PSA test for prostate cancer

Why some men have had a PSA test - symptoms

Few men with early prostate cancer have any symptoms. Most urinary symptoms are caused by benign (non-cancerous) enlargement of the prostate. They are sometimes called Lower Urinary Tract Symptoms (LUTS), and include'

  • Pain or difficulty when passing urine
  • Poor urine stream 
  • Passing urine more frequently than usual, and especially at night
  • Rarely, blood in the urine or sperm 

When men consult a doctor with urinary symptoms they may be offered a PSA test to help to diagnose the problem. The PSA test is not a very accurate test but a raised PSA can be an early indication of prostate cancer (see 'What is the PSA test?' and 'Finding information about the PSA test').

If a man comes with symptoms some doctors routinely do a PSA test, but experts disagree on whether it should be routine or whether men should be counselled and encouraged to make an informed decision before being tested. This is because the main treatments for prostate cancer have important side effects and treatment may not be successful. Also, getting a positive PSA test result out of the blue can be very distressing. 

Some men hadn't been given much information before they had the PSA test (see also 'Deciding whether or not to have the test'). 

Urinary frequency is a common problem for men over 50 years old. Some men had to pass urine six or seven times a night, and felt they had to pee again within a few minutes. Some also had aches and pains. They had a PSA test which did not suggest cancer. 

One of these men said that he felt much better after taking an antibiotic and that his symptoms were probably due to an infection and to benign enlargement of the prostate (sometimes called prostatism). Having later learnt that the PSA test is unreliable he began to question the value of the test.

Another man needed to pass urine four or five times an hour. He also had some backache. His PSA was slightly raised, but he was told that this and the symptoms were due to an infection.

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Prostate cancers usually cause symptoms when they are large enough to press on the urinary tube (urethra). Some men we talked to had urinary symptoms, and after further investigations were diagnosed with cancer. One man admitted that he did not tell his GP that he had had symptoms for over six months. 

Blood in the urine or sperm can also be a symptom of prostate cancer, though more often these symptoms are due to other problems. One man explained that previously he had had a trans-urethral resection (TURP) operation because his prostate was enlarged. Ten years later he started to pass blood in his urine. He didn't realise that he still had his prostate gland and that blood could be a symptom of cancer.

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Weight loss and impotence might suggest a physical problem and one man we talked to who had these symptoms was diagnosed with cancer.

But symptoms such as impotence, weight loss, unexplained fatigue, and bone pain are usually due to something other than prostate cancer.


Last reviewed May 2016.

Last updated May 2016.


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