Symptoms:

With the advent of PSA testing, most prostate cancers are now found before they cause symptoms. Additionally, while most of the symptoms listed below can be associated with prostate cancer, they are more likely to be associated with non-cancerous conditions.

• Urinary hesitancy (delayed or slowed start of urinary stream)
• Urinary dribbling, especially immediately after urinating
• Urinary retention
• Pain with urination
• Pain with ejaculation
• Lower back pain
• Pain with bowel movement

Additional symptoms that may be associated with this disease:

• Excessive urination at night
• Incontinence
• Bone pain or tenderness
• Hematuria (blood in the urine)
• Abdominal pain
• Anemia
• Unintentional weight loss
• Lethargy

Signs and tests:

A rectal exam often reveals an enlarged prostate with a hard, irregular surface. A number of tests may be done to confirm the diagnosis of prostate cancer.

• PSA test may be high, although non-cancerous enlargement of the prostate can also increase PSA levels.
• Free PSA may help tell the difference between BPH and prostate cancer.
• Urinalysis may show blood in the urine.
• Urine or prostatic fluid cytology may reveal unusual cells.
• Prostate biopsy confirms the diagnosis.
• CT scans may be done to see if the cancer has spread.
• A bone scan may be done to see if the cancer has spread.
• Chest x-ray may be done to see if the cancer has spread.

A newer test called AMACR is more sensitive for determining the presence of prostate cancer than the PSA test.