Not just blood in urine: 4 warning signs of prostate cancer you should not ignore

Prostate cancer is one of the most common cancers affecting men, especially over the age of 50. As per the American Cancer Society’s Prostate Cancer Statistics 2025 report, prostate cancer cases in the United States have shifted direction. From 2007 to 2014, incidence rates dropped by 6.4% per year, but then rose 3.0% annually from 2014 to 2021. That reversal is especially troubling for advanced-stage disease, which climbed even faster, around 4.6% to 4.8% per year.

What’s significant is that many of prostate cancer’s early symptoms are silent or easily mistaken for normal aging or other non-cancerous conditions like benign prostate enlargement or even urinary infections. While blood in the urine or semen often grabs the attention and quite rightly so, other warning signs may appear long before that bloody sign. Ignoring those warning signs without paying any attention to them may delay diagnosis and treatment.

Early detection of prostate cancer not only improves treatment outcomes, but it also raises awareness about subtle changes in your body. Symptoms that suggest a prostate problem that can be cancerous include changes in urination patterns, pain or discomfort, sexual function, unexplained physical symptoms, and more. These signs may be gradual and subtle, and one may dismiss them as minor or age-related, but paying attention to them and seeking medical evaluation saves lives.

Here, we break down four important prostate cancer warning signs besides blood in urine or semen, explain why they matter, and highlight when you should talk to a doctor for proper screening and evaluation. Early action can make all the difference.

The most frequent symptom of this condition that men tend to show is a change in the way they urinate, even before blood is visible. Since the prostate gland is situated around the urethra, even a small tumor is capable of pressing on the urethra.

What to watch for:

• Difficulty initiating urination
• "Stop-and-go" stream, with reduced quantity of flow
• Feeling as though the bladder is not emptied when urinating

Such symptoms are commonly brushed aside as “just what happens when a man gets older” or attributed to a common enlarged prostate, but when persistent, it's advisable to get checked by a physician.

The other significant symptom is that a man has to go to the washroom to urinate more frequently, especially when he wakes up during the night. Even when a man has to go to the washroom more, especially because he has nocturia, a condition that means he is waking up at night to go to the washroom, it can be a symptom even when he is not suffering from pain or other serious symptoms. This condition may result from the pressure that the growing prostate exerts on his bladder, which has reduced in size, hence making him go more frequently.

Prostate cancer has the potential to impact the nerves and blood vessels that are close to the prostate as well as the pelvis. This can result in problems with erectile dysfunction, even when there are no known reasons, such as stress or aging. On the other hand, there are instances where a man may also develop strange sensations during ejaculation, such as when ejaculation is painful, which is a less common symptom that shouldn’t be overlooked when other symptoms are experienced.

Although the earlier stages of prostate cancer might not provide sufficient pain, certain regions of the body’s aching may serve as a signal that indicates that the prostate cancer has been progressing beyond the prostate.

Watch for:

• Lower back pain
• Hip or pelvic discomfort
• Pain in the upper thighs

Such symptoms may occasionally indicate the presence of cancer in the nearby nerves or bones, with regard to the advancement of the disease. Pain that persists despite regular treatment should be brought to the attention of a physician.

In most cases, the initial prostate cancers are symptom-free, which is why annual screening procedures involving a blood test (PSA Test) and a rectal exam (DRE) are recommended, typically at age 45, but even earlier for some men who are considered to be high-risk. The presence of cancer, even when symptom-free, increases the rate of treatment success significantly. Even when men are unsure whether symptoms are possibly linked to cancer, it is essential not to disregard noticeable symptoms, which might indicate a different treatable condition.