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What Are the 5 Warning Signs of Prostate Cancer? Symptoms to Look For

Prostate Symptoms You Should Get Checked Out

Key Points
  • Urinary problems, such as a weak flow of urine, blood in the urine, or having to pee several times a night can be warning signs of prostate cancer.
  • These symptoms can also indicate more minor problems, such as a benign enlargement of the prostate.
  • If you’re a man over age 50, you may want to discuss prostate cancer screening with your doctor.
  • Eating a healthy, unprocessed diet, and addressing inflammation and imbalance in your gut, could help reduce your prostate cancer risk.
What are the 5 warning signs of prostate cancer: man with diarrhea opening the toilet

For something that’s the size of a walnut, the prostate gland, found only in men, can be particularly troublesome.

The prostate’s main function is to produce the seminal fluid that nourishes and transports sperm.

Almost all cases of prostate cancer are diagnosed in males over the age of 50, so it’s worth knowing the red flags to be aware of as the years go by. And of course, the lifestyle steps you can make to keep your prostate healthy and avoid this common cancer are important too. In this article we’ll discuss five warning signs of prostate cancer that you shouldn’t ignore.

What Are the 5 Warning Signs of Prostate Cancer?

Sometimes in the early stages, prostate cancer has no obvious symptoms, which is why some doctors recommend routine prostate cancer screening with a prostate-specific antigen (PSA) test (more on this below). But if you start experiencing any of these potential symptoms of prostate cancer, they should always be checked out [1, 2].

1. Painful or Burning Urination 

Many of the early signs that something is awry with the prostate revolve around urinary symptoms. This is because the prostate sits just under the bladder and surrounds the top part of the urethra (pee tube). Discomfort while peeing is therefore a prostate cancer warning sign and always worth investigating. Sometimes, men with early prostate cancer will also experience a painful or burning sensation with ejaculation.

2. Frequent Urination, Especially at Night 

Going to the bathroom often and getting up to pee during the night can also be a warning of prostate cancer. More often it’s not a sinister sign though: Increased frequency of urination is usually harmless in older men, and is commonly caused by benign enlargement of the prostate.

3. Difficulty Stopping or Starting Urination

A weak or unsteady urine flow, and in particular having difficulty getting a pee stream started, or dribbling when you finish peeing, is another warning sign to check out. Again, this urinary symptom is most often not sinister, but can sometimes be due to a tumor. However, this symptom should always be checked out. 

4. Sudden Erectile Dysfunction (ED)

Not being able to get an erection can have many causes, one of which may be prostate cancer. Health anxiety adds to the likelihood of experiencing ED, so the bottom line is to get the issue investigated as soon as possible. At least then you’ll know what you are dealing with. Other factors such as diabetes, smoking, and cardiovascular disease, can lead to ED [1].

5. Blood in the Urine or Semen

A trace of blood in pee or semen is always something to talk to your doctor about without delay, as it can be another one of the five warning signs of prostate cancer. More likely, blood traces will be the result of an infection or physical trauma, but a tumor should be ruled out. 

Other Prostate Cancer Signs

Other signs, usually of more advanced prostate cancer or cancer metastasis (spread to other parts of the body from the prostate) could include the following [2, 3, 4]:

It’s good to know that BPH isn’t thought to lead to prostate cancer [5]. However, inflammation is believed to contribute to both of them [6], so conquering this may help protect against both conditions.

Diagnosing Prostate Issues

Two common tests to diagnose prostate issues include a PSA test in conjunction with a digital rectal exam [7].

A digital rectal exam is a physical exam that involves a doctor inserting a gloved, lubricated finger into the rectum to feel the prostate.

A PSA test checks for elevated levels of prostate-specific antigen (PSA) in the blood. PSA is a protein made only by the prostate gland and levels tend to be higher in men with prostate cancer.

That said, a PSA blood test doesn’t always discern well between cancer and problems such as benign prostatic hyperplasia (BPH) and prostatitis, and needs careful interpretation [7].

Follow-up tests that may help to refine a diagnosis include [4]:

  • Urinalysis (testing of a urine sample for abnormal substances or signs of infection)
  • Urodynamic tests (tests that look at how well the bladder and urinary system stores and releases urine)
  • Cystoscopy (a procedure to look inside the bladder using a tiny camera)
  • Prostate Health Index (PHI) or PCA3 blood tests (both more accurate than PSA at identifying prostate cancer)
  • ExoDx Prostate Intelliscore or EPI (a simple urine test for risk assessment of prostate cancer)
  • Ultrasound, MRI or CAT scans
  • A prostate biopsy

Benign Prostatic Hyperplasia (BPH)

The signs of prostate cancer are shared by many other less-serious conditions. The most common of these is benign prostatic hyperplasia, an increase in size of the prostate that affects many older men [8]:

  • 50% of men at age 60 have an enlarged prostate.
  • At 85 years of age, this figure is 90%.

The Prostate-Gut-Inflammation Connection

How Gut Dysbiosis Works infographic

Though there’s not a lot of research in this area, it’s likely the gut microbiome can influence inflammation in prostate conditions, including prostate cancer [9].

