Early stage prostate cancer usually doesn’t have symptoms. It’s typically detected and diagnosed through regular screening tests and physical exams.

Prostate cancer is typically a slow-growing cancer. It starts in the prostate gland, a walnut-sized organ just below the bladder in people assigned male at birth. The prostate gland produces seminal fluid, a component of semen that transports sperm.

Prostate cancer does not have symptoms in its early stages, but keeping up with regular screenings and tests often leads to early detection.

The American Cancer Society indicates around 1 in 8 people assigned male at birth will be diagnosed with prostate cancer during their lifetime, and experts expect nearly 300,000 new prostate cancer diagnoses in 2024.

While prostate cancer primarily affects people over the age of 65 years, your risk for prostate cancer depends on a number of variables. Family medical history, race/ethnicity, and lifestyle habits may all contribute to risk.

Because prostate cancer is slow-growing and routine screening is recommended after a certain age, it’s often detected in its early stages.

Early stage prostate cancer is a broad diagnostic term used to indicate several formal stages of cancer that haven’t spread beyond the prostate gland. “Early stage” prostate cancer can mean something different for each person based on certain diagnostic markers and tumor features.

As a cancer that’s usually slow-growing, prostate cancer can stay in its early stages for years. It affects everyone differently, however, and there’s no way to know how long it may take your cancer to progress.

Stages of prostate cancer

Under current guidelines, prostate cancer is staged using the American Joint Committee on Cancer (AJCC) TNM system.

The TNM system assigns a cancer stage based on:

  • Tumor category: a clinical estimate or pathological determination of cancer’s size and spread
  • Node category: how many nearby lymph nodes are affected
  • Metastasis category: if cancer has spread to other, distant areas of the body

In addition to the TNM system, your doctor will factor in your prostate-specific antigen (PSA) level at the time of diagnosis, as well as the grade of cancer cells determined by abnormalities seen under a microscope.

When all of these factors are taken into account, prostate cancer is staged I through IV. In general, the lower the number of staging, the less cancer has advanced.

Early stage prostate cancer, or cancer confined to the prostate, can refer to the formal stages of I through IIIA.

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Most people with early stage prostate cancer don’t have noticeable symptoms.

As a slow-growing type of cancer, prostate cancer can exist in the prostate for long periods of time (years) before it grows enough to affect function or press on surrounding structures, causing discomfort.

Even when early stage prostate cancer does grow, the prostate gland isn’t directly involved in your vital life processes. This can make symptoms vague and less obvious than cancers affecting your lungs or heart, for example. Some symptoms might get dismissed as natural age-related changes or be attributed to other underlying causes.

Early stage prostate cancer symptoms are not common, and there’s no universal early warning sign that can prove cancer is affecting your prostate.

An older 2015 review of studies looking at clinical features in suspected prostate cancer suggests that, while lower urinary tract issues sometimes present, no signs or symptoms can be considered good predictors of prostate cancer.

How will I know when to go to the doctor?

Since most people don’t notice any symptoms of early stage prostate cancer, knowing when to visit your doctor comes from understanding your individual risk factors. Your age, race/ethnicity, lifestyle, genetics, and medical history can all matter.

Having a discussion with your doctor about your risk factors helps you decide when and if routine screenings should happen.

Regular physicals, along with prostate cancer screenings and tests, are your best chances at early detection.

As prostate cancer advances, it can start affecting surrounding structures of your pelvis. If prostate cancer metastasizes, or spreads to distant areas of the body, more whole-body symptoms are possible.

Symptoms of advanced prostate cancer can include:

  • increased frequency of urination, particularly at night
  • slow or weak urinary stream
  • discomfort when urinating
  • blood in the urine or semen
  • difficulty getting or maintaining an erection
  • weakness or numbness in the legs or feet
  • loss of bladder or bowel control
  • body aches and deep-seated bone pain
  • unexplained weight loss
  • chronic fatigue
  • blood in the urine or semen
  • pain or burning during urination
  • painful ejaculation
  • weak and/or more frequent urination

In metastatic prostate cancer, you may notice unique symptoms related to different areas of the body now affected by cancer. If cancer has spread to your lungs, for example, you may experience coughing or breathlessness.

Yes, it’s possible to detect prostate cancer early through PSA testing or a digital rectal exam (DRE).

PSA testing measures the level of PSA in your bloodstream. PSA is a protein made by the cells of the prostate gland. Higher-than-average PSA levels could indicate the presence of prostate cancer. Because false readings are possible, it cannot definitely diagnose prostate cancer.

Your doctor may also perform a DRE, which involves the insertion of a gloved, lubricated finger into your rectum to manually feel the prostate. Early stage prostate cancer can be too small for DRE detection, but manual assessment of the prostate can detect larger tumors or unusual changes in the organ’s size and structure.

If early screening tests come back suspicious of prostate cancer, your doctor will recommend a prostate biopsy or other advanced testing options.

Anyone with a prostate can develop prostate cancer, but certain people have a higher risk than others.

You may be more likely to develop prostate cancer if you:

  • are over the age of 50 years
  • are of African American descent or Caribbean or African ancestry
  • have a first-degree relative diagnosed with prostate cancer
  • were born with certain genetic variants
  • eat a diet high in dairy or calcium
  • live with obesity
  • have occupational exposure to certain chemicals, like arsenic

Experts are currently investigating possible links between prostate cancer risk and smoking, conditions of prostate inflammation, and surgical procedures like vasectomies.

Most people who receive a diagnosis of early stage prostate cancer don’t experience noticeable symptoms. If symptoms do appear, they’re often related to changes in urinary frequency and flow or blood in the urine or semen.

PSA testing and DREs can help detect early stage prostate cancer even when symptoms are absent. Your doctor will recommend a screening protocol based on your individual prostate cancer risk factors.