Prostate cancer at an early stage does not give any cancer specific symptoms. Only when tumors are involving the urinary tract, local symptoms corresponding to benign prostate hyperplasia (BHP) will develop.
Locally advanced or metastatic disease can be painful, cause bleeding, urine retention, hematospermia, and/or any symptoms of distant metastases.
Organ localized disease ≤ T2
- Obstruction symptoms such as hesitant urination, decreased force in the stream of urination, difficulties in emptying the bladder completely.
Locally advanced disease
- Hematuria (due to infiltration in the neck of the bladder and/or urethra)
- Hematospermia (rare)
- Hydro ureter, hydronephrosis, uremia may follow in cases of infiltration of the base of the bladder.
- Pain in the back and bone
- Neurological symptoms due to metastasis pressing on nerves and spinal nerve roots (vertebral column)
- Fatigue and weight loss
Distant metastases occur most frequently in the axis skeleton. Sclerotic bone metastases are typical in prostate cancer, but osteolytic metastases which can cause fractures do occur. The greatest danger is pressure on the spinal nerve roots or spinal cord, and and the risk of spinal cord paralysis.