Prostate cancer affected an estimated 2.8 million men in the United States last year, according to cancer.org. It is the most common cancer – after skin cancer – among American men, and approximately 1 in 6 men will be diagnosed with the disease in his lifetime. Fortunately, the survival rate is quite high if the cancer is detected and treated early.
September is Prostate Cancer Awareness Month, a time to learn about the signs and risk factors of the disease. Early detection and screening can help prevent the spread of the cancer. However, screening recommendations have been controversial, as results from the prostate-specific antigen (PSA) test and the digital rectal exam (DRE) can be inaccurate. The disease also usually grows and spreads at a slow pace, or not at all, and overtreatment can cause more problems than solutions.
The American Urological Association (AUA) recently released new guidelines recommending men ages 55 to 69 start asking their doctors about the benefits and harms of prostate cancer screening. The association recommends against screening for men younger than 55 who are at average risk, as well as for men ages 70 and older. The American Cancer Society (ACS) suggests that men should start discussing screening pros and cons at age 50. African American men or those with a family history should consider getting screened starting at age 45. The United States Preventative Services Task Force (USPSTF) recommends against routine PSA screening for men of all ages without symptoms.
Despite the differences of if and when to get screened, the general consensus is to speak to a doctor about the consequences of prostate cancer screening before going through with the process. Each case is unique, and an informed decision should be made only after accessing all risks and benefits.
So who is most at risk for prostate cancer? Researchers are still trying to pinpoint the exact causes of the disease, but they have identified several risks factors that may play a role:
- Being over the age of 40
- Being African American
- Having a family history
- Eating a lot of red meat or high-fat dairy products, and few fruits and vegetables
Unfortunately, symptoms during the early stages are scarce – a reason why many people encourage annual screenings after a certain age. During advanced stages, men may experience:
- urination problems, such as frequent urges to urinate and having a slow or weak urinary stream
- blood in the urine, or hematuria
- pelvis, hips, lower back pains
- trouble getting an erection
- loss of bladder or bowel control, or incontinence
If you believe that you may have prostate cancer, speak to your doctor. Men who are in the early stages may not need treatment, but should be monitored in case of progression (also called active surveillance). For more information on prostate cancer, please visit the ACS website.