Early on, PC can be symptomless, especially if cancer growth is in the outer prostate away from the urethra and not interfering with urination. Cancer can therefore be at the aggressive incurable/life-limiting stage 4 before other symptoms trigger a GP consultation.^25,26,27

Presenting symptoms can include urination changes, tiredness, erectile dysfunction or unexplained weight loss. For some, the first symptom is persistent bone or back pain, while affected lymph glands can contribute to pelvic pain or swelling/lymphoedema, eg in the legs. Blood in the urine or semen is not always present.^9,25,28