It’s thought that the prostate gland isn’t directly affected by the gut microbiota, but by the indirect effects of inflammation promoted by gut dysbiosis (gut microbe imbalances) [10].

In one 2018 study, the relationships between diet, gut microbes, and prostate cancer severity were observed in a group of obese prostate cancer patients who were losing weight prior to prostate surgery. This study identified that proteobacteria, clostridium, and blautia bacteria were unusually abundant and positively associated with prostate cancer severity [11].

Another theory is that the estrobolome, a collection of gut bacteria that can metabolize and alter the body’s estrogen levels, may promote cancer cell development by activating certain compounds that form carcinogens. Higher levels of estrogen in men have been associated with the development of prostate cancer cells [12].

For now, the exact relationship between the gut microbiome and prostate cancer is poorly understood, but studies do seem to confirm that people with this type of cancer have a different microbial profile than people who do not. Whether cancer causes dysbiosis or dysbiosis may contribute to cancer cell development is uncertain [12]. Either way, supporting a healthy gut is recommended for both your prostate and your overall wellness.

How to Boost Your Prostate Cancer Protection

What are the 5 warning signs of prostate cancer: various vegetables at a market

There’s no one specific diet or lifestyle that will prevent you from getting prostate cancer. However, a number of different dietary and health habits (laid out in the table below), might help boost your protection against the disease. In addition to this, avoiding or limiting sugary drinks and alcohol, getting regular exercise, maintaining a healthy weight, and limiting processed foods will help protect against cancers in general [13].

Helpful Foods

Helpful FoodWhat the Research Has FoundEvidence Quality
Drinking green teaA trend towards reduced incidence of prostate cancer with each 1 cup/day increase in green tea consumption. Supplements of green tea antioxidants were also helpful [14].Moderate to high (some randomized controlled clinical trials included)
Consuming tomatoes /lycopene Higher consumption of cooked (not raw) tomatoes and sauces is associated with a reduced risk of prostate cancer (cooking increases levels of the antioxidant lycopene). Higher blood lycopene levels are also correlated with lower prostate cancer risk [15, 16].Moderate (large number of men involved, but only observational/association studies)
Drinking coffeeStudies involving many thousands of male coffee drinkers indicate the benefits of coffee extend to a reduced risk of prostate cancer [17].High (an umbrella review of 112 systematic reviews/meta-analyses)
Eating oily fish   Some studies suggest foods high in the specific fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in oily fish, may be associated with a reduced risk of prostate cancer [18].Low-quality evidence
Carrot consumption    For each 10 gram (0.33 oz) per day increase in carrot intake, the risk of developing prostate cancer goes down by 4-5% [19].Low (limited number of studies of variable design)
Eating vegetables of the cruciferous family (e.g. cabbage, cauliflower, broccoli, brussels sprouts)Men who ate cruciferous vegetables have a 10-21% lower risk of prostate cancer. A few found only a 5% lower risk [20].Low quality due to a limited number of studies

Harmful Foods 

Just as some diet and lifestyle habits may reduce your prostate cancer risk, others appear to increase risk. If you’re looking to minimize your chance of prostate cancer, research suggests you should probably:

  • Avoid high-glycemic carbs (the refined type like sugars and white flour that rapidly raise blood sugar and spike insulin levels) [21]
  • Go easy on fried foods like fries, fried chicken, and donuts [22]
  • Avoid a diet high in inflammatory foods (such as added sugars, processed meat products, refined grains, and potato products) [23, 24]
  • Don’t have too much milk or dairy, and avoid calcium supplementation [25, 26]

Probiotics and Prostate Health

5 Top Probiotic Benefits For Men infographic

There’s no direct evidence that probiotics can reduce prostate cancer risk or affect the course of the disease in men who already have prostate cancer.

However, the benefits of probiotics include improving gut dysbiosis and inflammation [27, 28]. As discussed above, these might be underlying risk factors for developing prostate problems, including prostate cancer.

Probiotics can also be helpful to improve symptoms of prostatitis — an inflammation of the prostate that’s usually caused by a bacterial infection [29, 30, 31].

In a 2014 clinical trial, long-term treatment with rifaximin and a probiotic supplement reduced the recurrence rate of chronic prostatitis and prevented the spread of infection to other parts of the reproductive tract [32].

Some studies suggest chronic prostatitis may increase the risk of prostate cancer [33]. However, others say there’s no link, or that having prostatitis may even decrease your risk [33].

What Are the 5 Warning Signs of Prostate Cancer? A Quick Recap

As we’ve seen, most of the warning signs of prostate cancer are related to problems when you pee — if you’re going to the bathroom more often than before, see blood in your urine, or have weak flow, it’s important to get checked out. 

