March is Prostate Cancer Awareness Month, a timely reminder that early detection can make a significant difference. Prostate cancer often develops slowly, and in its early stages, symptoms can be subtle or mistaken for normal ageing. Many men dismiss urinary changes or discomfort as minor issues. Understanding the early signs and knowing when to seek advice is one of the most important steps in protecting long-term health.
Prostate cancer is the second most common cancer in the UK. Risk increases significantly in men over 50, with most cases occurring in men aged 75-791,2. Symptoms often do not appear until the cancer has progressed, and even then, they are often subtle or attributed to ageing. This article will highlight how important early detection is and what signs to look out for.
Why Early Prostate Cancer Symptoms Are Often Overlooked
With ageing, men often experience benign prostatic hyperplasia (BPH), which is prostate enlargement that often occurs with age. BPH affects around half of all men over 50 and may cause urinary changes and erectile dysfunction3. Symptoms occur when the enlarged prostate presses on the bladder and urethra4, but the condition is treatable and not usually something to worry about.
These symptoms, however, are also shared with advanced stages of prostate cancer. As a result, they may be overlooked or attributed to BPH or normal ageing3. This can contribute to the late diagnoses often seen with prostate cancer. In most cases, these symptoms are not due to cancer; however, if they appear, you should speak to your GP about testing.
10 Early Signs of Prostate Cancer Men Often Ignore
1. Needing to Urinate More Often, Especially at Night4,5
- Nocturia is the need to urinate at night.
- Common with age, but if it regularly disrupts your sleep, contact your GP.
2. Difficulty Starting Urination4,5
- Hesitancy or weak flow.
- Trouble beginning or a slow start can be a sign that the bladder or urethra is obstructed.
3. Weak or Interrupted Urine Stream4,5
- Reduced pressure or stop-start flow.
- If urinating feels slow or difficult, this should be brought up with your GP.
4. Feeling That the Bladder Has Not Fully Emptied4,5
- Persistent sensation or straining.
- Still feeling “full” after going or having to push could indicate an issue.
5. Urgent Need to Urinate4,5
- Sudden strong urge or difficulty delaying.
- A sudden, powerful need, sometimes with leaks, should be reported to your GP.
6. Blood in Urine (Haematuria)4,5
- Blood in the urine should never be ignored. Contact a GP immediately.
- Pink, red, or brown urine requires testing.
7. Blood in Semen4,5
- Less common and should not be ignored.
- Pink or red semen can be alarming, but it may be treatable with medical advice.
8. Erectile Difficulties4,5
- Often occurs alongside urinary issues, with overlapping or related causes.
- Sometimes ignored due to discomfort or embarrassment, ensure that you talk to a GP.
9. Persistent Lower Back, Hip, or Pelvic Pain4,5
- Possible sign of more advanced disease, distinct from muscle pains.
- Long‑lasting pain, especially with other symptoms, should be checked as soon as possible.
10. Unexplained Weight Loss or Fatigue4,5
- Later-stage symptoms are often ignored or blamed on stress or ageing.
- This should be reported to your GP, especially if alongside other symptoms.
The earliest stages of prostate cancer have no symptoms as it takes time for prostatic tumours to grow large enough to impinge on the bladder or urinary tract6.
These symptoms are not always due to cancer, though new or persistent symptoms warrant a visit to the GP for assessment.
Who Is Most at Risk?
Prostate cancer can affect anyone with a prostate, though those who are most at risk include7–9:
- Men aged over 50
- Black men
- People with a family history (father, brother)
- Those with genetic mutations (BRCA2)
- Obese or overweight individuals
Cancer risk is a spectrum; just because you are considered high risk does not mean you will get cancer. In the same vein, anyone can develop cancer, so being aware of warning signs is important10.
When Should You See a GP?
- Persistent urinary changes
- Blood in urine or semen
- New erectile difficulties with other symptoms
- Ongoing pain in the lower back or pelvis
If you have any of these symptoms and are over 50, you can ask your GP about testing for prostate cancer. In the UK, this involves:
- Prostate Specific-Antigen (PSA) testing11–13
- A blood test that identifies PSA levels.
- PSA is a protein released by normal and cancerous prostate cells.
- Levels can vary for many reasons. High does not necessarily mean cancer.
- Digital rectal examination (DRE)14
- A nurse or doctor feels the prostate through the rectum.
- A quick, painless method to check the shape, size, and texture of the prostate.
- The NHS can provide further information about what to expect during a DRE.
- Magnetic Resonance Imaging (MRI)15
- Allows the prostate to be imaged, identifying suspicious areas.
- Can inform the appropriate treatment course.
- Can prevent unnecessary, invasive biopsies.
- Biopsy16
- Targeted transperineal biopsies use information from the MRI to decide where the biopsy will be taken.
- Grid transperineal biopsies use a grid to take multiple samples from various areas.
- Tissue samples are sent to a laboratory to confirm if cancer cells are present.
The Role of PSA Testing and MRI
PSA testing is a non-invasive test that can be used to identify prostate enlargement and potentially cancer. Elevated PSA can result from non-cancerous issues like urinary tract infections or BPH, so it's often paired with a DRE for additional context. A high PSA prompts further checks but doesn't confirm cancer, while a normal level reduces but doesn't eliminate the risk.
