7 myths about prostate cancer every man should know

Prostate cancer is one of the most common, yet least talked about, forms of cancer in men. In fact, about 1 in 8 men will be diagnosed with prostate cancer during his lifetime. There are several myths associated with prostate cancer that all men should know.

1. Myth #1: Prostate cancer is an old man’s disease.
   While it may be true that the older you are, the more likely you are to be diagnosed with prostate cancer (65 percent of cases are diagnosed in men who are 65 or older), the fact remains that 35 percent of those diagnosed are at a younger age. This includes up to 1 in 38 men ages 40-59, and 1 in 15 men ages 60-69. The average age of diagnosis is about 67.

   Multiple expert groups recommend screening with a prostate-specific antigen (PSA) blood test for men between the ages of 55 and 70, or even as early as age 50. Screening for many men in their 50s also opens the door to address other urologic concerns that may or may not relate to a cancer risk but can have major impact on quality of life. Patients should discuss with their physicians about when is the right time to begin and end prostate cancer screening.
    

2. Myth #2: My dad had prostate cancer, so I will too.
   If a patient has a family history of prostate cancer, the chances of a prostate cancer diagnosis are greater than someone who doesn’t have this history. However, not everyone who has a family history of the disease will get it themselves and not everyone who gets the disease has a family history of it.

   As an example, if a patient has a father with prostate cancer, the chance of the patient getting the disease is only 1.5-fold higher than a patient without a family history. This means there is an almost 6 out of 7 chance that he will not be diagnosed with prostate cancer throughout his lifetime. Race is also an important risk factor as African American men face a higher risk of prostate cancer and aggressive disease.

   Patients with no particular risk factors, family history, or genetic mutations should consider initial PSA (prostate specific antigen) screening with a blood test to measure the level of the PSA protein between the ages of 45-55. For patients who have a family history of the disease or have inherited mutations of BRCA1 or BRCA2 genes, PSA screening test is recommended at age 40.
    

3. Myth #3: No symptoms means no cancer.
   Screening for prostate cancer occurs in men who are asymptomatic and report no urinary symptoms, bone pain or weight loss. While prostate cancer can cause various urinary symptoms, these are most often attributed to benign enlargement of the prostate. In fact, prostate cancer usually doesn’t cause urinary symptoms in its early stages. However, you shouldn't assume that the absence of symptoms means no cancer. If symptoms occur, they may include:
   • Frequent urge to urinate, especially at night
     • Trouble urinating, pain or burning
     • Weak urine flow
   • Blood in the urine or semen
   • Loss of bladder or bowel control
   • Painful ejaculation
   • Erectile dysfunction (ED)
   • Back or bone pain
      

4. Myth #4: A high PSA score always means prostate cancer.
   Prostate-specific antigen, or PSA, is a protein produced by cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. For this test, a blood sample is sent to a laboratory for analysis. PSA level is often elevated in men with prostate cancer. However, other conditions, including non-cancerous prostate enlargement, inflammation, infection, etc., can cause a higher PSA.

   The results of an initial PSA test can guide future recommendations. For example, a PSA score can be low enough that the next screening is not recommended for another 2-4 years. For average risk patients, screening is generally recommended every 1-2 years. For patients with higher-than-average PSA scores for their age, additional screening methods such as prostate MRI and other biomarker tests can be used to further stratify overall risk.
    

5. Myth #5: Vasectomies cause prostate cancer.
   This myth developed because many prostate cancers were often first reported in men who had vasectomies simply because they were being screened for prostate complications. Recent research involving millions of men who both underwent and did not undergo vasectomy suggests no clear link between the procedure and the risk of prostate cancer.
    

6. Myth #6: Treatment for prostate cancer always causes impotence, bowel issues or incontinence.
   While erectile dysfunction, bowel issues and urinary incontinence are possibilities following surgery or radiation therapy for prostate cancer, most men do not experience these complications. Today, there are numerous therapies and aids that can limit the possibility of these side effects following treatment. Additionally, recent advances, including new medications and novel treatments for advanced prostate cancer, are providing hope for patients and families.

   As an example, radioactive drugs that bind specifically to prostate cancer cells are proving very effective and very well tolerated for patients with advanced prostate cancers. Experts are also looking at better ways to use existing drugs earlier in the course of treatment, and in combination with other medications, to improve outcomes and reduce side effects.
    

7. Myth #7: All prostate cancers must be treated.
   You and your doctor may decide not to treat your prostate cancer for various reasons, including the progression of the disease, your age and current health status. Active Surveillance is a program that includes regular PSA testing and periodic prostate biopsies, and provides an active way to monitor cancer for appropriate patients. Your doctor may order tests to make sure the cancer does not grow or become more aggressive. If your situation changes, you may decide to start treatment.

   Initial screenings can help physicians determine overall risk for prostate cancer by comparing a patient’s PSA level to the average score for their age. The acceptance of active surveillance as a viable option to immediate treatment has made the screening decision an easier one for many men.
    

While there is no sure way to prevent prostate cancer, all men can be proactive about their health. It’s never too soon to talk to your primary care doctor about prostate cancer screening, especially if you are 50 years or older or experiencing any symptoms.