Prostate Cancer myths debunked

Prostate cancer is among the most common types of cancer in men. When discussing prostate cancer risk and treatments with concerned patients, the following common myths are worth correcting.

Myth 1: Prostate cancer always has symptoms.

Prostate cancer can have symptoms such as frequent urination, trouble urinating, pain during ejaculation, pain in the lower back and pelvis, etc. However, this is not true in all cases, and in some cases lack of symptoms may actually mean later-stage prostate cancer. In its earliest stages, prostate cancer is often asymptomatic. Catching it in time is not just about noticing symptoms early but also screening before potential symptoms even appear.

Myth 2: Prostate cancer only develops in elderly men.

While older men are at increased risk for prostate cancer, younger men can also be affected. The US Preventive Services Task Force (USPSTF) published a recommendation in 2018 that the choice for prostate-specific antigen (PSA) screening in men between 55 and 69 years old should be an individual one discussed with a physician.² Patients may be interested in getting screened at an even younger age if they have a family history of prostate cancer, particularly if that history also involves a younger age at diagnosis.

Myth 3: Prostate cancer will always cause erectile dysfunction.

Patients may fear the effects of prostate cancer and treatment, as there is potential for both erectile dysfunction and urinary incontinence. Prostatectomy and radiation therapy do come with the risk of erectile dysfunction. The likelihood of patients with post-treatment erectile dysfunction recovering their abilities often depends on the type of treatment; according to the Prostate Cancer Foundation, most men who undergo nerve-sparing treatment can improve significantly after one year.³ Treatment option, including prescription drugs, are available for those for whom erectile dysfunction persists.

Myth 4: Prostate cancer is only a concern if you have family history.

Family history does put patients at heightened risk of prostate cancer, but it is hardly the only risk factor. The National Cancer Institute also includes race (Black populations are at higher risk of prostate cancer than races), dietary fat, vitamin intake, and prostatitis as risk factors in prostate cancer development.⁴

Myth 5: An enlarged prostate is always the result of cancer.

Patients may be concerned if their prostates have become enlarged. This is a common occurrence when men get older, though. Benign prostatic hyperplasia (BPH) can be frightening for patients as its early symptoms may mimic prostate cancer. Per the US National Library of Medicine, though, BPH has not been linked to an increase in cancer risk.⁵

Myth 6: PSA tests are used exclusively to diagnose prostate cancer.

The PSA test is designed to see if further testing is required; it is not by itself a cancer screening service. If a man’s PSA level is elevated, further testing could be required (though prostate cancer is still possible without elevated PSA levels). A prostate biopsy will confirm whether or not the increased levels are due to prostate cancer.

Myth 7: Prostate cancer always requires immediate treatment.

Patients may be surprised to learn that prostate cancer, if caught early enough, may not require treatment immediately. If a patient diagnosed with prostate cancer is not showing any symptoms and the cancer has not spread, their treatment may begin with watchful waiting or active surveillance. The difference between the two is that watchful waiting requires monitoring without treating until symptoms appear, while active surveillance is more aggressive and involves more frequent testing.⁶ In the case of active surveillance, treatment would not begin until test results change and the cancer was growing.

References

1. Key statistics for prostate cancer. American Cancer Society website. https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html. Updated January 12, 2021. Accessed January 29, 2021.
2. Recommendation: prostate cancer: screening. US Preventive Services Task Force website. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening. Reviewed May 8, 2018. Accessed January 29, 2021.
3. Can prostate cancer cause erectile dysfunction? Prostate Cancer Foundation website. https://www.pcf.org/about-prostate-cancer/prostate-cancer-side-effects/erectile-dysfunction/. Accessed January 29, 2021.
4. Prostate cancer prevention (PDQ®) – health professional version. National Cancer Institute website. https://www.cancer.gov/types/prostate/hp/prostate-prevention-pdq. Updated March 27, 2020. Accessed January 29, 2021.
5. Enlarged prostate (BPH). MedlinePlus website. https://medlineplus.gov/enlargedprostatebph.html. Updated July 22, 2020. Accessed January 29, 2021.
6. Prostate cancer treatment (PDQ®) – patient version. National Cancer Institute website. https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq. Updated October 9, 2020. Accessed January 29, 2021.