Prostate Cancer Awareness

Prostate Cancer at a Glance | Rise in Advanced Cases | Staying Ahead of the Game

Questions to Ask Your Doctor about Prostate Cancer Screening

Risk Factors for Prostate Cancer | Treating Prostate Cancer

Questions to Ask Your Doctor about Prostate Cancer Treatment | Resources en español

September is Prostate Cancer Awareness Month. Though prostate cancer may not receive as much media attention as breast cancer, it is nearly as common, affecting about 1 in 8 men in their lifetime.

This year, about 288,300 men will be newly diagnosed with prostate cancer, more than any type of cancer aside from skin cancer, and about 34,700 men will die from prostate cancer—the most deaths from any cancer in men after lung.*

Receiving proper health screenings can be lifesaving. Unfortunately, research shows that men are less likely to visit their primary care doctor than women. A 2022 survey by the Cleveland Clinic revealed that more than half of men surveyed said they do not receive regular health screenings, and 77 percent of men did not know their complete family history regarding urological issues.

The American College of Surgeons (ACS) has partnered with the American Urological Association (AUA) to share vital information about the concerning rise in advanced cases of prostate cancer and how men can protect their health and make the most informed decisions about their healthcare.

*Data from: Cancer Facts & Figures 2023. Atlanta: American Cancer Society, Inc. 2022

Hear from the Experts

On Monday, September 11, ACS Governor James Eastham, MD, FACS, chief of urology service at Memorial Sloan Kettering Cancer Center, Kara Watts, MD, an associate professor of Urology at Montefiore Medical Center, and Kevin Koo, MD, MPH, an associate professor of Urology at Mayo Clinic College of Medicine and Science, participated in a virtual news conference hosted by the ACS and AUA.

Dr. Eastham, Dr. Watts, and Dr. Koo discussed:

• Rise in advanced cases of prostate cancer and what men can do to protect their health
• Populations most at risk of developing prostate cancer
• When men should start being screened for prostate cancer
• Signs and symptoms of prostate cancer that men should be aware of
• Common misconceptions about prostate cancer screening and treatment
• Advances in how prostate cancer is treated
• Tips for men on how to best advocate for their health

A recording of the virtual Newswise press conference is available to view online.

The prostate is a walnut-sized gland, located at the base of the bladder, that makes up part of the male reproductive system. The main job of the prostate and seminal vesicles is to make fluid for semen.

Prostate cancer develops when abnormal cells form and grow in the prostate gland. Not all abnormal growths, also called tumors, are cancerous (malignant). Some growths may be non-cancerous (benign).

After years of decline, cases of advanced prostate cancer are on the rise. According to the American Cancer Society’s 2023 annual Cancer Facts & Figures report:

• The proportion of men diagnosed with advanced-stage prostate cancer has more than doubled over the past 10 years, from 3.9% to 8.2%.
• From 2014 to 2019, there was a 3% increase in prostate cancer incidence rate each year, representing 99,000 new cases and the first increase in about 20 years.
• This increase may be due, in part, to changes in screening guidelines that may have caused fewer men to get screened earlier.

Screening remains the most effective way to protect against advanced disease. When caught early, prostate cancer is highly treatable.

Why Is Screening for Prostate Cancer So Important?

Screening for prostate cancer often starts with a simple blood test known as the prostate-specific antigen (PSA) test, which can help detect abnormalities in the prostate. Your doctor may also perform a prostate exam.

The AUA suggests that most men should receive a baseline PSA test between ages 45 to 50 years. Men with a family history or who are at increased risk of prostate cancer, including Black men, should talk to their doctor about screening earlier.

Learn more about the PSA test and another screening method, a digital rectal exam, with resources from the AUA.

