Prostate cancer prevalence explained
What To Know About Prostate Cancer Following Francis Collins' Diagnosis
When Francis S. Collins first learned that his prostate-specific antigen levels were rising, he wasn't particularly worried. A slow rise in PSA levels, which can indicate the presence of prostate cancer, is common in men older than 65, and most never develop severe disease.
However, when the former director of the National Institutes of Health underwent an MRI about a month ago, the scan revealed an enlarged tumor. By then, his PSA levels had also spiked, and he knew his diagnosis had drastically changed.
Now, the 73-year-old scientist has announced that he will have to undergo a radical prostatectomy, a surgical procedure that removes the prostate gland.
In a personal essay for The Washington Post, Collins details his journey to a prostate cancer diagnosis and his decision to go public with the news. He emphasizes the importance of early detection and clinical trials, and he highlights the pervasive health inequities in screening and treatments, including among Black men, who have a higher risk of getting the disease and dying from it.
By sharing his story, Collins expressed his desire to "lift the veil and share lifesaving information."
Here's what you need to know about prostate cancer, from early symptoms to treatment options.
What is prostate cancer?
Prostate cancer is a type of cancer that occurs in the prostate gland, which is a small gland that produces the seminal fluid that nourishes and transports sperm. It is one of the most common types of cancer among men, especially older men. It usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm.
However, some types of prostate cancer can be aggressive and spread quickly to other parts of the body, including the bones. PSA testing in combination with a physical exam are the best way to catch early aggressive prostate cancer. Symptoms can include pain or difficulty urinating, more frequent urination, and blood in urine or semen. But by the time symptoms show, the cancer has usually progressed to a more advanced stage that can be harder to treat.
How common is prostate cancer?
In 2020, prostate cancer was the second-most commonly diagnosed cancer and the fifth-leading cause of cancer-related deaths in the U.S., according to the National Cancer Institute. According to 2020 data published in the journal Frontiers in Public Health, there were approximately 1,414,000 new cases globally, and 375,304 deaths. It is the most frequently diagnosed cancer in 112 countries and the leading cause of cancer death in 48 of those countries.
Black men tend to be diagnosed at a more advanced stage of the disease and have a higher mortality rate. Men with BRCA1 and BRCA2 tumor suppressor genes also have an increased risk of developing more aggressive prostate cancer. A 2023 study published in the journal Nature found that carriers of BRCA2 mutations had a greater likelihood to be diagnosed with aggressive prostate cancer at a younger age compared with non-carriers.
How is prostate cancer treated?
Prostate cancer can be treated with a range of approaches including active surveillance, surgery that may involve removing the prostate, radiation therapy, hormone therapy, chemotherapy, immunotherapy and targeted therapies. Treatment selection is based on factors such as cancer stage, aggressiveness, patient health and preferences.
It is considered a treatable disease if caught early; 99% of men with the cancer will live for at least five years after their diagnosis if it has not spread beyond the prostate, according to the Cleveland Clinic.
What are some complications associated with prostate cancer?
Prostate cancer can lead to various complications that can affect a person's quality of life, including erectile dysfunction, urinary incontinence, bowel problems, infertility, fatigue and bone health issues.
When should men be screened for prostate cancer?
The U.S. Preventive Services Task Force recommends screening between ages 55 to 69. Men with a family history of prostate cancer, especially if a father or brother had it, have an increased risk of developing the disease, and they may need to be screened at an earlier age, around 50 years old.
Screenings are usually stopped after 70 for many reasons, one being that the risks of diagnosing slow-growing cancer may cause undue mental stress when the disease may not pose a significant threat to the person's health. Another reason is that PSA tests can sometimes lead to false positives, and patients may be overdiagnosed with indolent cancer.
However, the American Cancer Society said it is currently revising prostate cancer guidelines, which includes the age for stopping screenings.
Karen Knudsen, CEO of the American Cancer Society and a prostate cancer researcher, said the initiative was started two years ago. She added that the updated guidelines reflect the aging population, prompting a reevaluation of the current cancer guidelines to emphasize early detection since this cancer is readily treatable.
"As the population ages, the window of time that someone will develop prostate cancer expands," Knudsen said.
Does prostate cancer affect sexual function?
Prostate cancer and its treatments can have significant effects on sexual function in men. Various issues can arise depending on the cancer stage and the type of treatment received. One common effect is erectile dysfunction because surgery, radiation therapy, hormone therapy and other treatments can damage nerves and blood vessels essential for achieving and maintaining an erection.
Additionally, some treatments may reduce libido or sexual desire. Changes in ejaculation and fertility issues can also be experienced due to prostate cancer treatments.
