Call your doctor immediately if you:

• Are completely unable to urinate.
• Have painful urination and a fever higher than 100 F, chills, or body aches.
• Have blood or pus in your urine.

Call your doctor if you have painful urination and signs of a possible urinary tract infection that last longer than 24 hours. These signs include:

• A burning sensation while urinating.
• Pain in your lower back just below your ribs that is not related to any injury or physical exertion.
• Painful ejaculation.
• Difficulty starting or controlling your urination.

Call your doctor to schedule an appointment within 1 to 2 weeks if you have unexplained:

• Weight loss.
• Dull, aching pain in your lower back, hip, or pelvis.

In most men, the prostate gland gets larger as they get older. Having symptoms of an enlarged prostate does not mean you have cancer, but you should be checked by your doctor. Symptoms of an enlarged prostate include difficulty urinating and sexual dysfunction, among others. For more information on an enlarged prostate, see the topic Benign Prostatic Hyperplasia (BPH).

Watchful Waiting

Watchful waiting means waiting to see what happens to your prostate cancer without treatment.

• The main reason to choose watching and waiting is to avoid the potentially serious side effects of surgery or radiation. With treatment there is a chance that you will have erection problems and bladder problems and also a small chance that you will have bowel problems. Some men whose cancer has been caught in its early stages choose to watch and wait because most prostate cancer grows slowly. This choice makes the most sense for some men in their 70s or 80s or men who are in poor health.
• The main reason to choose treatment (and not watchful waiting) is that it makes the cancer much less likely to grow and spread.⁸

During watchful waiting, you have regular digital rectal exams and PSA tests to check the growth of your cancer. As long as there is no change, you may continue to watch and wait. If the cancer begins to grow rapidly or spread, you may consider other treatment.

Who To See

The following health professionals can evaluate urinary symptoms:

• Family medicine physician
• Internal medicine doctor
• Urologist
• Physician assistant
• Nurse practitioner

The following doctors treat prostate cancer:

• Urologist
• Radiation oncologist
• Medical oncologist

To prepare for your appointment, see the topic Making the Most of Your Appointment