Prostate Cancer: Myths and Facts

September is prostate cancer awareness month. Dr. J. Adams, a surgeon in London, the first to discover prostate cancer and at that time in the 1850’s, noted prostate cancer was “a very rare disease.” Interestingly, today, according to the latest Cancer Facts & Figures, 2019, prostate cancer is the most commonly diagnosed cancer (except for skin cancer) in men accounting for 20% of all male cancers.

MYTH: Most prostate cancers are diagnosed because men go to their doctor with symptoms.

FACT: Prostate cancers are most commonly detected when men undergo screening for prostate cancer which includes a blood test, a PSA, and a digital rectal exam (DRE) where the prostate size and shape is assessed.

*Note: Men, of average risk, should have a conversation with their doctor about when to begin prostate cancer screening at the age of 45.

FACT: Early stage prostate cancer doesn’t usually present with symptoms. The most common symptoms seen when cancer progresses include:

  • Frequent, difficult or painful urination
  • Blood in the urine
  • Trouble having or keeping an erection
  • Pelvic pain
  • Loss of appetite and weight
  • Bone pain

*Note: Whenever these symptoms are present, men should contact their healthcare provider.

MYTH: Prostate cancer is a disease of older men.

FACT: According to the American Cancer Society, 60% of prostate cancer is diagnosed in men aged 65 and older. Therefore, 40% of prostate cancers are diagnosed at an earlier age but infrequently before the age of 40. Factors that increase the chance of being diagnosed at a younger age include:

  • Being an African American; risk of being diagnosed is 1.7 times higher in this population as compared to Caucasian men. Further, African American men are twice as likely to die from prostate cancer than men of other races.
  • Having a father and/or brother diagnosed with prostate cancer can double your risk; it’s essential to know your family history.
  • Having an inherited gene mutation such as BRCA1 or BRCA2 or genetic syndrome called Lynch syndrome which causes inherited colon cancers. It is believed that 5-10% of cancers are inherited.

*Note: Men, who are at a higher risk, will need to begin prostate cancer screening at an earlier age.

MYTH: Men with an elevated PSA must have prostate cancer.

FACT: There are many reasons for a PSA to be elevated that are not cancer. The following can contribute to elevated levels:

  • As men get older, the PSA will gradually increase too. A cause for concern is when the PSA rapidly increases over a short period of time.
  • Enlarged prostate which is commonly seen in men over the age of 50.
  • A urinary tract infection.
  • Having sex within 24-48 hours of a PSA test.
  • A digital rectal exam can affect the PSA; it’s best to have blood drawn prior to this exam.
  • An infection of the prostate.

*Note: Some medications, such as those used to treat enlarged prostates, can cause PSAs to be artificially lower. Further, men who are overweight or obese may have artificially lower PSAs.

MYTH: Most men with prostate cancer will die from their cancer.

FACT: While prostate can be a serious disease, most men diagnosed with prostate cancer do not die from their disease. Advances in screening, diagnosis and treatment have improved survival.

MYTH: Prostate cancer patients always get chemotherapy or surgery.

FACT: Each man must understand the extent of their disease, risks of treatment and impact on quality of life. Men, who have local and early stage disease, have more treatment choices. Sometimes prostate cancer can be slow-growing, and treatment can cause untoward side effects. “Watchful waiting” is one option of doing nothing unless symptoms appear. “Active surveillance” is another option that includes monitoring PSAs and symptoms, and possibly performing prostate biopsies.

Authors

Bruce W. Porterfield, MD, PhD

Medical Oncologist / Hematologist

For over eighteen years, Dr. Porterfield, who is a board-certified medical oncologist has cared for patients in Green Valley, Arizona. Dr. Porterfield is passionate about empowering his patients with knowledge about their disease and ways they can live life to the fullest. He volunteers his time giving educational presentations to his patients, staff and the community. He and his wife Sherri are frequent speakers on KGVY's "Staying Healthy" radio show. Dr. Porterfield has also written several articles for local publications on a variety of health-related topics.

Sherri Porterfield, RN, MSN

Sherri Porterfield, RN, MSN

Nurse Navigator

Sherri Porterfield, RN, MSN is a Nurse Navigator with Arizona Blood and Cancer Specialists. She has over 25 years of experience educating patients and the community. She volunteers her time, giving presentations to several different groups in the Green Valley and Tucson. Sherri is also developing Arizona Blood and Cancer Specialists' Survivorship program, and has written several articles for local publications.

*Note: Men with prostate cancer are encouraged to gather medical opinions from different types of doctors including medical oncologists, radiation oncologists and urologists so that they are best prepared to make treatment decisions.

MYTH: There is not a connection between a father having prostate cancer and his daughter having breast cancer.

FACT: A man with the BRCA mutation is at higher risk of prostate cancer. If he passes the BRCA mutation to his daughter, she could be at a higher risk for breast and ovarian cancer.

While we pause and give our attention to prostate cancer this month, men and their loved ones need to be proactive all year long. Men need to be attentive to symptoms, regularly see their healthcare provider, and strive to be physically fit.