Six Things You Should Know About Prostate Cancer

Thomas F. Stringer, MD, a board-certified urologist and associate chairman of UF Health Urology, provides an expert’s perspective on a disease that affects 11% of men: prostate cancer.

September is Prostate Cancer Awareness Month.

Prostate cancer is common and may present without signs or symptoms in early stages.

“Second to lung cancer, prostate cancer is the next most common cause of cancer death in men in the United States,” Stringer said. However, according to the Surveillance, Epidemiology, and End Results program of the National Cancer Institute, the five-year survival rate of men diagnosed with prostate cancer in the U.S. is approximately 98%. Tumors within the prostate grow slowly and usually do not push against any major anatomical structures, so signs and symptoms may not be noticeable in early-stage prostate cancer.

Risk factors may render men more likely to develop prostate cancer.

Even though the cause of prostate cancer is unclear, certain risk factors may increase men’s risk of developing the condition.

• The older you are, the higher your risk of developing prostate cancer.
• African American men are roughly 70% more likely to develop prostate cancer.
• Men with a family history of prostate cancer are approximately twice as likely to develop the disease.

For men at high risk, the PSA screening discussion and decision should be initiated as young as age 40.

Prostate cancer screening can detect cancer.

Screening, or looking for cancer before it causes symptoms, can help find prostate cancer at its earliest stages to provide effective treatment. The goal of prostate cancer screening is to identify high-risk, localized prostate cancer that can be successfully treated and to prevent the mortality and morbidity associated with incurable, advanced or metastatic disease. The world has faced the pandemic, which negatively impacted routine screening for a multitude of cancers, including prostate, with a resultant resurgence of advanced prostate cancer at diagnosis. Although the U.S. Preventive Services Task Force concluded that men should begin screening at 55, the Prostate Cancer Advisory Council feels this recommendation falls short of addressing risk factors that could influence when men should be screened. Stringer said, “There are populations at risk for earlier onset of disease as well as more aggressive disease at onset. Therefore, we recommend PSA-based screening for African American men and those with strong family histories of prostate cancer to begin screening in their 40s.” He also recommends those exposed to Agent Orange, a powerful herbicide widely used during the Vietnam War, be screened earlier. Talking to a health care provider about risk factors is important in deciding whether to be tested earlier.

Prostate cancer is treatable if diagnosed early.

Treatment recommendations depend on several factors, including the symptoms, type of cancer and patient’s preferences. For example, if the cancer meets criteria for low-risk disease, the patient may be eligible for active surveillance. Approximately 40% of men are eligible for active surveillance based on low-risk factors at the time of diagnosis. Of those men, two-thirds never require a treatment intervention based on continued low-risk factors during follow-up.

“The reality is that not everyone has to be treated for prostate cancer,” Stringer said. “Active surveillance means that you’re actively watching ⁠— drawing blood tests, checking the prostate, re-biopsy and reimaging the prostate. It’s all a part of the process to make sure the disease isn’t progressing while we are paying attention to it.”

Medical research is working to make progress in prostate cancer prevention and treatment.

Physicians and scientists around the world are committed to learning more about the causes, treatments and possible preventions of prostate cancer. Researchers are working to detect prostate cancer earlier and more precisely and looking for methods to treat prostate cancer more effectively. UF Health is using technology to take a 3D image of the prostate by ultrasound and fuse the image with magnetic resonance imaging, or MRI, scans to do biopsies based on the target. “Certainly, it’s more accurate in detecting high-risk prostate cancer. We are working on a simulation of teaching residents how to perform the technique of image-guided prostate biopsy without having a patient there,” Stringer said.

If your life has been touched by prostate cancer, you are not alone.

Patients and their families can be heavily affected by the diagnosis of prostate cancer. Support and advocacy groups can offer a place to turn to for help and empowerment. These groups gather a community of people who share a diagnosis to share information, encouragement and support. Stringer recommends those interested in patient advocacy to explore the Florida Prostate Cancer Advisory Council website. “We have a website that discusses screening, management, up-to-date research around the state and clinical trials. Part of that interaction is that it has patient advocates.” Advocacy and support groups offer an outlet to talk about feelings, a place to receive suggestions and a forum to learn coping skills to changing situations.