Rena Malik, a urologist based in Southern California, says that many men tend to have erectile dysfunction before they have prostate cancer surgery, and the procedure exacerbates the problem. But that doesn't mean sexual function "is destroyed," she said.
"There are lots of protocols for men to try to preserve erectile function, like putting them on medications or using vacuum erection devices very soon after surgery to try to preserve sexual function," said Malik. "But ultimately, erectile dysfunction is something that is a risk of surgery."
O.J. Simpson's Death Prompts 4,500% Spike In Web Searches For Prostate Cancer, And More Questions People Are Asking This Week
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.
What are Canadians searching for online? This week's most popular health-related questions, answered. (Images via Getty Images)
Every day, Canadians turn to the internet for answers to their biggest health-related questions. Whether we're avoiding a trip to the doctor or simply curious to learn more about the latest headlines, there's nothing off-limits when it comes to web searches.
When news broke that former NFL star O.J. Simpson had died from cancer, web searches to learn more about his cause of death spiked by 4,900 per cent.
What kind of cancer did O.J. Simpson have?O.J. Simpson died on April 10th from prostate cancer. (Image via Getty Images)
On Thursday, Simpson's family released a statement to X (formerly Twitter) announcing his death: "On April 10th, our father, Orenthal Simpson, succumbed to his battle with cancer. He was surrounded by his children and grandchildren. During this time of transition, his family asks that you please respect their wishes for privacy and grace."
The 76-year-old, who was acquitted of criminal charges for the murder of his wife, Nicole Brown Simpson, and Ron Goldsmith but found liable in a separate civil trial, kept his cancer diagnosis private. In Februray, a local Las Vegas news outlet reported that Simpson was receiving treatment for prostate cancer.
According to the Prostate Cancer Foundation of Canada, prostate cancer is the most diagnosed cancer for men in Canada. Approximately 1 in 8 men will be diagnosed with prostate cancer in their lifetime, with an estimated 24,400 new cases diagnosed each year.
The prostate gland is located just below the bladder and surrounds the urethra; it produces fluid that along with sperm makes up semen. When detected early, prostate cancer Symptoms of prostate cancer may include painful urination, blood in the urine or semen, painful ejaculation, frequent urge to urinate (especially at night), weakened stream of urine and pain in the hips, pelvis or back. Weight loss, kidney problems and bone pain could also be signs that cancer has spread or advanced.
One in 29 men are expected to die from prostate cancer, however when detected early, prostate cancer can be treated and in some cases, eliminated. Unlike other forms of cancer, prostate cancers are usually slow growing; cells can begin changing up to 30 years before tumours become large enough to cause symptoms. By the time symptoms appear the cancer may have spread. Regular prostate screenings (usually every two to three years) can also help detect cancer before symptoms appear. Visit your doctor if you experience any symptoms or have concerns about prostate health.
What are the signs of eye damage from the solar eclipse?The April 8th solar eclipse caused many Canadians to search for signs of eye damange. (Photo by Lev Radin/Pacific Press/LightRocket via Getty Images)
After this week's phenomenal solar eclipse, there was a 3,500 per cent uptick in web searches for signs of eye damage.
According to the Canadian Opthalmological Society, solar retinopathy (or eclipse retinopathy) is a "photochemical injury to the macular tissue" that can be caused by even just a few seconds of looking at the sun.
Symptoms of solar retinopathy include blurred vision, eye pain and vision loss in the centre of your eyesight and requires immediate medical attention from an eye care professional.
While there is no treatment for solar retinopathy, most people improve within three to six months. However, there must be regular visits to an eye care professional to monitor vision loss. In some cases, vision loss or distortions will be permanent.
What are the signs of appendiceal cancer?"The Cleaning Lady" star Adan Canto died from appendiceal cancer in January. (Photo by FOX via Getty Images)
This week, there was a 450 per cent increase in web searches for both appendiceal cancer and actor Adan Canto.
Although Canto died in January, his character made its final appearance on this week's episode of the series "The Cleaning Lady." The 42-year-old's character was killed in a storyline that according to showrunners was "carefully thought out and discussed" so that the cast and crew could pay tribute to Canto while allowing "other characters to process his absence."
The episode prompted inquiries into Canto's cause of death, which was due to cancer of the appendix or as it's also called, appendiceal cancer. According to BC Cancer, cancer of the appendix accounts for "less than 1 per cent of all colorectal tumours, or less than 1000 cancers a year across Canada."
Appendiceal cancer is difficult to detect and there are currently no screening tests available. While some people may experience abdominal or pelvic pain, bloating or fluid in the abdomen. Appendiceal cancer often goes undetected until it spreads to other areas of the body or causes appendicitis that will prompt medical intervention.
