The patient usually comes to the doctor with complaints of slow urinary stream, hesitancy of initiating urination and often of frequency of urination (e.g. having to get up several times at night to pass urine). These are the symptoms of ‘bladder outflow obstruction’ which is most usually associated with the commoner benign prostatic hypertrophy of older age, but occasionally they may augur the development of a cancer in the prostate. Nowadays, with the earlier diagnosis of prostate cancer due to the PSA screening programme, we are more frequently diagnosing prostate cancer in patients who have no new symptoms referable to the urinary tract.
Occasionally, the patient comes with back pain or some other symptom caused by spread (metastasis) of the tumour but this is unusual and most patients present without overt evidence of spread of this cancer.