From mensjournal.com
Top cancer specialists are urging men to look past the common symptoms of aging and recognize these critical warning signs
It's often said that if you have your health, you have everything, and there’s plenty of truth to that. Your overall well-being enables you to fully enjoy life, pursue opportunities and dreams, and lead an active, independent lifestyle as you age. Staying in the clear isn’t about just avoiding the doctor. It’s about a relentless commitment to the pillars of longevity like heavy lifting, clean fuel, managed stress, and deep sleep.
However, even the best routine has its blind spots. While most aspects of our health are within our control, you can’t always outrun your genetics and chronic conditions, both of which are the silent variables that raise your risk for the heavy hitters like cancer. For most guys, prostate cancer is something they plan on worrying about “later.” That’s a mistake.
Prostate cancer remains one of the most common threats to men in the U.S. In 2022, the CDC reported over 255,000 new cases. By the end of 2026, those numbers are projected to climb to roughly 333,830 new diagnoses, with an estimated 36,320 men losing the fight. When the stats are this high, understanding the warning signs isn’t just “good advice, “it’s a mandatory part of your survival strategy.
“One of the most challenging aspects of prostate cancer is that in its early stages, it often presents with no symptoms at all,” explains Dr. Christopher Koller, Urologic Oncologist, Hackensack University Medical Center, and Co-Principal Investigator for clinical trials at Hackensack Meridian John Theuer Cancer Center. “This is why understanding the risk factors and screening is so crucial. However, when symptoms do begin to appear, they can be subtle and easily dismissed as normal signs of aging.”
We spoke with experts to learn five warning signs of prostate cancer that men 45 and older often miss.
5 Often-Overlooked Signs of Prostate Cancer
1. Changes in Urinary Habits
According to Dr. Koller, the prostate gland sits right below the bladder and surrounds the urethra. When a tumour develops, it can place excess pressure on the structures surrounding it, which could cause noticeable changes in urination. Per the National Health Service (NHS), these changes may include straining to urinate, finding it difficult to begin peeing, experiencing a weak urine flow, or an urgent need to pee.
“Urinary symptoms from prostate cancer tend to appear only when the cancer has grown large enough to obstruct the urethra, which may indicate a more advanced stage of the disease,” Dr. Koller points out.
2. Blood in the Urine
If you notice blood in your urine stream (hematuria), this is a red flag that shouldn’t be ignored. While Koller stresses it’s most often benign, “urologic evaluation is warranted to ensure there is not an oncologic origin.”
Research confirms that diagnostic evaluation is highly recommended when experiencing hematuria, as cancer impacting the urinary system is diagnosed in roughly 3% of individuals with microhematuria and an estimated 10% of those with macrohematuria.
3. Painful Urination
While your mind might automatically jump to a urinary tract infection when you feel a sharp burn during urination, that same discomfort is a common red flag for prostate cancer. This happens because a growing tumour can press against the urethra and irritate the surrounding tissue as your body tries to empty your bladder.
4. Sudden Onset of Erectile Dysfunction (ED)
It’s important to note that difficulty achieving or maintaining an erection can be due to various causes. However, a sudden shift in erectile function can be linked to prostate cancer in rare cases and should be addressed by a urologist. This is especially true if you’re experiencing any urinary symptoms as well.
Keep in mind that it’s much more common for ED to become a side effect of prostate cancer treatment. “[Examples would be] surgery or radiation, which can affect the nerves and blood vessels responsible for erections,” Dr. Koller says.
5. Pain in the Hips, Pelvis, or Lower Back
If you’re experiencing persistent pain in the lower back, pelvis, or hips, this can be a sign that prostate cancer has progressed and potentially spread to the bones.
“This is different from the occasional muscle ache and should be taken seriously,” Dr. Koller tells us. “This type of pain is often described as a dull, deep ache and may be constant. If you are experiencing new, persistent back pain along with urinary symptoms, it is crucial to seek a medical evaluation.”
Who Is Largely at Risk
Cancer is usually measured in years. According to Dr. John Phillips, M.D., Chair and Professor of Urology at New York Medical College, “[It has] historically been largely associated with elderly men. For patients who have a family history of prostate cancer, or any urinary symptoms, or have any concerns about the potential impact of prostate cancer on their urinary symptoms or quality of life, a prompt referral to a urologist is indicated.”
When to Begin Routine Prostate Cancer Screening
If you don’t have any risk factors for prostate cancer, you fall under the “average risk” umbrella, and Dr. Koller encourages you to begin the conversation at age 50.
“The American Cancer Society recommends that men with an average risk of prostate cancer begin discussing the pros and cons of screening with their doctor at age 50,” he says.
Men at high risk of prostate cancer should get screened even earlier, as early as 40. According to the American Cancer Society, this includes African American men and those with a first-degree relative—either a father or a brother—who received a prostate cancer diagnosis before age 65.
“Certain factors place you in an even higher risk category, warranting the earliest discussions about screening,” Dr. Koller explains. “You should begin discussions this early if you: have more than one first-degree relative who had prostate cancer at an early age, [or] have known inherited genetic mutations, such as in the BRCA1 or BRCA2 genes, which are linked to an increased risk of prostate cancer.”
Factors That Can Increase One’s Risk of Missing Early Warning Signs
One of the most common reasons early prostate cancer is missed is a lack of screening. That’s why it’s essential to be mindful of your family history and any potential risk factors so you can determine when to start the screening process. Making your health a top priority is key—everything else can wait.
“There is also the tendency for men to dismiss subtle urinary changes as a normal part of aging, a belief that leads them to delay seeking medical advice. This is often compounded by a lack of awareness or a fear of medical exams (particularly the DRE),” Dr. Koller notes. In addition, poor sleep hygiene, obesity, tobacco usage, and an unhealthy diet can all increase your risk of developing prostate cancer. Emphasizing nutritious meals, regular exercise, and stress management can help lower your risk.
