From health.com
AT A GLANCE
- Prostate cancer is highly treatable when caught early, but many cases cause no symptoms at first, making screening important.
- Risk increases with age, but younger men can develop prostate cancer too, and lifestyle, genetics, and race can all play a role.
- Not every prostate cancer needs immediate treatment—some grow slowly and can be safely monitored.
Prostate cancer is the second most common cancer in men in the U.S. behind skin cancer, with an estimated 3.5 million men currently living with the disease.
As rates continue to rise—with a 3% annual increase since 2014—experts share the eight things they want you to understand about prostate cancer right now.
1. It’s Not Exclusive To Older Adults
While prostate cancer is much more common with age—most men are diagnosed around 67—it’s not just an “old man’s disease,” Aleksander Druck, MD, a urologist with expertise in prostate cancer at Orlando Health Medical Group Urology, told HEALTH. A growing number of cases occur in men under age 55, often due to a genetic predisposition.
Your race may also affect your risk. Black men are diagnosed about 70% more often than white men, Nathan Goodyear, MD, an integrative physician with Williams Cancer Institute, told HEALTH. And when prostate cancer does develop in these men, they tend to be younger.
2. Your Lifestyle Habits Can Affect Your Risk
You can’t completely prevent prostate cancer, but experts said there are some factors in your control. Staying active, maintaining a healthy weight, and not smoking can all help lower your risk.
“If you’re a man over 45, have an honest conversation with your doctor about your own risk,” Goodyear recommended.
3. Early Cases Often Have No Symptoms
Patients rarely experience symptoms in the early stages of prostate cancer—a fact that 80% of Americans don’t know.
“How you feel doesn’t necessarily tell us whether prostate cancer is present,” Jeffrey Yoshida, MD, a board-certified urologic oncologist at City of Hope, Orange County, told HEALTH. Most men feel completely fine when they’re diagnosed, Druck added.
As the disease progresses, early symptoms may include blood in semen or urine, pain with ejaculation, or difficulty emptying the bladder, Kristine Peregrino Lacuna, MD, a genitourinary medical oncologist at Memorial Sloan Kettering Cancer Center, told HEALTH.
4. Screening Can Be Part of Your Primary Care
Around ages 45 to 50, you can talk to your doctor about adding a prostate-specific antigen (PSA) test to your routine bloodwork. This screening tool measures a specific protein made by the prostate. If it’s abnormally high, your doctor may refer you to a urologist for further evaluation, Druck said.
But experts caution that high PSA levels aren’t the be-all and end-all. “I tell patients to think of it as a signal that we may need more information,” Yoshida said. Other factors can raise PSA levels, including prostate enlargement, recent ejaculation, or vigorous exercise, Druck added.
5. Prostate Cancer Is Most Treatable When Caught Early
Overall, prostate cancer is highly treatable, with a five-year survival rate of about 98%. When caught early, before it spreads to distant parts of the body, that rate is nearly 100%.
“Caught early, it’s very treatable and potentially curable,” Druck said, emphasizing the importance of screening.
6. Some Tumours Grow Much Faster Than Others
Many prostate cancers grow so slowly that people can live with them for decades, but a smaller number of cases are more aggressive.
In long-term studies of untreated prostate cancers, the lowest-grade tumours carried a less than 5% risk of spreading over 15 to 20 years. By contrast, the highest-grade tumours often progressed to life-threatening disease within a few years.
Still, Druck assured that “for most men, it’s a slow-moving disease that’s caught early and managed successfully.”
7. Mild Cases Don’t Always Need Treatment
It’s a common misconception that a prostate cancer diagnosis means you need treatment immediately, Yoshida said.
Only aggressive forms typically require prompt treatment. If your doctor finds abnormal or low-risk cells, they might choose to monitor the cancer—with PSAs, biopsies, and MRIs—rather than treat it.
This option helps patients avoid or postpone unwanted side effects, such as sexual or urinary issues. “This isn’t ignoring the cancer,” Yoshida clarified. It’s keeping a close eye on it with regular testing and avoiding overtreatment, Lacuna said.
8. Chemotherapy Isn’t the Norm
When treatment is necessary, Druck said surgery and radiation are the go-to methods. Chemotherapy is generally reserved for more advanced disease.
The specific course of treatment will depend on the person, Druck added. Some people may need their prostates removed, a procedure called radical prostatectomy, while others may need a combination of treatments, including hormone therapy that lowers testosterone.
A care team—including a urologist, radiation oncologist, and medical oncologist—will work with you to decide the right path, Yoshida said.
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