Sperling Prostate Center

10 Key Warning Signs of Prostate Cancer

UPDATE: 11/8/2021
Originally published 7/3/2017

All of the prostate cancer (PCa) warning signs we posted below in 2017 are still valid. That is, they are accurate, but they are late in the disease. By the time they appear, it is often because an early tumor that had no early symptoms has now enlarged to the point that it interferes with urinary or sexual function. This is a true red flag that should immediately have you setting an appointment with your doctor. You hope you don’t have PCa, and if you do, you hope there’s still time for a local treatment.

Is there an earlier warning sign? There is, but you have to take action to find it. You see, the body rarely offers no signs of a prostate malignancy, but the blood does. It’s called the PSA blood test, which stands for Prostate Specific Antigen. Why is this important, since it can mean other things besides PCa? The answer is, because it’s a cheap annual way to spy on the health of your gland.

True, if your PSA comes back suspiciously high, it doesn’t necessarily mean you have PCa. But it’s worth checking out! There are two easy ways to get more information before rushing into a biopsy:

  1. Wait a couple of months and have a repeat blood draw. If PSA has returned to normal (for your age), you probably don’t have PCa and can wait till your next annual blood test.
  2. If a repeat blood draw is still high—or even a bit higher—have a noninvasive imaging scan called a multiparametric MRI (mpMRI) of the prostate. If done by an experienced radiology team on a powerful 3T magnet, such as we have, the results provide a portrait of the gland that can rule a biopsy in or out. (If a biopsy is needed, be sure to have a real-time in-bore MRI targeted biopsy for the fewest needles yet the most accurate result).

To sum up, only you can choose to watch for the very earliest PCa warning sign by means of an annual blood test. You can thank yourself if the results are negative, and thank yourself again if you are diagnosed with PCa while you still have ample time for AS or a minimally invasive treatment that preserves quality of life. Never take a chance on regret if any of the symptoms below eventually turn up.


Prostate cancer is considered highly curable when it is detected early! This is also when a patient has the most treatment choices, including Active Surveillance and focal therapy with minimal side effects.

No symptoms in early stages

The problem is, early stage prostate cancer is a silent lurker with no symptoms. However, a growing tumor will eventually cause symptoms. Since many noncancerous conditions like infection or normal age-related prostate enlargement can cause similar symptoms, only a doctor can tell the difference.

Here are 10 prostate cancer warning signs you should pay attention to. To help you remember them, I have divided them into three categories: urinary function, sexual function, and pain.

Urinary symptoms

  • More frequent need to urinate
  • Urination difficulties (hard to start or hard to stop)
  • Weak or slow stream; dribbling
  • Blood in urine

Sexual symptoms

  • Change in erectile function (hard to get or maintain an erection)
  • Less ejaculate
  • Blood in semen

Pain symptoms

  • Painful urination
  • Painful orgasm/ejaculation
  • Pain in your lower back, hips, upper thighs (possible cancer spread to bones)

If you experience any of these symptoms, see your doctor. It’s worth repeating that any of these warning signs may not necessarily point to prostate cancer – but why take chances? The sooner prostate cancer is diagnosed, the more treatable it is.

Look at it this way. Even if something other than prostate cancer is causing urinary, sexual or pain symptoms, the earlier you act, the better quality of life you will enjoy once the problem is cured.

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    NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

    About Dr. Dan Sperling

    Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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