New Screening Test Improves Detection of Prostate Cancer Using Circulating Tumor Cells and Prostate-Specific Markers

Men's Health Month: Prostate Cancer Q&A With Dr. Dahut

To close out Men's Health Month, the Cancer Connections team sat down with Dr. William Dahut, the American Cancer Society's chief scientific officer, to discuss prostate cancer. Given the recent news surrounding this topic, Dr. Dahut clarified what prostate cancer is, the importance of screening, the symptoms to watch for, new treatment options, and common myths associated with the disease.

Cancer Connections: What is prostate cancer?

Dr. Dahut: Prostate cancer begins when cells in the prostate gland start to grow out of control. The prostate is a gland found only in males. It makes some of the fluid that is part of semen.

Cancer Connections: How common is prostate cancer?

Dr. Dahut: Prostate cancer is one of the most common cancers in men, especially over age 50. Prostate cancer is the second-leading cause of cancer death in American men, behind only lung cancer. About 1 in 8 men will be diagnosed during their lifetime. But each man's risk of prostate cancer can vary based on his age, race/ethnicity, and other factors. For example, prostate cancer is more likely to develop in older men. About 6 in 10 prostate cancers are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age of men when they are first diagnosed is about 67.

Cancer Connections: What are the early signs of prostate cancer?

Dr. Dahut:

Early prostate cancer usually causes no symptoms. While not common, symptoms of early prostate cancer might include:

Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night

Advanced prostate cancer means it has grown larger and has possibly spread to other areas. When prostate cancer is advanced, it can cause problems with urination and blood in the urine or semen, as well as other symptoms, including:

Pain in the hips, back (spine), chest (ribs), or other areas, from cancer that has spread to the bones

Weakness or numbness in the legs or feet, or even loss of bladder or bowel control, from cancer in the spine pressing on the spinal cord

Cancer Connections: If a person doesn't have symptoms, does that mean they don't have prostate cancer?

Dr. Dahut: No, a lack of symptoms does not mean that someone does not have prostate cancer. Many prostate tumors are slow-growing and can develop for many years before they cause symptoms (difficulty urinating, blood in urine or semen, and unexplained weight loss). Some cancers may never cause any symptoms at all in a man's lifetime. Early detection is key, as symptoms often don't appear until the cancer is advanced.

Cancer Connections: Should I be getting screened, and what are the screening options?

Dr. Dahut: The American Cancer Society recommends that men discuss prostate cancer screening benefits and limitations with their doctor, starting at age 50 for White men, age 45 for Black men, and age 40 for men at very high risk. Screening is usually done with a blood test looking to detect elevated levels of PSA (prostate-specific antigen). Elevated PSA levels may lead to imaging with an MRI (magnetic resonance imaging) of the prostate and potentially a prostate biopsy.

Cancer Connections: What increases the risk of prostate cancer, and how can men reduce their risk?

Dr. Dahut: There are no well-established, modifiable risk factors for prostate cancer. Advancing age, African ancestry, and a family history of prostate cancer are all known to increase risk. However, we can all reduce our risk of a cancer diagnosis by not smoking, maintaining a healthy body weight, staying physically active, eating a healthy diet high in fresh fruits and vegetables and whole grains and low in red and processed meat, not drinking alcohol or drinking in moderation, and talking to our doctor about our family cancer history and when to get screened and then getting those screening tests.

Cancer Connections: What is the prognosis for someone diagnosed with prostate cancer today?

Dr. Dahut: The prognosis for someone diagnosed with prostate cancer today is generally very good, especially if the cancer is detected early. Compared to all men, 97% of men diagnosed with prostate cancer survive for at least 5 years after their diagnosis. This number approaches 100% for men diagnosed with early-stage disease; however, it is less than 40% for men diagnosed with late-stage disease. In fact, for men diagnosed with early-stage prostate cancer, less than 1% will die from the disease within 10 years after diagnosis. Metastatic prostate cancer (cancer that has spread from where it started to other parts of the body) is not curable, but the outcome is different from person to person, with many men living between 3 to 5 years after diagnosis.

