• Asymptomatic


• Poor stream


• Retention of urine


• Urgency


• Frequency


• Hematuria (blood in the urine)

Related to secondary tumour deposits:

• Bone pain (back and pelvis):


• Pathological fractures


• Enlarged lymph glands


• Kidney failure

Related to the general effects of malignancy:

• Weight loss


• Tiredness


• Malaise


• Anemia


• Loss of appetite

Early prostate cancer is usually completely asymptomatic. By the time that prostate cancer becomes bothersome or clinically apparent it has usually spread beyond the confines of the prostatic capsule and is no longer amenable to cure. In the first world early prostate cancer is usually diagnosed following screening. Prostate cancer can also be a chance finding in the tissue removed by transurethral resection for suspected benign prostatic enlargement.

The primary tumour can cause lower urinary tract symptoms similar to benign prostatic hyperplasia. Obstructive symptoms include poor stream, incomplete emptying and straining while passing urine. Irritative symptoms include dysuria, frequency, urgency and nocturia. Prostate cancer can also cause blood in the urine but this is not common.

Prostate cancer typically spreads to the bony skeleton and the lymph glands of the pelvis. Bony metastases commonly involve the lower spine and pelvic girdle causing backache. Lymphatic involvement can cause swelling of the legs and obstruction of the drainage tubes of the kidneys (ureters). Prostate cancer can cause renal failure by ureteric obstruction or by bladder outlet obstruction.

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