Prostate cancer symptoms, PSA as a cancer test, and more myths

Is prostate cancer an “old man’s disease”? Does it cause any pain or other symptoms? Is a man risk-free if he has no family history of prostate cancer? Is the PSA test a prostate cancer test?
In general, men do not talk about prostate cancer. But that does not mean that we should accept the myths around this condition affecting millions worldwide.

 

“Only elderly men can get prostate cancer”

Where does the myth come from?

Prostate cancer occurs mainly in older men. About 65% of cases are diagnosed in men who are 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66.

The reality behind the myth

All men are at risk for developing prostate cancer: 1 in 3 of prostate cancer patients are diagnosed at an age earlier than 65.

Important risk factors to consider beyond age include race, family history, physical health and lifestyle. Even the geographic location is a factor that seems to be related to the likelihood of developing prostate cancer.

“I have no symptoms, so I don’t need to get tested for prostate cancer”

Where does the myth come from?

Many prostate cancers start in the outer part of the prostate gland, away from the urethra (the tube that carries urine out of the body). If a tumor is not large enough to put much pressure on the urethra, you may not notice any effects from it.

The reality behind the myth

Early prostate cancer generally does not cause any symptoms at all. Moreover, symptoms can often be attributed to something else. However, more advanced prostate cancers can sometimes cause symptoms, including a need to urinate frequently, difficulty starting or stopping urination, weak or interrupted flow of urination, painful or burning urination, difficulty having an erection, painful ejaculation, blood in the urine or semen, or frequent pain and stiffness in the lower back, hips or upper thighs. If you experience any of these symptoms, be sure to tell your doctor.

 

“Prostate cancer is slow, so I don’t need to worry about it”

Where does the myth come from?

Most patients with early-stage prostate cancer are asymptomatic (without any symptoms). As a result, these patients tend to overlook their medical appointments, putting themselves at risk.

The reality behind the myth.

It is true that in some cases of prostate cancer, it grows slowly. However, there are also cases of aggressive tumors, or tumors that have spread beyond the prostate (metastatic disease). Therefore, it remains very important to focus on early diagnosis. Furthermore, once prostate cancer has been found, patients need to understand the complexity of this disease and make treatment decisions that are right for them in consultation with a trusted medical professional.

“I don’t have a family history of prostate cancer, so I am not at risk”

Where does the myth come from?

Family history and genetics do play a role in a man’s chances for developing prostate cancer. A man whose father or brother had prostate cancer is twice as likely to develop the disease.

The reality behind the myth

While a family history of prostate cancer doubles a man’s odds of being diagnosed to 1 in 3, this disease remains quite common. For example, 1 out of 6 American men will be diagnosed with prostate cancer in their lifetime (which compares to 1 in 8 women who will be diagnosed with breast cancer). Furthermore, African-American men are 60% more likely to be diagnosed with prostate cancer, and 2.4 times more likely to die as a result.

“The PSA test is used to detect prostate cancer, so it is a cancer test”

Where does the myth come from?

The PSA test can help doctors determine how likely a man is to have prostate cancer. Prostate-Specific Antigen (PSA) is a substance made by cells in the prostate gland (both normal cells and cancer cells). PSA is mostly found in semen, but a small amount is also found in the blood. Most healthy men have PSA levels under 4 nanograms per milliliter (ng/mL) of blood. The possibility of having prostate cancer increases as the PSA level increases.

The reality behind the myth

The PSA tests measures levels of prostate-specific antigen in the prostate, not cancer, and the PSA level can also be increased by a number of factors other than prostate cancer. PSA is produced by the prostate in response to a number of triggers, including inflammation or infection (prostatitis), enlargement of the prostate gland (benign prostatic hyperplasia) or, possibly, cancer. Think of it as a first alert smoke alarm, instead of a fire alarm. The PSA test is the first step in the diagnostic process for cancer. It has made detection of cancer in its early stages, when it is best treated, possible. Experts believe the PSA test saves the life of approximately 1 in 39 men who are tested.

If your PSA level is high, your doctor may advise either waiting a while and repeating the test, or prescribe antibiotics to help any potential infection subside, or get a prostate biopsy to find out if you have cancer. 

 

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Other sources include Prostate Cancer Foundation