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
• Weight loss
• Lethargy

A rectal exam often reveals the hard, irregular surface of an enlarged prostate.

Testing considerations:

• PSA (prostate specific antigen) may be elevated, although other conditions such as benign prostatic hypertrophy (BPH) can cause the PSA to rise. PSA levels are determined by a blood test.
• Free PSA may be more specific in differentiating BPH from prostate cancer.
• Urinalysis may reveal blood in the urine.
• Urine or prostatic fluid cytology may reveal atypical cells.
• A prostate biopsy confirms the diagnosis.
• CT scans may be performed to rule out metastasis (spread of the cancer).
• A bone scan may be performed to rule out metastasis.
• Chest X-ray may be performed to rule out metastasis.

A newer test called AMACR is more sensitive for determining the presence of prostate cancer than the PSA test and may become more widely used to diagnose disease.