Dr. Yaw Nyame
Dr. Yaw Nyame

Prostate cancer is the second most common cancer in men in the United States. According to  data from the American Cancer Society, there are more than 3 million men who have had a prostate cancer diagnosis living in the United States today. More than 190,000 new cases will be diagnosed, and more than 33,000 American men will die from prostate cancer this year. 

Prostate cancer is a serious disease, but if it is detected early, it is highly treatable.

This is why it is important for men to understand their risks for prostate cancer, know the signs and symptoms of the disease, and consider regular screenings if in good health. 

Understanding Your Risks

Knowing your prostate cancer risk will help inform conversations with your doctor and may impact recommendations on when you should receive screenings and what types of screenings you may want to consider. Key risk factors outlined by the American Cancer Society  include:

Age:  Prostate cancer risk is low in men under 40, but begins to rise significantly after age 50. Approximately 60 percent of prostate cancer cases are men older than 65.

Race/Ethnicity:  Prostate cancer is more common among Black men and tends to occur in Black men at a younger age compared to men of other races/ethnicities.

Geography:  Prostate cancer is more likely to be found among men living in North America, northwestern Europe, Australia and on Caribbean islands compared to those living in Asia, Africa, Central America and South America. Factors such as more intensive screening for prostate cancer are believed to account for part of this difference, but environmental and lifestyle differences such as diet and activity are likely to play a role as well.

Family history:  While most prostate cancers occur in men without a family history of the disease, research has found that having a father or brother with prostate cancer more than doubles a man’s risk of developing it. This risk is even higher if a man has several relatives who have had prostate cancer.

Genes:  Prostate cancer has been linked to  several gene mutations, and it is estimated that these play a role in about 10 percent of prostate cancers.

Signs and Symptoms

In its early stages, prostate cancer has few signs or symptoms, so regular screenings are vital. Once the disease has reached more advance stages, it is  associated with symptoms including:

Problems urinating and the need to urinate more often;

Blood in the urine or semen;

Sexual dysfunction;

Pain in the hips, back or chest, which can be a sign that the cancer that has spread to bones; and

Weakness or numbness in the legs or feet, or loss of bladder or bowel control, which can be caused by cancer pressing on the spinal cord.

Screenings

The most common prostate cancer screening test is a prostate-specific antigen test which has resulted in early diagnosis in about 80 percent of men with the disease. The test measures the amount of PSA, a protein produced by tissue in the prostate, in your blood.

PSA testing has been associated in a percent reduction in dying from prostate cancer among men who undergo routine testing. Screening however can be associated with harms which include detecting  indolent cancers.

The American Urological Association  recommends  beginning PSA testing for men at high risk for prostate cancer, including men with a family history, as early as age 40. For those with normal risk, the Association recommends beginning regular screening at age 55.

Genetic testing also may be appropriate for certain men — particularly those who have strong family histories of prostate, breast, ovarian and colorectal cancers.

I encourage all men to talk to their physician about their prostate cancer risks and recommended screening options. This vital step may mean the difference between early detection and advanced disease for some men and can save lives.   

For more information about prostate cancer, visit https://www.seattlecca.org/diseases/prostate-cancer/prostate-cancer-facts.

Dr. Yaw Nyame  is a physician at Seattle Cancer Care Alliance who specializes in diagnosis and treatment of prostate cancer, kidney cancer and other urologic cancers.