Prostate cancer, the second most common cancer around the world among men, is a disease that is very survivable when diagnosed early. Screening is the best way to find early cancer. Overall, prostate cancer has a high cure rate, including 99% of the cases that are identified, diagnosed, and treated early.
Often, prostate cancer grows relatively slowly and may take years to become detectable, and even longer to spread outside the prostate (metastasize). However, the disease comes in many forms, and some cases are more aggressive and need urgent treatment.
Who's at Risk?
Men at the most risk for prostate cancer are older, African American, have a family history of the disease, and have certain inherited genetic conditions. Smoking and excess body weight may increase the risk of aggressive prostate cancer, and Black men have more than a 70% higher risk than white men for as yet unknown reasons.
Genetics plays a central role in prostate cancer, contributing to more than half of all cases. That makes prostate cancer the most "inheritable" of all cancers. Men with a close relative with prostate cancer may be twice as likely to develop the disease; those with two or more relatives have nearly four times the incidence. The risk rises if family members were diagnosed before age 65.
Social determinants, such as access to healthcare and behavioral and sociodemographic characteristics, may also play a prominent role in the risks of developing and surviving prostate cancer. For example, a diet that is low in vegetables and high in processed meat and saturated fat may be a risk factor. More research is necessary to understand the relative contribution of genetics and biology compared with non-genetic causes.
What are the Signs and Symptoms?
In the early stages, prostate cancer usually causes no symptoms. The first sign is often found during a routine screening exam.
Uncommonly, prostate cancer may present with symptoms including:
- Urinary signs and symptoms: need to urinate often and during the night, inability to urinate, and trouble starting or stopping urinary flow
- Erection and ejaculation symptoms: painful ejaculation, blood in the ejaculate, and trouble achieving an erection
However, these symptoms are more commonly due to non-cancerous conditions such as benign prostate enlargement rather than to prostate cancer.
Late-stage prostate cancer commonly spreads to the bones, which can cause pain in the hips, spine, ribs, and other areas.
Prostate cancer screening includes a digital rectal exam (an examination of the prostate via a gloved finger in the rectum) and a prostate-specific antigen (PSA) test -- a blood test for the PSA protein used as a "disease marker" to represent prostate cancer. A high PSA test score may increase the suspicion of prostate cancer. More testing usually includes imaging and a biopsy to determine the presence of cancer. Blood and urine tests are available that may provide additional information.
"Medical Journeys" is a set of clinical resources reviewed by physicians, meant for the medical team as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.
