder, and even a small tumour can affect urinary flow.
Common signs and symptoms of prostate cancer in the early stages may include:
- Needing to urinate more frequently, particularly at night (nocturia)
- Difficulty starting urination
- A weak, slow, or interrupted urine stream
- Stopping and starting when urinating
- Feeling that the bladder has not fully emptied
- A sudden or urgent need to urinate
These early signs of prostate cancer may develop gradually and are not always caused by prostate cancer. These symptoms can sometimes result from normal ageing or from benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate. However, if you notice persistent urinary changes, it is important to be assessed by a doctor.
If you are experiencing any of the above, you can speak to Prof PS here.
Warning Signs and Symptoms of Prostate Cancer Men Should Not Ignore
Although urinary symptoms are the most common early signs of prostate cancer, other possible signs and symptoms can occur. These are less common in early stage disease, but may become more noticeable as the cancer progresses.
Additional warning signs of prostate cancer may include:
- Blood in the urine (haematuria)
- Blood in the semen (haematospermia)
- Discomfort or burning when urinating
- Pain or discomfort in the pelvis, lower back, or hips
- Changes in erectile function
- Unintentional weight loss or fatigue (more associated with advanced disease)
These signs may also be symptoms of an enlarged prostate, a non-cancerous condition caused by age, but they should never be dismissed. These symptoms, especially blood in the urine or semen, should always be promptly evaluated by a doctor.
How Do You Know If You Have Prostate Cancer?
A key challenge to prostate cancer is that the early signs of prostate cancer are often mild and easy to overlook. In the early stages, prostate cancer may not cause noticeable symptoms. The only reliable way to detect prostate cancer, especially at an early, treatable stage, is through appropriate medical testing.
Diagnostic tests for prostate cancer may include:
- PSA blood test — measures the level of prostate-specific antigen in the blood, which can be elevated in prostate cancer
- Digital rectal examination (DRE) — allows the doctor to feel the prostate for abnormalities
- Stockholm-3 or other biomarker tests — more precise blood tests that can reduce unnecessary biopsies
- Multiparametric MRI (mpMRI) scan — detailed imaging of the prostate to identify suspicious areas
- Targeted prostate biopsy — a tissue sample to confirm or exclude cancer, guided by MRI findings
Testing should be considered based on individual risk. The main risk factors for prostate cancer include:
- Age — risk rises significantly in men over 50; most diagnoses occur in men over 60
- Family history — men with a father or brother diagnosed with prostate cancer have approximately double the risk
- Ethnicity — Black men are at higher risk, often at a younger age, and this risk increases further with a family history
- BRCA gene mutations — particularly BRCA2, which is associated with a more aggressive form of the disease
To discuss effective prostate cancer treatment options including advanced surgical treatments such as robotic prostate cancer surgery, get in touch with Prof PS.
Why Early Diagnosis of Prostate Cancer Matters
Recognising the early signs of prostate cancer allows men to seek medical advice sooner and receive appropriate testing. When prostate cancer is diagnosed at an early stage, treatment options, including surgery and radiotherapy, are most effective.
A landmark long-term European study confirmed that PSA screening is associated with a significant reduction in prostate cancer deaths over more than two decades, providing strong evidence for the value of early detection.
Prof PS specialises in robotic prostatectomy — a minimally invasive surgical technique for removing the prostate — with a focus on preserving urinary continence and sexual function. He also leads the PRESIDENT trial, the UK’s first government-funded randomised controlled trial investigating cytoreductive surgery for metastatic prostate cancer.
If you are seeking expert advice regarding possible early signs of prostate cancer, you can contact Prof PS here.
When Should You See a Doctor About Prostate Cancer Symptoms?
You should see a doctor if you notice any of the following:
- Persistent or worsening urinary symptoms lasting more than a few weeks
- Blood in your urine or semen
- Unexplained pelvic, lower back, or hip pain
- You are over 50 and have not discussed your prostate cancer risk with a doctor
- You are a Black man or have a family history of prostate cancer — consider risk assessment from age 40–45
You do not need to wait for symptoms before seeking advice. If you have known risk factors, proactive discussion with a specialist is recommended.
FAQs
What are the earliest signs of prostate cancer?
The earliest signs and symptoms of prostate cancer usually involve urinary changes, including needing to urinate frequently, difficulty starting urination, a weak urine flow, or feeling that the bladder does not fully empty. However, many men with early prostate cancer have no symptoms at all, which is why testing is important for men with risk factors.
Can prostate cancer develop without symptoms?
Yes. Some men experience no early signs of prostate cancer at all, especially in the early stages. Prostate cancer can be detected through testing. Contact Prof PS today to discuss the appropriate testing for you.
When should I see a doctor about prostate symptoms?
If you have any concern about whether you have prostate cancer, always speak to a doctor regardless of symptoms. You should see a doctor if urinary symptoms persist, worsen, or are accompanied by blood in the urine, pelvic pain, or other potential early signs of prostate cancer. Early evaluation is always better than waiting.
Do urinary symptoms always mean prostate cancer?
No. Many urinary symptoms are caused by non-cancerous conditions such as a benign prostate enlargement, among other conditions. However, these symptoms should still be assessed to rule out prostate cancer.
What is the PSA test and is it reliable for detecting prostate cancer?
The PSA (prostate-specific antigen) test is a blood test that measures a protein produced by the prostate. An elevated PSA level can indicate prostate cancer but can also be raised by BPH, infection, or inflammation. It is not a definitive diagnostic test on its own. PSA is typically used alongside MRI and sometimes biomarker tests such as Stockholm-3 to build a clearer picture before considering biopsy.
What is the difference between localised, locally advanced, and metastatic prostate cancer?
Localised prostate cancer is confined entirely within the prostate gland. Locally advanced prostate cancer has grown beyond the prostate into surrounding tissues, such as the seminal vesicles, but has not spread to distant organs. Metastatic prostate cancer has spread to other parts of the body, most commonly the bones and lymph nodes. The stage significantly affects which treatment options are most appropriate.
Who is most at risk of prostate cancer in the UK?
Men over 50, Black men (who are at higher risk from a younger age), and men with a first-degree relative (father or brother) diagnosed with prostate cancer are at the highest risk in the UK. Men with BRCA2 gene mutations are also at elevated risk. If you fall into any of these groups, speak to a doctor about prostate cancer risk assessment.