The incidence of cancer, particularly among young individuals, is on the upsurge, with an anticipated 2 million new cancer cases expected in the United States by 2024. A significant portion of these diagnoses comprises prostate cancer cases, which is one of the most prevalent cancers affecting men in the United States. In fact, prostate cancer accounted for approximately 29% of cancer cases diagnosed among men in 2023 and 11% of cancer-related deaths. Regrettably, it is also recognized as the second leading cancer among men.
The screening for prostate cancer can be conducted through two main methods: a rectal exam, where a physician physically examines the gland for any abnormalities, or through a blood test known as PSA (prostate-specific antigen) testing. However, despite the availability of these screening methods, a significant barrier lies in convincing men to undergo these screenings. According to Susan Mello, an associate professor of communication studies specializing in health communications, the discomfort and embarrassment associated with these screenings often deter individuals from seeking preventive measures.
A critical aspect that influences prostate cancer screening is health literacy. Many individuals lack an understanding of what they should be screened for or when they should undergo testing. Factors such as age, family history, and race play a crucial role in determining the risk of developing prostate cancer. For instance, Black men face a higher risk of prostate cancer compared to men of other races, with one in six Black men being diagnosed in their lifetime. The American Cancer Society recommends that men at an average risk begin screening at the age of 50, while Black men and those with a family history should start screening earlier, at ages 45 and 40, respectively.
Prostate cancer boasts a strong five-year survival rate, primarily due to advancements in treatment methods. The conventional approach to treating prostate cancer involves surgical removal of the gland, radiation therapy, or chemotherapy. According to Asieh Golozar, the director of clinical research at Northeastern’s Observational Health Data Sciences and Informatics Center, doctors may opt for a combination of therapies to eliminate tumors and prevent the spread of cancer to surrounding organs. Hormonal therapy also serves as an additional treatment option.
Early detection of prostate cancer through PSA testing offers the advantage of prompt intervention. However, this can present challenges in deciding the appropriate course of treatment, particularly for patients diagnosed in the early stages of the disease. The dilemma lies in the potential overdiagnosis of patients who may not experience symptoms or require immediate treatment. Furthermore, treatment methods such as surgery and radiation therapy can have adverse effects on sexual function and urinary continence, impacting the quality of life for patients.
The symptomatology of prostate cancer varies, ranging from urinary issues to bone pain and erectile dysfunction. For individuals with advanced-stage disease, treatment is often beneficial, whereas active surveillance may be suitable for young or elderly patients in poor health. The concept of active surveillance involves closely monitoring the prostate and instituting treatment only if the cancer progresses to a dangerous stage. This tailored approach to care aims to balance the risks and benefits of treatment while ensuring optimal outcomes for patients.