An NCI-designated Comprehensive Cancer Center
By Travis Marshall | September 19, 2016


Prostate issues are a normal part of getting older for many men. Hormonal changes cause enlarged prostates in almost 90 percent of men by the time they turn 80. But while an enlarged prostate can be uncomfortable, it’s prostate cancer that men should be most concerned about.


Here Sumanta Kumar Pal, M.D., medical oncologist and assistant professor in the Department of Medical Oncology & Therapeutics Research at City of Hope shares 10 important facts every man should know about prostate cancer.

1. It’s more common than you think.

Prostate cancer is the most common type of nonskin cancer among men, according to the National Cancer Institute, and the second leading cause of death by cancer in men, after lung cancer. The Prostate Cancer Foundation says that 3 million American men are currently living with prostate cancer, and more than 27,000 die from the disease each year.

2. It can be cured — if caught early.

"One of the biggest misconceptions about prostate cancer is that it's a relatively benign, slow-growing cancer," Pal explained. "With early detection, the cure rate for prostate cancer is almost 99 percent. But that number drops significantly in more aggressive cancers or once it has metastasized." This underscores how vital screening and early detection are for saving the lives of men with prostate cancer.

3. You might need early screening.

Because early detection can have such a large effect on a patient's outcome, experts like Pal suggest that men talk with their doctor and get a personalized assessment of when they should start screening rather than simply getting the standard exam at age 50. Depending on family history and other risk factors, starting screening as early as age 40 may be the right choice.

4. Race affects risk.

African-American men have the highest risk for prostate cancer of any American males, while Asian-Americans have the lowest risk in the country. For the entire U.S. male population, one in seven get prostate cancer, but that number is one in every five for African-American men. Not only are African-Americans more likely to get it, but they are also 2.4 times as likely to die from it, according to the Prostate Cancer Foundation.

That's why City of Hope recently launched a new initiative to educate African-American men about this risk, and encourage them to seek early screening and treatment.

5. There are symptoms, but they're not definitive.

The symptoms of prostate cancer, if there are any, are often symptoms that can be attributed to other things, like prostatitis. These could be things like needing to pee frequently or having trouble controlling the urine stream, as well as sexual issues like erection dysfunction or painful ejaculation. Check with your doctor if you experience any of these, but don't wait to experience them before getting screened for prostate cancer.

6. Screening tools are getting better.

There's been a lot of debate over the years about the tools used to screen men for prostate cancer. Tests measuring the levels of prostate specific antigen, or PSA, only show that something unusual is happening with the prostate, not that a patient has cancer. And the standard biopsy for prostate cancer takes samples from a fixed pattern around the organ rather than pinpointing specific tumors.

Pal says City of Hope has improved diagnostic tools for prostate cancer, including MRI-guided biopsies to target specific tumors. He's also currently working on a clinic trial for a test that may detect early-stage prostate cancer cells in the blood. "With the very high sensitivity of the test, we were the first to detect circulating tumor cells in patients with localized prostate cancer," Pal said. "This could really improve our ability to define a patient's prognosis."

7. Prostate cancer doesn't always require surgery or treatment.

Once a man is diagnosed with prostate cancer, the aggressiveness of the cancer is determined using a tool called the Gleason Scale. Prostate cancer with a Gleason score of 6 or less is considered low risk, 7 is intermediate and 8 to 10 is high risk.

For those with low-risk cancers, there's a good chance the cancer will grow so slowly that they won't need treatment in their lifetimes. Instead of treatment, the doctor may recommend active surveillance: regular PSA tests and biopsies to make sure it doesn't get more aggressive.

8. Consider the long-term effects of treatment.

You and your doctor should consider the potential long-term effects of treatment and weigh them against the aggressiveness of the cancer. A study in the New England Journal of Medicine looked at data from the Prostate Cancer Outcomes Study and found that 15 years after surgery or radiation treatment for prostate cancer, a significant number of the men had experienced either sexual dysfunction, problems urinating, or both — issues that can significantly reduce a man's quality of life.

9. Treatments vary widely.

Every man is different, so the treatment plan for each case of prostate cancer is determined on a case-by-case basis. Treatment could require a surgical procedure to destroy the tumors or remove the prostate. It may also include radiation, chemotherapy, hormone treatments or immunotherapies. Or your doctor may recommend a combination of these.

10. Lifestyle changes might help — but it's not a magic cure.

Some studies show there could be a link between lifestyle factors like diet and obesity and increased rates of prostate cancer, though age, family history and race remain the most significant risk factors. The best lifestyle changes men can make to improve their prostate health are ones that improve overall health: quitting smoking, maintaining a healthy weight and eating a diet that is high in fruits, vegetables and whole grains, and low in red meats and full-fat dairy products.


Learn more about City of Hope's prostate cancer program and research. If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.


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