Waking up during the middle of the night to pee occasionally is okay but when it is a nightly routine, it makes you wonder if it is just age, too much tea at night… or something more severe like prostate cancer.You’re not alone in asking this question. For many men, frequent nighttime urination especially as they get older raises concerns about prostate health. The truth is, while it can be a symptom of prostate cancer, it’s far more often linked to other, non-cancerous conditions. The challenge is figuring out which is which, and when it’s worth getting checked.The prostate is a walnut-sized organ sitting below the bladder and in front of the rectum. Its primary function is to make fluid that feeds and protects sperm. As men get older, it's common for the prostate to swell a condition referred to as benign prostatic hyperplasia (BPH). Although BPH isn't cancer, it may produce urinary symptoms by compressing on the urethra and making it more difficult to completely empty the bladder.Dr. Amit, Senior Consultant Urologist, Andrologist & Transplant Surgeon, says, "The prostate is a tiny gland that makes a big difference in urinary function. Because it changes with age, symptoms such as nocturia bedtime trips to the bathroom—may develop, but they don't necessarily imply cancer."What Counts as “Frequent” Nighttime Urination?There is no one-size-fits-all rule for how often a night it is "normal" to have to urinate, as it is different for each individual. The majority of men urinate as many as two times during the night without it being a medical issue. During their 60s and 70s, men may need to urinate more often.If you’re waking up every hour or two, and it’s not related to drinking more fluids, medications like diuretics, or lifestyle habits, it’s worth discussing with a doctor—especially if the change has been sudden or persistent.When Frequent Urination Might Signal Something MoreProstate cancer is the second most prevalent cancer in males globally. It typically grows in silence, with minimal or no symptoms in its early stages. This is why regular screening becomes essential. In others, urinary alterations might be the initial perceptible sign—particularly when the cancer is more developed. These signs can range from:Struggling to begin urinationWeak or interrupted stream of urineSensation of incomplete emptying of the bladderBlood in urine or semenPainful urination or ejaculationNew pain in the back, hips, or pelvisThe above symptoms may be due to causes other than cancer, but should not be neglected. "Recurring urinary changes—particularly when mixed with blood in the urine, unexplained pain, or a family history of prostate cancer—deserve prompt medical attention," writes Dr. Amit.Other Typical Reasons for Nocturnal UrinationIt is worth noting that frequent urination, particularly at night, has numerous potential reasons, such as:Benign Prostatic Hyperplasia (BPH): An enlarged prostate compressing the urethraOveractive bladder: A bladder that is contracting too frequently, even when it is not fullUrinary tract infections: May irritate the bladder and lead to urgencyMedical conditions: Diabetes, heart disease, or kidney disease may affect fluid balanceLifestyle factors: Consuming alcohol or caffeine in the late evening, or large evening fluid consumptionMedications: particularly diuretics for hypertension or heart diseaseIdentifying the cause is the first step to effective treatment.How Doctors Diagnose the Cause of Prostate Cancer?If you’re experiencing frequent urination—day or night—your doctor will take a detailed history and may recommend:Physical examination (including a digital rectal exam to check the prostate)Urine tests to rule out infection or bloodBlood tests, especially a prostate-specific antigen (PSA) test to look for changes that could indicate cancerImaging such as ultrasound or MRI if necessaryYour physician will also be interested in your fluid intake, medications, and duration of the symptoms. The more specific your data, the better it is to determine the cause.The PSA test detects the amount of prostate-specific antigen in your bloodstream. A high PSA level can indicate prostate cancer, but can also increase due to BPH, infection, or even recent sex. That's why PSA tests are interpreted along with other results, including prior PSA levels and physical exam findings.Screening usually begins at age 50 for all men, but those who are at increased risk—men with a family history of prostate cancer, for example—are started earlier.What Are The Treatment Options if Cancer is Found?Treatment for prostate cancer varies depending on the cancer's stage and aggressiveness, your age, and overall health. Treatment may include:Active surveillance for cancers that grow slowly and might never become a problemSurgery, including minimally invasive robotic proceduresRadiation therapyHormone therapy to slow cancer's growthCombination therapies for more advanced diseaseEarly detection dramatically improves cure rates.Why Ignoring Symptoms is Risky?Prostate cancer frequently has a high cure rate if caught early. But if untreated, it can spread to bones and other organs, making it much more difficult to treat. That's why it's essential not to ignore urinary symptoms as "just aging" without excluding more dangerous causes.Dr. Amit asserts, "Although most instances of nocturia are caused by non-cancerous factors, it's not worth the risk. A quick consultation can provide you with clarity and peace of mind—or diagnose something early when it's most curable."Nocturia is very common, particularly as one gets older. It's typically the result of benign conditions, yet in a few instances, it may be an initial indicator of prostate cancer. The most important thing is to pay attention to changes, monitor symptoms, and schedule regular check-ups—especially if you have risk factors.Don't dismiss what your body is saying. Whether it's an innocent habit or a serious medical problem, you won't know for certain until you get examined. And if it proves to be prostate cancer, catching it in time may mean the difference between life and death.Dr. Amit Saple is the Executive Director and Senior Consultant Urologist, Andrologist & Transplant Surgeon at Asian Institute of Nephrology and Urology, Vizag in India