5 Common Questions About Prostate Cancer, Answered

Prostate cancer is serious business: It’s the second most common form of cancer and the leading cause of cancer deaths among men. One in eight men will be diagnosed with the condition in his lifetime. Naturally, there are a lot of questions surrounding prostate cancer — and people need to understand the risks.

In this post, we’ll answer some of the most commonly asked questions about prostate cancer. Some we’ve covered previously, but in honor of Prostate Cancer Awareness month, we thought it would be helpful to include them all together in a single post.

1. What are the symptoms of prostate cancer?

Understandably, men want to know the signs and symptoms of prostate cancer to catch it early. After all, there is a greater than 99% survival rate when prostate cancer is identified early, before it spreads.

Unfortunately, it’s not so easy to detect prostate cancer in its early stages, when it typically produces no symptoms. For this reason, prostate cancer is known as one of the “silent cancers.”

It’s when the tumor has grown and causes the prostate to swell and be blocked that symptoms, including difficulty urinating, blood in urine or semen, and discomfort in the pelvic area, develop. Other symptoms of advanced prostate cancer may include:

• Leaking urine when you laugh or cough
• Frequent urination, especially at night
• Difficulty emptying the bladder
• Painful ejaculation
• Difficulty getting an erection

There are other symptoms, including persistent pain in the back, hips, ribs or other areas and loss of bladder or bowel control, that may indicate the tumor has spread from the prostate to other parts of the body.

The lack of symptoms in the early stages underlines the importance of getting regular screenings and talking with your doctor about your risk profile starting at age 40.

2. What are the treatment options for prostate cancer?

Treating prostate cancer depends on several factors starting with the stage and aggressiveness of the cancer.

In some cases, prostate cancer is localized, small, slow-growing and not considered clinically significant. These characteristics make a good candidate for active surveillance — meaning your physician will recommend closely monitoring the cancer for signs that it is growing more quickly, with visits and PSA tests about every six months. A physician may recommend observation, also called watchful waiting — a less intensive regimen involving fewer tests.

In certain cases, physicians may use radiation treatment, sometimes in conjunction with hormone therapy, which aims to reduce levels of androgens that help prostate cancer cells grow.

The options change when the cancer is more advanced.

When a doctor determines that the cancer is isolated to the prostate and has not spread, patients may undergo a prostatectomy to remove the gland in a procedure that is increasingly done laparoscopically. Patients and their families frequently inquire about the different treatments available.

Chemotherapy isn’t common for most men with prostate cancer, but it is sometimes used to treat advanced cases and when the tumors have spread well beyond the prostate.

New immunotherapy treatments help a person’s own immune system fight back against cancer cells. There are three FDA-approved immunotherapy drugs for prostate cancer, plus ongoing clinical trials to help evaluate others.

Still another option is targeted therapy, a precision medicine approach that identifies a particular genetic component of the tumor to disrupt its growth

3. What are the side effects of prostate cancer treatments?

The use of radiation or chemotherapy brings the same side effects experienced by other cancer patients, including fatigue, possible hair loss, nausea or digestive issues, and skin changes.

Because the prostate is part of the male reproductive system, many treatments can affect sexual functions, with erectile dysfunction being a prime concern. Other side effects can include diminished libido, dry orgasm, reduced fertility, nerve damage, and urinary and bowel problems.

Discussing these risks with a physician helps in making informed decisions about treatment.

4. What is the prognosis and survival rate for prostate cancer?

The prognosis for men with prostate cancer depends on various factors, including the cancer stage at diagnosis, PSA levels, and the patient’s overall health.

The good news is that when caught early, prostate cancer has a greater than 99% five-year survival rate. Because more than 80% of all prostate cancers are detected when the cancer is confined to the prostate or the immediate surrounding area, treatment success rates are higher than with many other types of cancer.

However, when the prostate cancer is advanced or has spread to other parts of the body, the five-year survival rate drops to 34%.

It’s more reason to discuss your own prostate cancer risk profile with your doctor starting at age 40.

5. Can you prevent prostate cancer, or detect it early?

While it is absolutely possible to detect prostate cancer early, when it’s easiest to treat, researchers don’t yet know what causes it. So there’s no way to prevent prostate cancer from occuring in the first place. The best strategy is to be aware of the risk factors and follow a healthy lifestyle.

Physicians employ a twofold method to diagnose prostate cancer:

• Screen for prostate-specific antigen (PSA), a protein produced by the prostate, using a blood test to look for abnormal levels
• Conduct a biopsy to evaluate a prostate tissue sample

Unfortunately, PSA levels can be elevated for many reasons that have nothing to do with cancer, including recent sexual activity, rigorous exercise or an enlarged prostate, which is common with age. In fact, research shows that more than 75% of patients with an elevated PSA don’t need a biopsy, which carries its own set of risks. New urine-based biomarker screenings like MyProstateScore 2.0 offer physicians more certainty to inform the next steps — including whether to perform a biopsy.

The main risk factors for prostate cancer are being over age 50, having a family history of the disease, African ancestry and certain inherited genetic changes. As with many conditions, following good lifestyle habits — eating a healthy diet, getting regular exercise, avoiding smoking and maintaining a healthy weight — is the best way to both lower your risk and increase the odds of surviving prostate cancer.

As a reminder, men should discuss their own prostate cancer risk profile with their doctor starting at age 40. Understanding the basic facts related to prostate cancer gives you and your doctor an informed starting point to work together on the best course for your health.