September 22, 2022

What All Men Should Know About Prostate Cancer: Risk, Symptoms, Diagnosis and Treatment

Prostate cancer is the second most common cancer among men in the United States, after non-melanoma skin cancer. In 2019 (the latest year for which data is available), for every 100,000 men in the U.S. there were 112 new prostate cancer cases reported and 18 deaths. Here in Massachusetts, that rate is 110.5 new cases and 18 deaths per every 100,000 men. ¹

The good news is that most cases of prostate cancer (about 70%) are diagnosed early, when the cancer is still localized and highly treatable. The 5-year survival rate for men diagnosed with early-stage localized prostate cancer is 100% according to the most recent CDC data. But once the cancer has spread (metastasized) to distant areas of the body, the 5-year survival rate drops to just 32.6%.

That’s why being aware of the risk factors, symptoms, and screening recommendations for prostate cancer is so important. Here’s what you need to know.

Prostate Cancer Risk, Causes and Prevention

There are a variety of factors that increase risk for developing prostate cancer.

• The strongest risk factor is family history – men with a close relative who has had prostate cancer are twice as likely to develop the disease themselves. Genetic factors drive 58% of prostate cancers.²
• Age is another risk factor. About 60% of prostate cancers are diagnosed in men over the age of 65.
• Race plays a role as well. Men of African descent are 75% more likely to develop prostate cancer than white men, and they’re more than twice as likely to die from the disease.
• Lifestyle factors – the only risk factors that you can control – include a diet low in vegetables and high in processed meat and saturated fat; a lack of exercise; and obesity. The link between poor diet and prostate cancer is likely hormonal. Testosterone speeds the growth of prostate cancer, and fats stimulate increased production of testosterone and other hormones. High testosterone levels may also cause dormant prostate cancer cells to become active again, leading to prostate cancer recurrence.By contrast, eating a healthy diet high in vegetables (especially those in the broccoli family) and low in processed meats and saturated fats can reduce your risk of developing prostate cancer, as well as reduce your risk of prostate cancer recurrence if you’ve already been diagnosed with the disease.²

Prostate Cancer Symptoms

Early prostate cancer often doesn’t cause any symptoms. But as the cancer progresses, the most common symptoms of prostate cancer include:

• Pain and/or a “burning sensation” when urinating or ejaculating.
• Frequent urination, especially during the nighttime.
• Trouble starting urination, or stopping urination once in progress.
• Sudden erectile dysfunction.
• Blood in either urine or semen.

If you experience any of these symptoms, you should talk with your doctor.

Prostate Cancer Screening and Diagnosis

Because there are usually no symptoms associated with early-stage prostate cancer, screening is very important. Depending on your risk factors, most men should have an annual prostate cancer screening between the ages of 50 and 69. For those with a family history of prostate cancer or high risk factors, screening may begin at age 45.

Screening for prostate cancer involves digital rectal exam and prostate specific antigen (PSA) levels. Professional organizations tend to vary in their recommendations as to whether or not PSA screenings should be routinely done. Some have guidelines while others suggest it should be left to the physician and patient to discuss.

If screening tests point to an abnormality, your doctor will may do additional tests to confirm the diagnosis. These tests may include an ultrasound, magnetic resonance imaging (MRI), and a biopsy of the prostate.

Prostate Cancer Treatment

Comprehensive prostate cancer treatment is provided at The Cancer Center at UMass Memorial Health – Harrington. Current treatment options for prostate cancer include surgery, radiation therapy, chemotherapy or, in the case of very slow-growing types of prostate cancer, watchful waiting until the disease progresses. Some men choose to delay treatment until symptoms progress; others might choose a treatment regimen based on the side effects that accompany the recommended treatment or their comorbidities, or additional conditions. It is important for patients to discuss these options with their health care provider at the time of diagnosis.

It is generally recommended to follow patients with active surveillance who have a low risk of disease as indicated by a PSA of less than 10 and a Gleason score of less than 7. A Gleason score is based on a biopsy-based test that helps to determine how aggressively the prostate cancer is likely to behave both in how quickly it grows and how likely it is to spread outside of the gland.

Important Takeaways

Prostate cancer is highly treatable and curable when diagnosed in the early stages, but early stage disease often doesn’t cause any symptoms. That’s why men should discuss prostate cancer screening with their primary care provider (PCP) beginning at age 45, the earliest age at which screening may be recommended. Don’t have a PCP? Find a PCP here.

 

1 https://www.cdc.gov/cancer/prostate/statistics/index.htm

2 https://www.pcf.org/patient-resources/family-cancer-risk/prostate-cancer-risk-factors/