in the early stages prostate cancer often causes no symptoms for many years. as a matter of fact these cancers frequently are first detected by an abnormality on a blood test (the psa) or as a hard nodule (lump) in the prostate gland. occasionally the doctor may first feel a hard nodule during a routine digital (done with the finger) rectal examination. the prostate gland is located immediately in front of the rectum. rarely in more advanced cases the cancer may enlarge and press on the urethra. as a result the flow of urine diminishes and urination becomes more difficult. patients may also experience burning with urination or blood in the urine. as the tumor continues to grow it can completely block the flow of urine resulting in a painfully obstructed and enlarged urinary bladder. these symptoms by themselves however do not confirm the presence of prostate cancer. most of these symptoms can occur in men with non-cancerous (benign) enlargement of the prostate (the most common form of prostate enlargement). however the occurrence of these symptoms should prompt an evaluation by the doctor to rule out cancer and provide appropriate treatment. furthermore in the later stages prostate cancer can spread locally into the surrounding tissue or the nearby lymph nodes called the pelvic nodes. the cancer then can spread even farther (metastasize) to other areas of the body. symptoms of metastatic disease include fatigue malaise and weight loss. during a rectal examination the doctor can sometimes detect local spread into the surrounding tissues. that is the physician can feel a hard fixed (not moveable) tumor extending from and beyond the gland. prostate cancer usually metastasizes first to the lower spine or the pelvic bones (the bones connecting the lower spine to the hips) thereby causing back or pelvic pain. the cancer can then spread to the liver and lungs. metastases (areas to which the cancer has spread) to the liver can cause pain in the abdomen and jaundice (yellow color of the skin) in rare instances. metastases to the lungs can cause chest pain and coughing.
what are the symptoms of prostate cancer?