To prevent prostate cancer from happening in the future, changing up your diet can help, as may addressing inflammation in your gut. For more detailed information, my book, Healthy Gut, Healthy You, has a comprehensive step-by-step plan of how to turn poor gut health around. You can also request a consultation with an experienced practitioner at the Ruscio Institute for Functional Medicine.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

➕ References

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  15. Rowles JL, Ranard KM, Applegate CC, Jeon S, An R, Erdman JW. Processed and raw tomato consumption and risk of prostate cancer: a systematic review and dose-response meta-analysis. Prostate Cancer Prostatic Dis. 2018 Sep;21(3):319–36. DOI: 10.1038/s41391-017-0005-x. PMID: 29317772.
  16. Rowles JL, Ranard KM, Smith JW, An R, Erdman JW. Increased dietary and circulating lycopene are associated with reduced prostate cancer risk: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2017 Dec;20(4):361–77. DOI: 10.1038/pcan.2017.25. PMID: 28440323.
  17. Grosso G, Godos J, Galvano F, Giovannucci EL. Coffee, caffeine, and health outcomes: an umbrella review. Annu Rev Nutr. 2017 Aug 21;37:131–56. DOI: 10.1146/annurev-nutr-071816-064941. PMID: 28826374.
  18. Campi R, Brookman-May SD, Subiela Henríquez JD, Akdoğan B, Brausi M, Klatte T, et al. Impact of metabolic diseases, drugs, and dietary factors on prostate cancer risk, recurrence, and survival: A systematic review by the european association of urology section of oncological urology. Eur Urol Focus. 2019 Nov;5(6):1029–57. DOI: 10.1016/j.euf.2018.04.001. PMID: 29661588.
  19. Xu X, Cheng Y, Li S, Zhu Y, Xu X, Zheng X, et al. Dietary carrot consumption and the risk of prostate cancer. Eur J Nutr. 2014 Dec;53(8):1615–23. DOI: 10.1007/s00394-014-0667-2. PMID: 24519559.
  20. Liu B, Mao Q, Cao M, Xie L. Cruciferous vegetables intake and risk of prostate cancer: a meta-analysis. Int J Urol. 2012 Feb;19(2):134–41. DOI: 10.1111/j.1442-2042.2011.02906.x. PMID: 22121852.
  21. Sadeghi A, Sadeghi O, Khodadost M, Pirouzi A, Hosseini B, Saedisomeolia A. Dietary Glycemic Index and Glycemic Load and the Risk of Prostate Cancer: An Updated Systematic Review and Dose-Response Meta-Analysis. Nutr Cancer. 2020;72(1):5–14. DOI: 10.1080/01635581.2019.1621356. PMID: 31184513.
  22. Lippi G, Mattiuzzi C. Fried food and prostate cancer risk: systematic review and meta-analysis. Int J Food Sci Nutr. 2015 Jun 26;66(5):587–9. DOI: 10.3109/09637486.2015.1056111. PMID: 26114920.
  23. Zhu Y, Li Q, Xu X. Dietary inflammatory index and the risk of prostate cancer: a dose-response meta-analysis. Eur J Clin Nutr. 2020 Jul;74(7):1001–8. DOI: 10.1038/s41430-019-0500-3. PMID: 31554922.
  24. Mohseni R, Abbasi S, Mohseni F, Rahimi F, Alizadeh S. Association between Dietary Inflammatory Index and the Risk of Prostate Cancer: A Meta-Analysis. Nutr Cancer. 2019;71(3):359–66. DOI: 10.1080/01635581.2018.1516787. PMID: 30273060.
  25. Rinninella E, Mele MC, Cintoni M, Raoul P, Ianiro G, Salerno L, et al. The Facts about Food after Cancer Diagnosis: A Systematic Review of Prospective Cohort Studies. Nutrients. 2020 Aug 5;12(8). DOI: 10.3390/nu12082345. PMID: 32764484. PMCID: PMC7468771.
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  27. Gagliardi A, Totino V, Cacciotti F, Iebba V, Neroni B, Bonfiglio G, et al. Rebuilding the gut microbiota ecosystem. Int J Environ Res Public Health. 2018 Aug 7;15(8). DOI: 10.3390/ijerph15081679. PMID: 30087270. PMCID: PMC6121872.
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  29. Chiancone F, Carrino M, Meccariello C, Pucci L, Fedelini M, Fedelini P. The Use of a Combination of Vaccinium Macracarpon, Lycium barbarum L. and Probiotics (Bifiprost®) for the Prevention of Chronic Bacterial Prostatitis: A Double-Blind Randomized Study. Urol Int. 2019 Sep 17;103(4):423–6. DOI: 10.1159/000502765. PMID: 31527377.
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  31. Cai T, Gallelli L, Cione E, Perletti G, Ciarleglio F, Malossini G, et al. The use of Lactobacillus casei DG® prevents symptomatic episodes and reduces the antibiotic use in patients affected by chronic bacterial prostatitis: results from a phase IV study. World J Urol. 2021 Sep;39(9):3433–40. DOI: 10.1007/s00345-020-03580-7. PMID: 33442769. PMCID: PMC8510959.
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  33. What is the risk of prostate cancer in patients with chronic bacterial prostatitis (CBP)? [Internet]. Available from:

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