Prostate cancer, by nature, is silent in its initial stages. Its symptoms don’t appear until later, when patients may notice a need to urinate frequently, particularly at night. Prostate cancer may also cause a difficulty or inability to urinate, a weak or interrupted flow of urine or painful and burning urination. Other symptoms may include painful ejaculation, blood in urine or semen, and frequent pain or stiffness in the lower back, hips or extremities.