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Prostate Cancer

Signs and symptoms of prostate cancer

Men describe symptoms they experienced before diagnosis.

Men with early prostate cancer may not have any symptoms, as these usually only occur when the cancer gets big enough to put pressure on the urethra (the tube that carries the urine to the outside). In men over 50, the prostate gland can get larger due to a non-cancerous condition known as benign prostatic hyperplasia (BPH).

The symptoms of both benign prostatic hyperplasia and prostate cancer are very similar and it is often difficult to tell the difference between the two without further tests.

Over three-quarters of the men we interviewed consulted their GPs because of signs or symptoms, although a few men were diagnosed as the result of routine PSA tests (see 'The PSA test' and 'Ideas on PSA screening & tests on demand'). Before the diagnosis was made many of the men we talked with reported difficulty in passing urine, urgency, and passing urine more frequently than usual, particularly at night.

Some men gave detailed descriptions of their symptoms. In some cases symptoms were quite mild while in other cases symptoms were much more severe.

 

Richard describes his symptoms. He had to get up several times during the night to pass urine. He...

Richard describes his symptoms. He had to get up several times during the night to pass urine. He...

Age at interview: 53
Sex: Male
Age at diagnosis: 47
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I was diagnosed with prostate cancer in 2005. I had all the symptoms of somebody who’s suffering from prostate cancer, difficult to pee, getting up several times during the night, bursting to go and then not able to go properly, and this lasted, you know quite a few weeks stroke months, went to see my GP, who sent me for a blood test to test my PSA level, I didn’t know what that was at the time. So I got the results of that test, he suggested that there may be a problem with my prostate, I was sent to the hospital for them to do a biopsy. They did a biopsy, which, a very unpleasant procedure but necessary, and then got the results of that confirming that I had prostate cancer, and then was given the options by the consultant. After discussing it with my wife, decided the best thing to do was have the prostate removed which I did in July 2005. The operation itself was pretty straightforward, but the recovery was very difficult. There’s a lot of side effects, a lot of incontinence, erectile dysfunction, and it’s quite a long recovery period, so that was very difficult, much more so than the operation itself, but in the years after that it’s just got a lot better and everything’s sort of, all my functions returned to normal, including the erectile dysfunction problem after two years, and since then I’ve been fine, I have an annual check, and my PSA level is zero, which it should be, and I’ve been fine ever since.

 
 

 

 

Comments that his symptoms of difficulty in passing urine got steadily worse.

Comments that his symptoms of difficulty in passing urine got steadily worse.

Age at interview: 64
Sex: Male
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Well I think it goes back many months. I realised I was going to be a candidate for prostate yonks ago when I had great difficulty passing urine and wanted to pee all the time. So it's that terrible combination of wanting to do it then not being able to do it and of course the embarrassment of going for a pee and finding loads of other people come in to a public loo at the same time and they've all gone and you're still there trying to start 

(laughs).

How long ago did all that problem start?

I would think that's probably been going for 2 or 3 years and steadily getting worse and more noticeable at night when I would get up probably 4 or 5 times and I supposed dribble more than anything. I never knew whether it was wanting to go to the loo that was waking me up or in fact I was just a poor sleeper and when you don't sleep you want to go to the loo.

 

Considers the lack of response from his doctor when he described his problems passing water.

Considers the lack of response from his doctor when he described his problems passing water.

Age at interview: 66
Sex: Male
Age at diagnosis: 66
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But I think one significant point is back 7 years ago, and this started with prostate trouble, the usual thing frequent loo visits, day and night so sleep was being interrupted. And it was a nuisance in work and I was also making long visits at the time to Africa and so it was a nuisance on the aeroplane as well. And with the groups I was working with and there was a problem with retention clearly, I was going to the loo and having a pee and then finding I had to go back 10 minutes later to finish the job. I mean so that was the sort of basic background. But I had a good medical guide, I think it's not a bad idea, with nice diagrams, I think it was a Macmillan guide and I kept looking at that and that proved to be quite useful. But as it was a nuisance I went to see my GP and the response I got I think is typical, he said 'Well that's normal,' I was 59 at the time.

 

Explains how investigations started after a urine infection that would not clear with antibiotics.

Explains how investigations started after a urine infection that would not clear with antibiotics.

Age at interview: 57
Sex: Male
Age at diagnosis: 56
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Well when I was about 40 I had the first experience of urine infection and it was quite unpleasant you know I had to sort of go to the doctor in the middle of a weekend and a lot of pain, impossible to pass urine and so on. And he sort of did a rough examination and said that I'd got an infection, I didn't have any tests at that stage but I went onto an antibiotic and that seemed to get rid of it. So, oh I suppose after about 10 days I was sort of reasonably okay, feeling a bit weak but, now that repeated itself about 3 times and each time I had antibiotic and it seemed to clear it up. Then a bit more recently, about 2 years ago I went onto an antibiotic and it didn't clear it up at all. I had a second antibiotic, this was provided by the GP but he decided that I really ought to go and see a consultant urologist at the local hospital so I agreed to do that. Waited about 6 weeks, something like that, saw the urologist and basically the sort of process of various investigation started.

 

Comments that his symptoms began with an irregular flow when passing water.

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Comments that his symptoms began with an irregular flow when passing water.

Age at interview: 67
Sex: Male
Age at diagnosis: 66
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I suppose it was 5 years ago or something like that, I was going to the GP about something else but it had just struck me that urinating wasn't quite the same as it had been. I think there was probably some dribbling or something or stopping in the middle and then having to go again, something like that in a mild kind of way. And I mentioned this to the GP and he immediately referred me to a urologist and this was about 5 years ago something like that. And he initiated a battery of tests and about the test concerned, kind of bladder function, peeing and all that and one of them was a PSA of course and at that stage, at the first take my PSA was 6, slightly above the level of 4 which is supposedly normal. He didn't propose to do anything but then I had to go back in 6 months time and have another PSA.
 

