When To Call a Doctor

Call your doctor immediately if you:

• Are completely unable to urinate.
• Have painful urination and a fever higher than 100°F (38°C), 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, belly, 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).

Active surveillance

Active surveillance (watchful waiting) means that you will be watched closely by your doctor. If you are a younger or active man who is at low risk, this will mean regular checkups. If the cancer starts to grow more quickly, you will need to have other treatment, such as surgery. Your regular checkups may include digital rectal exams, PSA tests, and biopsies.

If you are an older man with serious health problems or close to the end of your life, you may not be able to handle treatments or even want to have treatments. If this is true in your case, your doctor will watch you closely. But active surveillance won't lead to any treatments except those needed to keep you comfortable (palliative care).

• For younger or active men, the main reason to choose active surveillance is to avoid or delay the side effects of treatments.
• For younger or active men, the main reason to choose other treatment (and not active surveillance) is to not miss the chance of curing the cancer. If the cancer grows and spreads, it may be harder to treat.
• For some older men or those who aren't expected to live long, the main reason to choose active surveillance is to have the best possible quality of life.

Active surveillance is a good treatment choice for men who have low-risk cancer that has not spread.⁶ If you have cancer that is more likely to spread, you will need to have other treatment unless you are only expected to live a short time.

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
• Urologic oncologist
• Radiation oncologist
• Medical oncologist

You may want to get a second opinion from a different specialist before making your treatment decision. For example, if your doctor is a family medicine physician, you may want to talk to a radiation oncologist, urologist, or urologic or medical oncologist.

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