September is Prostate Cancer Awareness Month, so medical experts are urging men to educate themselves on the disease that will be diagnosed in an estimated 313,780 Americans this year.
While prostate cancer remains the most common cancer in men and the second-leading cause of cancer death, a powerful message of hope underscores the statistics: when detected early, it is highly treatable.
The cornerstone of combating prostate cancer is early detection. The disease is often silent in its initial stages, only presenting symptoms like frequent urination, bone pain, or blood in the urine once it has advanced.
“The most common initial symptoms of advanced prostate cancer are actually bone pain and weight loss,” says Dr. Christopher Saigal, Vice Chair of Urology at UCLA Health. “This underscores why waiting for symptoms is not a strategy. Screening is how we find it early, when it’s most curable.”
Screening involves a simple Prostate-Specific Antigen (PSA) blood test. The general guideline is for men to start annual PSA testing between ages 50 and 70. However, major risk factors necessitate earlier action.
Understanding Your Personal Risk
Not all men face the same level of risk. Key factors that increase susceptibility include:
- Age: About 60% of cases are diagnosed in men 65 or older.
- Race: Black men and those of African descent are at significantly higher risk and often develop more aggressive forms of the disease.
- Family History: Having a father or brother with prostate cancer, or a strong family history of breast or ovarian cancer, increases risk.
“For men with higher risk, especially Black men, we recommend starting the conversation about screening as early as age 40,” advises Dr. Saigal.
From Diagnosis to Treatment: A Range of Options
If a PSA test is elevated, the diagnostic process has evolved. “We now use MRI-guided biopsies in the clinic,” explains Dr. Saigal. “This allows us to precisely target any abnormal areas, making the procedure quicker and more accurate.”
A diagnosis is not a single outcome. Prostate cancer is classified as low, intermediate, or high risk. For many with low-risk cancer, “active surveillance”—closely monitoring the cancer without immediate treatment—is a safe option with a 99% 10-year survival rate.
For those who need treatment, options have advanced dramatically to minimize impact on quality of life.
- Robotic Surgery: Minimizes incisions and helps preserve pelvic functions.
- Precision Radiation: Techniques like external beam therapy and brachytherapy (radioactive seeds) target cancer cells while sparing healthy tissue.
- Focal Therapies: Newer options like cryotherapy (freezing) or heat-based ablation target only the cancerous part of the prostate, potentially offering fewer side effects.
“Patients are often concerned about side effects like urinary incontinence or erectile dysfunction,” says Dr. Saigal. “The key is shared decision-making. We use tools to help patients choose the best treatment based on their cancer’s risk level and their personal preferences.”
A Declining Death Rate, But a New Concern
There is encouraging news: the prostate cancer death rate has been cut in half since the 1990s, thanks to better screening and treatment.
However, a recent 3% annual increase in incidence rates and a slowing decline in deaths are concerning trends. Experts attribute this to a reduction in screening following past guideline changes, leading to more cancers being discovered at a later, less treatable stage.
This September, doctors emphasize that informed, personalized screening is the best defense. Men are encouraged to discuss their individual risk with their primary care physician to make a plan that could save their life.
For more information on screening and risk factors, visit the American Cancer Society at cancer.org