Written by Karen Asp

For most of your life, your prostate minds its own business and does its job-producing fluid for semen.[1] But as you get older, it can start to go off script in a serious way. Roughly one in eight men will be diagnosed with prostate cancer in their lifetime.[2; 3] The average age of diagnosis: 66.[2]

“In 2020 alone, even before the arrival of COVID-19, the number of men expected to die from prostate cancer was estimated to hit a record high of any other year within the last two decades,”[4; 5] says Laurence H. Belkoff, D.O., a urologist and managing partner of the UCSEPA Division of MidLantic Urology in Bala Cynwyd, Pennsylvania.[5; 6; 7]

Numerous factors may be contributing to the increase. For starters, there’s no clear guidance on when to start screening. That’s a miss, Dr. Belkoff says, because “when caught early, prostate cancer has a 99 percent chance of survival.”[3; 5; 8] “This is three times higher than when prostate cancer is found in an advanced stage, which has only a 30 percent survival rate.”[5; 8]

The American Cancer Society recommends that men discuss prostate cancer screening with their health care providers.[9] Most providers advise annual screenings starting at age 50 for men who are at average risk. However, if you’ve had a first-degree relative diagnosed with prostate cancer before age 65, your risk is considered high and you should start screening at age 45. More than one first-degree relative diagnosed before age 65? Your risk is even higher: Start screening at 40.[9]

Prostate screenings can tell you whether you’re likely to have the disease, in which case, further would be needed. First up for screening is a prostate-specific antigen (PSA) test, which is credited with saving lives by detecting prostate cancer early. [10] A PSA test measures a level of protein in your prostate, indicating your level of risk that you have cancer. Through annual PSA screenings, your doctor can pick up on a concerning upward trend in your risk level, ordering further testing, if needed, before symptoms appear. This is critical because when detected in its first stages, survival rates for prostate cancer are close to 100%. You can check your PSA levels from home now. During a screening, your doctor will also do a digital rectal exam to feel any abnormalities in your prostate.

There’s also the concern that COVID-19 may be making some men hesitant to visit their providers unless they feel it’s necessary, Dr. Belkoff says.[5] This is dangerous: “For many men, prostate cancer often doesn’t present symptoms,” he says.[5; 10] That’s why getting an annual prostate cancer screening (which many men no doubt skipped in 2020) is so important.[5; 9]

If you think you have prostate issues, from pain to a change in urination patterns, several factors unrelated to prostate cancer could be at play. These include such conditions as benign prostatic hyperplasia (enlargement of the prostate), prostatitis, or an overactive bladder, Dr. Belkoff says.[10; 11] What matters is that you know the signs that something could be wrong with your prostate and call your provider if you spot one. Start with these five:

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1. You Have Blood in Your Urine

Any amount of blood — a little or a lot — should alert you to contact your health care provider.[13] It could be related to a urinary tract infection or kidney stones,[13] but “this can signal bladder cancer or even prostate cancer late in the disease,”[13; 14] says Damon Davis, M.D., a urologist with the Urology Specialists of Maryland at Mercy Medical Center in Baltimore.[14; 15] While pain can sometimes be present, it’s not always the case.[13; 14]

2. You Have a Weak Stream

Struggling to get out more than a trickle when you’re in the bathroom? An enlarged prostate could be to blame. According to the Centers for Disease Control and Prevention, your prostate tends to increase in size as you get older, literally putting the squeeze on your urethra — the tube that carries urine out of the body.[16]

For reference, your prostate is about the size of a walnut when you’re in your 20s. By the time you hit 60, it could be as large as a lemon.[17] And as it grows, it can press against your bladder and urethra. This can slow or even block the flow of urine.[16; 17]

Fortunately, an enlarged prostate isn’t usually a major problem, Dr. Davis says.[14; 17] But if it causes problems with urination, you may need medical attention. Your provider can prescribe medications to help with the symptoms, and there are also various procedures and surgeries that can treat the enlargement.[17]

3. Urinating is Difficult, and There’s a Burning Sensation, Too

Paired together, these are the two most common symptoms of prostatitis — the swelling and inflammation of the prostate gland, Dr. Belkoff says.[5] Prostatitis, most often caused by a bacterial infection, is the top urinary tract problem for men under 50 and the third most common for men over 50, the National Institutes of Health reports.[18]

Other symptoms include lower back or groin pain. If you any symptoms including fever and chills, your provider may diagnose you with acute bacterial prostatitis, which requires immediate treatment with antibiotics, Dr. Belkoff says.[5; 18]

4. You Frequently Wake Up During the Night to Pee

This is a common complaint, and the issue usually starts in your 50s and worsens as you get older. This could be another sign of an enlarged prostate, Dr. Davis says. Fortunately, simple strategies can help, such as limiting your intake of fluids at night. (Instead, try to meet your fluid requirements earlier in the day.)[14; 17]

5. Your Urinary Patterns Have Changed in Any Way

If you notice any change in your urination patterns, says Dr. Belkoff, you should visit your health care provider as an at-home test would not be suitable. (That includes the symptoms listed above.) “A common tip-off for possible prostate cancer is any urinary symptom that differs from your normal patterns,” Dr. Belkoff says. Because the prostate sits next to the bladder and surrounds the urethra, any pressure from a cancerous tumor can disrupt urination.[5; 17]

Check your prostate from home now.

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  1. Prostate Cancer Foundation
    Prostate Gland

  2. American Cancer Society
    Key Statistics for Prostate Cancer
    https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html#:~:text=About 1 man in 8,at diagnosis is about 66.

  3. Prostate Cancer Foundation
    By the Numbers: Diagnosis and Survival
    https://www.pcf.org/about-prostate-cancer/what-is-prostate-cancer/prostate-cancer-survival-rates/#:~:text=The 5-year survival rate,prostate cancer is generally low.

  4. Zero Cancer
    Prostate Cancer Deaths To Hit Highest Numbers in Two Decades
    https://zerocancer.org/zeronews/2020rates/#:~:text=WASHINGTON%2C D.C. – Despite most cancers,increase of 5 percent since

  5. Laurence Belkoff

  6. Urologic Consultants
    Laurence H. Belkoff, DO, FACOS

  7. Midlantic Urology
    Laurence H. Belkoff, DO, MSc. FACOS

  8. American Cancer Society
    Survival Rates for Prostate Cancer

  9. American Cancer Society
    American Cancer Society Recommendations for Prostate Cancer Early Detection

  10. U.S. Preventative Services Task Force
    Prostate Cancer: Screening

  11. Zero Cancer
    Prostate Cancer Symptoms
    https://zerocancer.org/learn/about-prostate-cancer/symptoms/#:~:text=Many prostate cancer symptoms are,Frequent nighttime urination

  12. American Cancer Society
    Signs and Symptoms of Prostate Cancer

  13. Mayo Clinic
    Blood in Urine (hematuria)

  14. Damon Davis, M.D

  15. Mercy Medical Center
    Damon E. Davis, M.D.

  16. Centers for Disease Control and Prevention
    What Is Prostate Cancer?
    https://www.cdc.gov/cancer/prostate/basic_info/what-is-prostate-cancer.htm#:~:text=The prostate is a part,empties urine from the bladder).

  17. National Institutes of Health
    National Cancer Institute
    Understanding Prostate Changes: A Health Guide for Men
    https://www.cdc.gov/cancer/prostate/basic_info/what-is-prostate-cancer.htm#:~:text=The prostate is a part,empties urine from the bladder).

  18. National Institutes of Health
    National Institute of Diabetes and Digestive and Kidney Diseases
    Prostatitis: Inflammation of the Prostate