Talk with Your Doctor About Prostate Cancer Risk, Detection and Treatment Options

Prostate cancer is the second-most common cancer in men, second only to skin cancer.

The American Cancer Society estimates there will be 174,650 new cases of prostate cancer in the United States this year. The organization estimates about 31,600 men will die from prostate cancer in 2019. That amounts to 1 man in 41 succumbing to the disease.

The odds of contracting prostate cancer are even more sobering, with 1 in 9 men diagnosed with the disease during their lifetime, according to the American Cancer Society.

Prostate cancer develops mainly in African American and older men in general, according to the organization’s website. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66.

Because the risk is higher in older men, the U.S. Department of Health and Human Services does not recommend screening for men under age 55. Men between ages 55 and 69 might want to be screened based on discussions with their doctors.

Screening is not recommended past age 70, the federal agency noted, because the risks outweigh the benefits for most men.

If you fall into the at-risk age group, you should have a discussion with your physician. Here are some of the questions the Department of Health and Human Services recommends you ask your doctor:

  • Am I at higher risk for prostate cancer? In addition to age and race, others in higher-risk categories include men whose father, brother or son have had prostate cancer.
  • Are there things I can do to lower my risk for prostate cancer? The Mayo Clinic recommends adopting a low-fat diet, increasing the amount of fruit and vegetables you eat and cutting down on dairy consumption. Maintaining a healthy weight and exercising on a regular basis also can reduce the risk.
  • What are the risks and benefits of prostate cancer screening and treatment for me? The main types of screening are a digital rectal exam and a prostate-specific antigen test that measures the amount of antigen in the blood.
  • Are there any warning signs or symptoms of prostate cancer I should look out for? Signs include urinary problems; blood in the urine or semen; pain in the hips, pelvis, spine or upper legs; pain or discomfort during ejaculation; and difficulty getting an erection.
  • If the results of the screening test show that I might have prostate cancer, what are my options for diagnosis and treatment? One option is watching and waiting, which involves a prostate-specific antigen (PSA) test every six months. Other options include radiation, chemotherapy or surgery.

Just screening for prostate cancer presents risks, according to the National Cancer Institute. These include:

  • Finding prostate cancer may not improve health or help a man live longer.
  • Treatments for prostate cancer, such as radical prostatectomy and radiation therapy, may have long-term side effects in many men, including erectile dysfunction and urinary incontinence.
  • Some studies of patients after diagnosis show a higher risk of death from cardiovascular disease or suicide.
  • Complications from a biopsy of the prostate may include fever, pain, blood in the urine or semen, and urinary tract infection.
  • Tests are not always reliable, as some men may test negative when they actually have cancer, and others may get positive results where no cancer exists.

If time permits, the American Cancer Society recommends seeking a second opinion, which can give you more information and help you feel more confident about the treatment plan you choose.

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