Cancer Connections: Are there any promising new treatment options for prostate cancer in the research pipeline?

Dr. Dahut: There have been recent advancements in the treatment of advanced stage prostate cancer, such as potent androgen receptor inhibitors, targeted therapies for men with specific mutations such as BRCA2, immune based therapies for a subset of men with prostate cancer precision-based radiation using radioisotopes, and antibody therapy targeted against new biomarkers in prostate cancer.

Cancer Connections: What is one myth about prostate cancer that you would like to clear up?

Dr. Dahut: There are several myths about prostate cancer, including that it only affects older men and that PSA screening is not beneficial. However, data shows that regular PSA screening and treatment can significantly reduce the risk of dying from prostate cancer, especially for aggressive cases. It's essential to avoid treatment until it's clear that the cancer is aggressive, as many men can live with untreated prostate cancer for years without complications. While prostate cancer is more common in older men, we estimate more than 55,000 men under the age of 60 will be diagnosed with prostate cancer in 2025. Another myth is that prostate cancer is not a dangerous disease. Although prostate cancer may not always need treatment and is easily treated early in the disease, approximately 35,000 men will die of prostate cancer in 2025 in the U.S. Finding prostate cancer before it becomes metastatic is crucial in improving the outcome of men with the disease.

Cancer Connections: What resources are available to men facing a prostate cancer diagnosis?

Dr. Dahut: The American Cancer Society has many resources available to men facing a prostate cancer diagnosis, as well as other cancer patients and their families, including patient lodging and transportation, patient navigation support, and caregiver support.

Additional resources from the American Cancer Society: 

ESPN Anchor Jay Harris Talks Screening, Treatment After Prostate Cancer Diagnosis

Your browser is not supportedusatoday.Com

usatoday.Com wants to ensure the best experience for all of our readers, so we built our site to take advantage of the latest technology, making it faster and easier to use.

Unfortunately, your browser is not supported. Please download one of these browsers for the best experience on usatoday.Com

Artificial Intelligence Model Improves Prostate Cancer Detection

Photo Credit: iStock.Com/Mohammed Haneefa Nizamudeen

Diffusion basis spectrum imaging combined with AI enhances diagnostic accuracy for prostate cancer

A study published in the June 2025 issue of Journal of Urology evaluated artificial intelligence models applied to diffusion basis spectrum imaging metrics for predicting clinically significant prostate cancer before biopsy.  

They assessed 241 patients who underwent prostate magnetic resonance imaging with conventional and diffusion basis spectrum imaging sequences before biopsy between February 2020 and March 2024. Artificial intelligence models used DBSI metrics as input classifiers, with biopsy pathology serving as the reference standard. The DBSI-based model was compared to prostate-specific antigen, PSA density [PSAD], and Prostate Imaging Reporting and Data System [PI-RADS] for discriminating clinically significant prostate cancer defined by Gleason score greater than 7.  

The results showed that the diffusion basis spectrum imaging–based model independently predicted clinically significant prostate cancer with an odds ratio of 2.04 (95% CI, 1.52–2.73; P < .01), alongside PSA density (OR 2.02; 95% CI, 1.21–3.35; P = .01) and Prostate Imaging Reporting and Data System classification (OR 4.00 for PI-RADS 3; 95% CI, 1.37–11.6; P = .01; OR 9.67 for PI-RADS 4–5; 95% CI, 2.89–32.7; P < .01), after adjustment for age, family history, and race. The DBSI-based model alone showed similar performance to PSA density plus PI-RADS (AUC 0.863 vs 0.859; P = .89). The combination of the DBSI-based model and PI-RADS achieved the highest discrimination (AUC 0.894; P < .01). Using the DBSI-based model in patients with PI-RADS 1–3 could have reduced biopsies by 27%, missing 2% of clinically significant prostate cancer compared to biopsying all.  

Investigators concluded that the diffusion basis spectrum imaging–based artificial intelligence model accurately predicted clinically significant prostate cancer and, when combined with PI-RADS, could potentially reduce unnecessary prostate biopsies. 

Source: auajournals.Org/doi/10.1097/JU.0000000000004456

---