 

Describes his extremely painful water retention.

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Describes his extremely painful water retention.

Age at interview: 80
Sex: Male
Age at diagnosis: 77
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Right can I start please by asking you how you first discovered you had a problem with the prostate.

I had water retention which is agonising and as a result of that I went to the hospital and they then had me in, this would be about 3 years ago and...

Did you go to your GP first?

Yes I would have done yes

And did the GP do anything or say anything?

No, well what happened was this water retention was at night and my wife who's been wonderful throughout, I just cannot over-emphasise what help she's given me, got my son to run me up because that's what the local doctor on call had said, take me to the hospital.

But when you say water retention, you couldn't pass urine?

I couldn't.

You couldn't go to 

And it's agonising, it's the most ghastly feeling, I thought I'd die, I'd like to have done.
 

 

Bruce sought medical advice after experiencing changes both in sexual potency and frequency of...

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Bruce sought medical advice after experiencing changes both in sexual potency and frequency of...

Age at interview: 88
Sex: Male
Age at diagnosis: 82
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And did you know about your brother-in-law’s experience, was that what prompted you to go very quickly to the doctor?

 
Not really, no not really, this had happened years before, but when I had the experience of a lack of potency, it was obviously, there was something there, because I never had any trouble, we were married for fifty-two years, never had a problem before, and then I was getting up at night and so on and so on, so that all pointed to having an investigation which I had.

 

 

Haq had symptoms for about six months. Passing urine was difficult and painful.

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Haq had symptoms for about six months. Passing urine was difficult and painful.

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And did you have any symptoms at all yourself?
 
Yes I had the symptoms, I had difficulty passing water like whenever I, an urge and if I don’t go straight away, I hold it for a while then I couldn’t start.
 
I had to so painful start and then, this is something I was I actually experienced.
 
And how long had you had that symptom for?
 
Oh about six months.

In a few instances men mentioned blood in their urine and one man said that the first sign that anything was wrong was excruciating back pain.

 

Comments on how he first found traces of blood in his urine.

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Comments on how he first found traces of blood in his urine.

Age at interview: 77
Sex: Male
Age at diagnosis: 75
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Perhaps we could start, I'd like to ask you how you first discovered that you had a problem at all, or what made you seek help?

Well it first occurred one evening just before I was going to bed. I went to pass water and I noticed a trace of blood in it, not much. I thought well that's very odd, but I thought it would pass and then later, just before actually going to bed I went to the toilet again and there again was this trace of blood.

How long ago was this?

Two years ago, 2 years, I think it was in the April of 98. I thought, well I should see my doctor. He was reassuring, very good, he said 'Oh I'll make some notes,' and he said 'there will be some tests I would like to make,' he said 'it could be many things,' and he said 'I don't wish you to be alarmed.' And so that set it off from there.
 

 

Stephen's prostate cancer was diagnosed very late. His first symptom was back pain, due to...

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Stephen's prostate cancer was diagnosed very late. His first symptom was back pain, due to...

Age at interview: 62
Sex: Male
Age at diagnosis: 60
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I went to my GP, I can remember the exact date, it was the 10th August 2009, I woke up with the most excruciating back ache, back pain, and I couldn’t go to work, I went to the doctor and said “I’ve got this terrible pain”, and she said, “Oh, we’ll give you some painkillers and it should sort itself out”, that continued for a while, I went back to my doctor a number of times, during a three month period and saw different doctors, they all said the same, “You’ve just got back problem, it will sort itself out, just take painkillers, take the cheapest you can get”, and they kept on that it was just a muscular skeletal problem, I asked if I could have an x-ray and they said, “No, you don’t need an x-ray”. I was seeing another, hospital doctor, in connection with my cholesterol levels, and on a regular monitoring, I mentioned to him that I had this back pain, he said, “How are you?”, I said, “I’m fine except that I’ve got this back pain”, he said, “Oh, go and have an x-ray, it’s probably nothing but it’s worth having a look”, so he sent me for an x-ray, I had an x-ray, and he said, “Well it’s showing something, so I think you should have an MRI scan”, at this time, the thought of prostate hadn’t entered my head at all, because all I had was this absolutely excruciating back pain.
 
I had the MRI scan on the Saturday, on the Thursday before, I went to see my GP, and said that I was having the scan, and said, “Would you like to have a copy of it?”, and she said, “No, I don’t want to see it, I’m (going to) send you to the local cottage hospital to have, to go to a physiotherapy class”. On the Sunday I then went off to work in Romania, on the Tuesday, I got a call from the hospital, saying, “Can you please come in straight away, because we think there is something seriously wrong”, so I got a flight back to the UK, and went straight to the hospital, they admitted me immediately, they said, “Don’t go home, don’t go home, come straight from the airport, come straight in, because we’re very worried”, so I went in, and immediately they started tests, and after a few tests they said, “Well, we think you’ve got prostate problems, prostate cancer, we think it’s metastasised into the bones, we need to do biopsies, on your bones, and your prostate just to make sure”, they did that, and then I was diagnosed, that all happened towards the end of November 2009, so, I went to the hospital, as I was saying, I was in hospital, I had, I was diagnosed, and they started my treatment, and so because it’s metastasised into your bones, I’ve lost two vertebrae which have been completely replaced with tumours, it’s in my hips, it’s in my ribs, it’s in little bits of my abdomen. They said, “We think the best treatment for you is hormone therapy”.
 
 
 
 

Last reviewed July 2017.

Last updated January 2014.

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