MRIs create detailed 3D prostate images using magnets and radio waves. They are a highly accurate, non-invasive tool that can be used to identify suspicious changes and potential tumours. MRIs have up to 90 per cent sensitivity for low-risk cancer17 and can also be used to guide targeted biopsies for better results. This supports decisions on diagnosis, monitoring, and treatment.
There are currently no screening services for prostate cancer due to the non-specific results of PSA testing in those without symptoms18.
Men over 50 or those experiencing symptoms can request a PSA test from the GP.
Why Awareness in March Matters
March is Prostate Cancer Awareness Month.
Raising awareness and educating people on the early signs of prostate cancer empowers men to have conversations and advocate for their health.
By normalising these conversations, we remove the stigma surrounding urinary and sexual health, ultimately contributing to earlier detection and better health outcomes for men across the UK.
Conclusion
Prostate cancer is the UK's second most diagnosed cancer. The early warning signs are often subtle or mistaken for ageing or BPH, leading to late diagnosis. Persistent urinary changes, blood in the urine or semen, sexual dysfunction, or pelvic pain are all issues that should be discussed with your GP and potentially followed up with PSA testing.
Awareness leads to earlier diagnosis and better outcomes. March is Prostate Cancer Awareness Month. It is a time to encourage vital conversations, reduce stigma around urinary and sexual health, and encourage men to advocate for their health.
Proactive steps, like requesting a PSA testing or MRI screening, offer peace of mind and can catch issues early when treatments are most effective.
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References
1. Prostate Cancer UK. Prostate cancer now the most common cancer in the UK, latest NHS figures reveal. Prostate Cancer UK. Accessed March 5, 2026. http://prostatecanceruk.org/about-us/news-and-views/2026/01/prostate-most-common-cancer
2. Cancer Research UK. Prostate cancer statistics | Cancer Research UK. Accessed March 5, 2026. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer
3. NHS. Enlarged prostate. nhs.uk. October 20, 2017. Accessed March 5, 2026. https://www.nhs.uk/conditions/enlarged-prostate/
4. NHS. Symptoms of prostate cancer. nhs.uk. August 8, 2025. Accessed March 5, 2026. https://www.nhs.uk/conditions/prostate-cancer/symptoms/
5. Prostate Cancer UK. What are the signs and symptoms of prostate cancer? Prostate Cancer UK. Accessed March 5, 2026. http://prostatecanceruk.org/prostate-information-and-support/risk-and-symptoms/prostate-cancer-signs-and-symptoms
6. Prostate Cancer UK. We won’t stop until we have a screening programme for all men. Prostate Cancer UK. Accessed February 17, 2026. http://prostatecanceruk.org/get-involved/campaigning/prostate-cancer-screening
7. NHS. Causes of prostate cancer. nhs.uk. August 8, 2025. Accessed March 5, 2026. https://www.nhs.uk/conditions/prostate-cancer/causes/
8. Cancer Research UK. Risks and causes of prostate cancer. Accessed March 5, 2026. https://www.cancerresearchuk.org/about-cancer/prostate-cancer/risks-causes
9. Prostate Cancer UK. Prostate Cancer Risk Factors. Prostate Cancer UK. Accessed March 5, 2026. http://prostatecanceruk.org/prostate-information-and-support/risk-and-symptoms/are-you-at-risk
10. Macmillan Cancer Support. Cancer causes and risk factors explained. Accessed March 5, 2026. https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/causes-and-risk-factors
11. Cancer Research UK. What is the PSA test? Accessed February 17, 2026. https://www.cancerresearchuk.org/about-cancer/tests-and-scans/prostate-specific-antigen-psa-test
12. NHS. PSA test. nhs.uk. September 4, 2024. Accessed February 17, 2026. https://www.nhs.uk/tests-and-treatments/psa-test/
13. Prostate Cancer UK. PSA blood test. Prostate Cancer UK. Accessed February 17, 2026. http://prostatecanceruk.org/prostate-information-and-support/prostate-tests/psa-blood-test
14. Prostate Cancer UK. Digital rectal examination (DRE). Prostate Cancer UK. Accessed February 17, 2026. http://prostatecanceruk.org/prostate-information-and-support/prostate-tests/digital-rectal-examination-dre
15. Cancer Research UK. MRI scan. Accessed February 19, 2026. https://www.cancerresearchuk.org/about-cancer/tests-and-scans/mri-scan
16. Prostate Cancer UK. Prostate biopsy. Prostate Cancer UK. Accessed February 17, 2026. http://prostatecanceruk.org/prostate-information-and-support/prostate-tests/prostate-biopsy
17. Harvey H, deSouza NM. The role of imaging in the diagnosis of primary prostate cancer. J Clin Urol. 2016;9(2 Suppl):11-17. doi:10.1177/2051415816656120
18. Prostate Cancer UK. Why don’t we screen all men for prostate cancer? Prostate Cancer UK. Accessed March 6, 2026. http://prostatecanceruk.org/about-us/news-and-views/2025/08/why-dont-we-invite-all-men-for-a-prostate-cancer-test
Image adapted from Figure 3 and used under the Creative Commons license.
