Prostate cancer warning signs: What doctors say you need to know

This cancer grows and spreads silently, so it’s important for men to get screened.

When Al Roker shared that he'd been diagnosed with prostate cancer in late September, he mentioned an eye-opening statistic: 1 in 9 men will be diagnosed in their lifetime, and for Black men that rate is 1 in 7. Roker is sharing his diagnosis to raise awareness of the disease and how common it is.

Prostate cancer symptoms are not easy to spot, which is why screening and early detection is crucial.

“Prostate cancer is not symptomatic until late, so screening is important,” Dr. Michelle Yu, a urologic oncology fellow at University of Pittsburgh Medical Center, told TODAY.

Symptoms of prostate cancer may include:

  • Problems urinating or the need to urinate more often, especially at night
  • Blood in the urine
  • Kidney or flank pain
  • Night sweats
  • Fatigue
  • Weight loss
  • Bone pain

Yu said that by the time men notice such symptoms the cancer has likely spread to other parts of the body and will be a lot harder to treat. (Of course, some of these symptoms could be caused by other conditions.)

What is prostate cancer?

Cancer of the prostate develops when cells in the prostate, a gland that’s important for male reproduction, grow abnormally. This type of cancer often progresses slowly.

“One in 9 men get it — it’s incredibly common,” said Dr. Rana McKay, an assistant clinical professor at University of California San Diego and a spokesperson for the Prostate Cancer Foundation (PCF). “Because of the type of disease this is there’s some stigma. We need to be raising awareness.”

A lot of high-profile men have helped increase awareness of prostate cancer by coming forward with their own stories about screening, diagnosis and treatment.

Some high-profile men who've had prostate cancer include:

When should men be screened?

The good news? Screening is easy and effective. “The most important thing is screening,” McKay said.

Prostate cancer is one of those diseases where early screening and early detection improves outcomes. And the survival rate from prostate cancers is 98% after five years, according to the American Cancer Society.

“The good news is, the majority of people diagnosed with prostate cancer don’t die of their disease, given the effectiveness of treatment,” McKay said.

Your doctor can help evaluate your risk and recommend the best time to start screenings. The U.S. Preventive Services Task Force recommends that men evaluate their need for a screening at age 55-69. Though, guidelines from other cancer organizations recommend talking to a doctor sooner. According to the PCF, screenings generally start at:

  • Age 40 for men with a family history of prostate cancer
  • Age 40 for African American men, who are at higher risk, though the American Cancer Society recommends Black men should discuss screening at age 45
  • Age 50 for men who don’t fit into those categories

“The number one thing men can do is to ask their doctor if they are eligible to be screened,” McKay said.

Here’s how screening works

To screen for prostate cancer, your doctor will perform a digital rectal exam (DRE). This test involves inserting a gloved finger into your rectum to feel for any irregularities in the prostate. The test might be uncomfortable, but it’s brief, and it’s an important step toward uncovering prostate cancer early.

Your doctor will also check your blood to measure prostate-specific antigen (PSA) levels. PSA levels go up when there’s a problem with the prostate — that problem could be prostate cancer, an infection or another condition.

Here’s how you can lower your risk

What are causes of prostate cancer? It’s not clear exactly. Genetics and environmental factors both play a role, McKay said. One in 10 men have a genetic predisposition for prostate cancer.

Diet, exercise and quitting smoking can help decrease your risk for developing prostate cancer. Choose a diet lower in fat and processed carbohydrates, and maintain a healthy body weight to help reduce your risk of developing more aggressive prostate cancer.

Also, some studies show that having sex frequently can lower your risk.

Treatment advances bring more choice

If your rectal exams shows an abnormality or your PSA levels are elevated, your doctor will probably recommend a biopsy of the prostate and may recommend an MRI or other imaging studies as well.

If you’re diagnosed with prostate cancer, you have a range of treatment options to consider based on your age, overall health and how early your cancer was caught — the stages of prostate cancer vary depending on how it has advanced.

“The treatment landscape is rapidly evolving,” McKay said. “In the last decade there’s been the introduction of many more drugs that work better and make people live longer and live better.”

Treatment options include prostate cancer surgery, radiation therapy, chemotherapy and hormone treatment. Your doctor could also recommend active surveillance, which involves monitoring your cancer for signs that it’s progressing.

Ask your provider any questions,” Yu said, “and take charge of your own health discussion.”

This story was updated on November 6, 2020.