Prostate cancer is one of the leading cancers in males assigned at birth (MAAB). Symptoms may include pain, bladder issues, or sexual dysfunction. Early detection is key.

Statistics from the Centers for Disease Control and Prevention show that 201,082 new cases of prostate cancer in the United States were reported in 2020 alone.

Learn more about these early symptoms of prostate cancer, as well as when it’s time to take action.

Prostate cancer, especially in the early stages, will typically cause pain, urinary symptoms, and it can affect your sexual function.

Urinary symptoms

Prostate cancer shares many similar symptoms with benign diseases of the prostate. The earliest prostate cancer symptoms are often urinary. Warning signs can include:

  • frequent urination
  • urination that burns
  • difficulty with starting urine flow
  • weak flow, or “dribbling”
  • blood in the urine
  • frequently urinating at night

Many of these symptoms can be indicative of noncancerous diseases of the prostate, a gland located near the bladder in MAABs. These include an enlarged prostate, also known as benign prostatic hyperplasia (BPH), and prostatitis, an inflamed prostate gland, usually due to infection.

Unlike prostate cancer, BPH and prostatitis usually don’t cause bloody urine. If you see blood in your urine, call your doctor for an evaluation immediately.

Learn more: What’s the difference between prostatitis and BPH?

Sexual dysfunction

The prostate gland plays a key role in the male reproductive system, so unsurprisingly, prostate cancer can cause sexual dysfunction.

MAABs may have problems getting or maintaining an erection or experience painful ejaculation. Some men with early prostate cancer experience no symptoms.

Because of changes in hormone levels, sexual dysfunction becomes more common with age. Still, you shouldn’t brush off erectile dysfunction or other symptoms due to aging. Tests can help determine whether your symptoms are cancerous or not.

Frequent pain

Once prostate cancer spreads, it can cause pain in and around the area of the prostate gland. MAABs with the disease can also experience pain in other areas:

  • hips
  • lower back
  • pelvis
  • upper thighs

Pain is also likely to occur in multiple areas. For example, you might experience painful urination in conjunction with pelvic pain. Any ongoing or chronic pain should be assessed by a doctor to rule out serious health problems.

Unintentional weight loss

In most cases, unintentional weight loss is a sign of later-stage prostate cancer.

That said, it can be an early sign of cancer in rare cases.

If you’re losing weight without trying and having other symptoms that suggest a problem with your prostate, see your doctor.

In addition to physical symptoms, some other signs can indicate the presence of prostate cancer in your prostate cancer screening.

Prostate-specific antigen (PSA) test

The prostate-specific antigen (PSA) test detects a higher-than-usual protein concentration generated by your prostate gland in the blood.

A high PSA concentration can indicate prostate cancer even before you notice other symptoms. However, this can also be caused by other conditions.

Generally speaking, there is no definite limit for PSA levels in the blood. Previously, 4 nanograms per milliliter (ng/mL) has been considered standard.

However, there are some prostate cancer patients with lower counts and people without it who have between 4-10 ng/mL.

That said, if your test indicates a potential for prostate cancer, your doctor will probably send you for additional testing.

Learn more about PSA levels and testing.

Digital rectal exam (DRE)

A digital rectal exam (DRE) is a procedure doctors use to check your lower rectum and other internal organs.

During the test, your doctor will slide a gloved and lubricated finger into your anus to feel for abnormalities.

They’ll be able to detect lumps on your prostate or an enlarged prostate, both of which could be signs of prostate cancer.

Abnormal DRE results by themselves don’t necessarily mean you have prostate cancer. However, in combination with a positive PSA level and other symptoms, your doctor may make the diagnosis.

It’s a good idea to call your doctor if you experience symptoms of prostate cancer, even if they’re mild.

The U.S. Preventive Services Task Force (USPSTF) suggests it may be a good idea to get a prostate cancer screening (including a PSA test) if you’re between 55 and 69, but this decision is up to you in consultation with your doctor.

The USPSTF also recommends against getting a prostate cancer screening (including a PSA test) over the age of 70 unless you specifically want to be screened or your doctor refers you.

That said, the National Cancer Institute recommends that MAABs in their 30s or 40s see a doctor immediately if they experience prostate cancer symptoms. While these symptoms don’t necessarily indicate prostate cancer, noncancerous prostate problems usually occur in men after the age of 50.

Symptoms like bloody discharge or extreme pain may warrant an immediate cancer screening.

Getting regular cancer screenings is also important, particularly if there’s a history of the disease in your family.

MAABs with family members with prostate cancer are up to three times more likely to develop the disease. Your risk may also be greater if breast cancer runs in your family. Sharing this information with your doctor can help you get timely testing done should any suspicious symptoms arise.

The majority of prostate cancer cases continue to be diagnosed during routine checkups. This can lead to a late diagnosis, in which the cancer has already progressed to a more advanced stage. Like many forms of cancer, the earlier prostate cancer is detected, the better the outlook.

It’s possible to have prostate cancer, BPH, and prostatitis simultaneously. Still, this doesn’t mean having a noncancerous prostate disease increases your risk of developing prostate cancer.

The best way to protect yourself is to pay attention to your symptoms earlier rather than later. Being proactive can lead to earlier treatment and a better outlook.

Learn more about prostate cancer.