What are the first symptoms of prostate cancer?
In most cases, early-stage prostate cancer is completely asymptomatic and is often detected only through an elevated PSA (prostate-specific antigen) level during screening or via physical examination. When symptoms do occur—for example, due to tumor growth and urethral compression—they manifest as lower urinary tract symptoms (LUTS). These include difficulty or hesitancy in initiating urination, a weak or interrupted urinary stream, post-micturition dribbling, increased urinary frequency (especially at night, i.e., nocturia), sudden urinary urgency, or a sensation of incomplete bladder emptying. Additional symptoms may include blood in the urine (hematuria), and less frequently, blood in the semen or erectile dysfunction. Because these identical symptoms are also characteristic of benign prostatic hyperplasia (BPH) and prostatitis, the symptoms alone do not provide a definitive diagnosis, thus requiring urological evaluation (PSA test, physical examination, and imaging).\n\nThe evaluation of lower urinary tract symptoms (LUTS) coded in primary care, macroscopic or microscopic hematuria, and newly onset erectile dysfunction is significantly associated with the detection of clinically significant prostate cancer.\n\nDuring urological investigations, specific urinary complaints such as nocturia (nighttime urination), urge incontinence, and post-micturition dribbling have shown a statistically significant correlation with the presence of histologically confirmed malignant prostate tumors.
References
- Diagnostic and prognostic outcomes for men with prostate cancer detected through opportunistic, asymptomatic PSA testing or symptomatic presentation to primary care: The PC3 cohort study. PMID 42580815
- Prevalence of Benign Prostatic Hyperplasia and Prostate Cancer Among Men Presenting with Lower Urinary Tract Symptoms at a Tertiary Referral Hospital in Dar es Salaam, Tanzania: A Retrospective Cross-Sectional Study. PMID 42074717