Not only is prostate cancer the second most common type of cancer in males in the U.S. across all races and ethnicities, right behind skin cancer, it is also the type of cancer that has the highest number of new cases per year. But while the number of new cases has been rising, the number of deaths by prostate cancer has been decreasing in recent years. What causes this dissonance? In this article, we separate the facts from the fiction, and share everything you need to know about prostate cancer.
What is a prostate?
The prostate is a rubbery walnut-sized gland in males located underneath the bladder and in front of the rectum. It produces the seminal fluid that helps carry and sustain the sperm. Therefore, it plays a key role in fertility and reproduction. As males get older, the prostate tends to get bigger, exposing males to three different health conditions: Benign Prostatic Hyperplasia (BPH), Prostatitis, and Prostate Cancer.
Approximately half of males over 50 will experience prostate enlargement, or BPH, a condition in which the prostate grows to a point at which it tampers with the ability to pass urine and ejaculate. The urethra, the tube that carries urine and semen in males, goes through the prostate. When the gland swells, it presses against the urethra, making it more difficult for the urine and semen to pass through. This is a very common, non-cancerous, and not life threatening condition. Treatment usually includes lifestyle changes and medication.
When a prostate problem involves inflammation – often caused by bacteria – it is called prostatitis. Prostatitis can affect males of any age and is usually quite painful, although is it possible to have the condition without experiencing symptoms at all. Similar to BPH, this condition is very common. But it differs in that it affects males younger than 50. It is, in fact, the most common urinary tract problem for males under the age of 50. Depending on the type of prostatitis, the condition is treated with antibiotics and lifestyle changes such as reducing alcohol intake.
The last and most severe type of prostate condition is cancer. Prostate cancer accounts for 14% of all new cases of cancer in the U.S., making it one of the most common types of cancer in the country. It is sex-specific and occurs only in biological males. Symptoms include irregular, frequent, and weak urination, blood in the urine or semen, difficulty starting urination and emptying the bladder, and painful ejaculation. It is important to note that in its early stages, prostate cancer doesn’t cause symptoms.
The three main risk factors are:
- Age: The condition is rare in males under 40; about 60% of cases are diagnosed in patients who are at least 65-years-old. The median age at diagnosis is 67.
- Race: Prostate cancer can affect any biological male, regardless of gender or race, but it is significantly more common among non-Hispanic Black males.
- Family history: Males with a first degree relative who have had prostate cancer are at higher risk of getting the disease.
Besides these factors, there might also be a link between prostate cancer and different lifestyle decisions. Over the years, arguments have been made regarding a connection between prostate cancer and weight loss, dairy consumption, obesity, smoking, exposure to chemicals, prostatitis, sexually transmitted infections, and getting a vasectomy. It is important to state that the exact role of these factors isn’t clear, and that there is no conclusive evidence tying these to prostate cancer. Still, we would highly recommend you hold back on the cigarettes, maintain a healthy routine, and stay away from dangerous chemicals.
What is causing the increase in new cases of prostate cancer?
- Live long and prostate: As mentioned before, prostate cancer is most prominent after the age of 65. Life expectancy in the U.S. rose from 70.5 years in 1969 to 78.8 in 2019. This wonderful trend has a negative side effect of making problems that are associated with old age more prevalent.
- People get tested more: Whereas men have always tended to shy away from seeking treatment, they are now seeing doctors in higher numbers than ever. This is especially true when it comes to erectile dysfunction or urinary problems, which can cause significant discomfort and can sometimes be linked to prostate cancer.
What is causing the decrease in death rates of prostate cancer?
Prostate cancer usually doesn’t cause symptoms in early stages, so the willingness of people to get tested, especially after celebrating their 50th birthday, is key in battling the disease. Like any type of cancer, prostate cancer has stages. Cancerous cells usually develop within the prostate, and make their way to the prostate’s outer lining. In some cases, prostate cancer will stay there and won’t affect the life of its carrier at all. The concern, though, is that the cells will grow out of control and spread out to other organs and different parts of the body. When diagnosed early, some types of tumor don’t even call for treatment. If fact, thanks to modern medicine, most men diagnosed with prostate cancer do not die from it.
The way to detect cancer before symptoms appear is through screening. There are two types of screening for prostate cancer: A Prostate-Specific Antigen test (PSA test) and a Digital Rectal Examination (DRE). PSA is a protein made by the prostate. Many things, including enlarged prostates, can cause a spike in PSA levels, therefore it is not proof of cancer. It does point at a problem that needs further examination. DRE is a rectal exam, in which a medical professional feels the prostate for any abnormalities, such as lumps.
If the initial PSA test results come back high, getting a prostate biopsy might be the best option. Biopsy is the only way to definitively tell is a person has prostate cancer. If you are male and 50 or over, or 40 and at higher risk, we suggest you consult with a doctor about screening options. Antidote’s certified primary care clinicians are here to guide you through the process, through the app at your convenience, no insurance needed.