• • “Do I need a PSA test?”
    • If PSA testing isn’t brought up at your annual exam, make sure to ask about it. Your doctor can help you decide when to start screening depending on your family history and other risk factors.
  • “Am I at increased risk of developing prostate cancer?”
    • Many factors, including hereditary and lifestyle factors, can influence your risk for prostate cancer. Your risk of developing prostate cancer may be very different from a friend’s or colleague’s risk. Ask your doctor about when you should start screening.
  • “How will your office communicate my PSA results to me?”
    • Your doctor’s method of getting in touch and sending results (phone, email, or electronic medical record) may vary. Knowing what to expect and where to check for your results can help you keep track of your important health information.
  • “What does a rise in PSA level mean?”
    • A rise in PSA level does not automatically indicate cancer. PSA levels can fluctuate for a variety of reasons. Your doctor can provide guidance on the appropriate next steps. Sometimes, they might advise you to repeat the test; in other cases, additional imaging or a biopsy may be ordered to check for cancer.
  • “Should I see a urologist, or can I continue to see my primary care physician?”
    • Many primary care physicians (PCPs) can order a PSA test. Depending on your results and any symptoms, they may refer you to a urologist, a doctor who specializes in conditions and diseases of the urinary tract, for further testing or more specialized guidance.

Any genetically male patient can develop prostate cancer, but there are additional risk factors that put certain individuals at risk. According to the AUA, factors that increase a man’s risk of developing prostate cancer include:

• Age: As men age, their risk of getting prostate cancer goes up. Harm to the DNA (or genetic material) of prostate cells is more likely for men over the age of 55.
• Ethnicity: Black men have a higher rate of the disease. One in six Black men will be diagnosed with prostate cancer in the United States. Prostate cancer occurs less often in Asian American and Hispanic/Latino men than in non-Hispanic White men.
• Family History: Men who have a grandfather, father, or brother with prostate cancer face a higher risk of getting the disease. Having family members with breast and ovarian cancer also raises a man’s risk for prostate cancer.
• Weight: Studies link being overweight in your 50s and later to a greater risk of advanced prostate cancer. Doctors advise keeping to a healthy weight to reduce risk.

Treatment for prostate cancer will depend on a variety of factors, and some low-risk prostate cancers may only need to be monitored with an approach called active surveillance, or close monitoring with imaging and tests.

According to the AUA, some factors that may determine treatment options include:

• Stage and grade of the cancer (Gleason score and TNM stage)
• Risk category (whether the cancer is low-, intermediate- or high-risk)
• Age and health
• Preferences about side effects and long-term effects of treatment
• Treatment goals
• Results from other diagnostic tests

Some common treatment options for prostate cancer include radiation treatment, hormonal therapy, or surgery. Other emerging treatment options include immunotherapy, which harvests the body’s natural immune system to fight the cancer, and focal therapy, which targets smaller tumors using high-intensity focused ultrasound and other techniques.

Read more on treatment options for prostate cancer, including the surgical management of prostate cancer, from the AUA.

Treatment for prostate cancer has advanced considerably in the past decade, but it can still come with many undesirable side effects that may reduce your quality of life. Having open and honest conversations with your care team about side effects may help you prepare for treatment as well as consider therapies to reduce side effects. Ultimately, decisions should be based on your goals and conversations with your care team. Some questions to consider asking your care team include:

• “What treatment is right for me?”
  • Your quality of life is equally important as treating your cancer. Some types of prostate cancer may not even need to be treated, but others may require various forms of treatment. Treatments can and should be tailored to your specific type of cancer and your goals.
• “How will surgery or treatment affect my quality of life?”
  • Treatment for prostate cancer can impact your quality of life, including sexual and urinary function, as well as your balance and cognition. Your doctor can advise on what you can expect during and after treatment. Your doctor may be able to prescribe medication or other treatment options, including physical therapy, to help reduce side effects of treatment and maintain your quality of life.
• “I’m really struggling with erectile dysfunction (ED)/dizziness/lethargy, and it’s starting to impact my daily life. Yesterday, I didn’t have the strength to stand up and go to the bathroom by myself. What do you recommend?”
  • Your symptoms may change depending on the type of treatment you are receiving for your cancer. When talking about symptoms with your doctors, try to be as specific as possible and relate them back to your daily function, such as, “I’m having trouble getting out of bed,” or “I fell three times yesterday.” If talking about a specific symptom, such as erectile dysfunction, is uncomfortable for you, try writing your question on a piece of paper or asking a friend or family member to come with you for support.

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