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'I'm A Urologist Who's Been Studying Prostate Health For More Than 25 Years—Here Are The 5 Things I Tell Men With An Enlarged Prostate To Do'
Man with an enlarged prostate talking to his urologist
An estimated 70% of men in their 60s have an enlarged prostate. It's something extremely common to experience as men age and is typically not a cause for concern. However, if it isn't appropriately monitored, there can be complications. That's why it's important to know all the facts about what having an enlarged prostate means.
Related: The #1 Early Sign of Prostate Cancer Most People Miss, According to an Oncologist and Urologist
What Does It Mean to Have an Enlarged Prostate?"The prostate is located beneath the bladder and surrounds the urethra, which is a tube-like structure that aids in transporting urine from the bladder to the tip of the penis. Having an enlarged prostate does not necessarily indicate that you will experience symptoms. However, symptoms can range from mild to severe and frequently have a negative impact on quality of life," explains Dr. Vipul Patel, MD, a urologist and the Medical Director of the oncology program at the AdventHealth Cancer Center and of the Global Robotics Institute.
For those who do experience symptoms, Dr. Patel says they can include:
Difficulty starting urination
A feeling of incomplete emptying of the bladder
Frequent urination, especially at night
Urinary urgency and hesitation
Urinary retention (inability to pass urine)
Dr. Patel emphasizes that, in general, an enlarged prostate is not life-threatening. However, he says that complications can arise, such as getting urinary tract infections, experiencing acute urinary retention (when the bladder becomes obstructed, making it impossible to pass urine), getting bladder stones and kidney damage. To avoid any of this from happening, there are five key pieces of advice he wants all men with an enlarged prostate to know.
Related: The #1 Habit That Could Be Harming Your Bladder Health
5 Things Men With an Enlarged Prostate Need to Know, According to a Urologist 1. Get evaluated by your doctorIf you have an enlarged prostate, Dr. Patel says that communicating with your doctor is key. "Maintaining open communication with your health care provider and seeking support from family members or support groups can be valuable for managing the physical and emotional aspects of living with an enlarged prostate. Don't be afraid or shy in case you feel that the condition is a challenge for you and ask for assistance or advice," he explains.
Additionally, Dr. Patel recommends having an initial evaluation. "This evaluation typically involves a medical history, physical examination and laboratory test such as a urine analysis. You should be proactive about scheduling routine check-ups and follow your doctor's recommendations for ongoing management and care," he says. This is key for preventing any of the complications that can come from having an enlarged prostate.
2. Consider a prostate cancer screeningWhile you're at your doctor's appointment, Dr. Patel recommends talking to your doctor about whether a prostate cancer screening is appropriate for you. "Currently the American Urological Association recommends offering a baseline prostate screening test to people between ages 45 to 50 years, and possibly earlier for men at increased risk of developing prostate cancer based on the following factors: Black ancestry and strong family history of prostate cancer," he says.
Related: 4 Workouts That Will Benefit Anyone With Bladder Issues, from Dead Bugs to Pilates
3. Maintain a healthy lifestyleMaintaining a healthy lifestyle is important for everyone, and men with an enlarged prostate are no exception because it will support their urinary health. Dr. Patel says that this includes eating a balanced diet and getting enough fiber, staying hydrated by drinking plenty of water, avoiding excessive caffeine and alcohol consumption, exercising regularly and managing stress levels.
4. Know your treatment options"There are various management options available for managing symptoms of [an enlarged prostate], ranging from lifestyle modifications to medication, minimally invasive procedures and surgery," Dr. Patel says.
He emphasizes that it's always best to discuss your symptoms, preferences and treatment goals with your health care provider to determine the most suitable approach for your individual needs.
5. Check with your doctor before taking any medications or supplementsMany people don't think twice about taking a daily multivitamin or other supplements, but if you have an enlarged prostate, Dr. Patel says it's best to get the all-clear from your doctor before taking prescription medication, over-the-counter drugs or supplements.
"Men who have an enlarged prostate should be mindful of how certain medicines, supplements and 'natural products' could affect their urinary problems. You can always talk to your doctor about both prescription and over-the-counter medications that you are using, because some of them might be aggravating the situation. Your doctor may adjust the dose or time when taking these medications or recommend other drugs with fewer side effects in terms of urinary function," he explains.
It bears repeating that most men will experience an enlarged prostate as they get older. Keeping these five tips in mind will ensure no complications occur. And remember, if you have any questions or concerns at all, talk to your doctor—that's what they're there for!
Next up, check out this list of 10 foods that support bladder health.
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