Much of the country is reeling from the news about former President Joe Biden's prostate cancer diagnosis. However, the 46th U.S. President has already portrayed optimism and a plan to fight what doctors are calling an "aggressive" form of the disease. And whenever a public figure is transparent about their health struggles, the hope is that it'll bring greater awareness to prevention and treatment. With that in mind, doctors say these are the seven silent signs of prostate cancer most people ignore.
It's especially important to be aware of these potential symptoms since, among U.S. men, prostate cancer is the most common cancer, other than skin cancer, and the second-leading cause of cancer death, after lung cancer, according to the American Cancer Society. To put this in perspective, about one in eight men will be diagnosed with prostate cancer in their lifetime.
"Prostate cancer doesn't usually have symptoms until it's in its later stages," Virginia-based urologist Jennifer Young, MD, told the StoneSprings Hospital Center. "That's why screening with the prostate-specific antigen (PSA) blood test, and sometimes the digital rectal exam, are recommended."
In addition to getting regular screenings, doctors recommend keeping an eye out for the following symptoms of prostate cancer and notifying your doctor immediately if you think there is something wrong.
RELATED: Doctors Say Too Many Men Are Making This Fatal Prostate Cancer Mistake.
1. Sudden or unexplained weight loss
Man Loses 157 Pounds in 2 Years With One "Pain-Free" ExerciseShutterstockIf you’ve cleaned up your diet and have been exercising regularly, it’s clear why you might be shedding pounds. But if you’re suddenly losing weight out of nowhere, it could be a signal of a health problem—prostate cancer included.
According to Prostate Cancer U.K., weight loss often occurs with prostate cancer because of a "change in the way your body uses energy," and that can eventually make you feel tired and weak.
Often, this is a symptom of advanced (or metastatic) prostate cancer, meaning it's spread to other parts of the body. Specifically, you may notice poor appetite and unexplained weight loss if the prostate cancer has spread to the liver, notes Cancer Research U.K.
2. Chronic lower back pain
ShutterstockThere are many reasons you may experience lower back pain, but if it’s something that’s been bothering you for a while, it could be more serious than sore muscles or bad posture.
"It can be easy to ignore chronic low back pain and miss it as a prostate cancer symptom," says Tempe, Arizona-based naturopathic oncologistHeather Paulson, ND. "If you have low back pain that’s not getting better with treatment, be sure to check your PSA and rule out prostate cancer. Sometimes it’s the first sign you’ll notice."
Lower back pain is a common symptom in metastatic spinal cord compression (MSCC), which occurs "when cancer cells that have spread from the prostate grow in or near to the spine, and press on the spinal cord," explains Prostate Cancer U.K.
A 2021 study published in the Global Spine Journal (GSJ) states that among prostate cancer cases that spread to the bones, the spine is the most common site because of the blood supply to the region.
RELATED: Colon Cancer Risk Drops With This 1 Simple Snack, Groundbreaking New Study Finds.
3. Frequent or reduced urination
Thirst and Urine CuesShutterstock
"One of several possible causes of having to urinate more frequently at night could be prostate cancer and prostate health, especially if you’re limiting liquid intake several hours before bedtime," Paulson says. This can be a sign of early-stage prostate cancer.
One cause could be an infection or an enlarged prostate. However, if prostate cancer "is pressing on your urethra or has spread to areas around the prostate, such as the urethra and bladder," it may also cause urination issues.
In addition to frequent urination, prostate cancer can lead to a weak flow when urination.
"When there’s a mass or swelling in the prostate, it can press on the urethra," Paulson explains. "It’s almost like pinching a straw. If you pinch a straw, it's hard for liquid to come through your straw. The same thing can happen to urine flow, making it hard to have a strong urine stream."
4. Pain or blood while urinating
4 | Urine RetentionShutterstockThe most common cause of pain or burning when urinating is a bladder infection, Paulson says.
"However, if your urine test comes back negative for infection or the burning and pain is persistent, be sure to dig a little deeper and check your prostate. It could be an easily missed sign of prostate cancer," she notes.
Urologic oncologistLisly Chéry, M.D., explained to the University of Texas MD Anderson Cancer Center that this happens because "The urethra, or the tube you urinate from, runs through the prostate. As prostate cancer grows, it can cause that tube to collapse and make it so the bladder cannot get urine past it."
In other cases, you may notice blood in your urine, a symptom that should never be ignored since it could be due to the prostate bleeding.
"No matter what the cause, if you see blood in your urine, get in to see your doctor," Paulson advises. "This can be linked to prostate cancer, bladder cancer, and dangerous infections."
RELATED: Women Can Now Check Themselves for Cervical Cancer at Home—Here's How.
5. Blood in the semen
Shutterstock
Like blood in your urine, seeing blood in your semen (formally known as hematospermia) can also signal prostate cancer, oftentimes in its early stages.
As Harvard Health explains, a mass in the prostate can obstruct the ejaculatory duct or other nearby ducts, and "when ducts are blocked, nearby blood vessels can dilate and rupture."
Additionally, testing for prostate cancer can temporarily cause blood in the semen. This includes a transrectal ultrasound prostate biopsy (TRUS-PB), which removes and biopsies a piece of prostate tissue.
Outside of cancer, other prostate abnormalities can also cause hematospermia.
"An enlarged prostate, also called benign prostatic hyperplasia, pinches the urethra and can lead to hematospermia, too," Harvard Health adds.
However, it's important to note that "more than 86% of men with hematospermia don’t have prostate cancer," Harvard Health points out. "One could argue, too, that these numbers may be elevated because a screening study like this is likely to attract men at greater-than-average risk of prostate cancer."
A decreased volume of semen can be another indicator of prostate cancer, according to Johns Hopkins Medicine, although that can also be attributed to factors like hydration levels and diet.
6. Erectile issues
5. Blood in the semeniStockAccording to Paulson, men should be screened for prostate cancer if they’re experiencing pain during climax or having difficulty getting an erection.
"The prostate gland plays a role in producing semen, and when cancer cells begin to spread, the normal sexual function of the penis can be compromised," explains the Regional Cancer Center Associates (RCCA).
“Many men put off talking about this symptom with their doctors, but the sooner it's treated, the better the results,” Paulson says.
Common prostate treatments, including hormone therapy, surgery, or radiotherapy, can also cause erectile issues, as can the stress and anxiety surrounding a cancer diagnosis.
RELATED: Walking This Many Steps Can Reduce Your Risk of 13 Types of Cancer.
7. Discomfort while sitting
Shutterstock
Pain or discomfort while sitting is another possible warning sign of prostate cancer, and it typically occurs as the disease progresses.
"As prostate cancer grows, it can start to invade the muscles in the pelvis or rectal wall," Chéry said. "This can give you the sensation that you’re sitting on a ball because the prostate may be inflamed."
