What you need to know about prostate cancer

This year, an estimated 248,530 men in the United States will be diagnosed with prostate cancer. Geoffrey Neuner, M.D., Radiation Oncologist and Vice Chair of Radiation Oncology for the Sandra and Malcolm Berman Cancer Institute at GBMC, says many of these men share a common risk factor: chance.

“In general, the most important part of developing prostate cancer is bad luck. While family history/genetic predisposition, age, diets high in animal fats, and smoking can play some role in developing prostate cancer, most risk comes from several factors combining in an unlucky way,” he said.

These unpredictable combinations in any individual man is one of the reasons screening for prostate cancer is so important. The American Cancer Society recommends men talk with their primary care doctor about screening around the age of 50 (for those with no first-degree relatives diagnosed with prostate cancer), and earlier if they are considered “high risk.” Dr. Neuner said having the conversation and knowing your options are both important because screening for prostate cancer is an evolving science.

“It’s a very nuanced conversation that takes a patient’s personal history, lifestyle, life expectancy, comorbidities, and other factors into account,” he said.

According to Dr. Neuner, when prostate cancer is found during a screening, treatment isn’t always the first course of action.

“The natural history of those cancers, especially low grade cancers, is they grow slowly and don’t tend to spread quickly,” he said. “We don’t necessarily treat the cancer as soon as we find it. Most men with low-risk cancers are placed in a program called active surveillance without treatment.”

Active surveillance usually consists of regular blood tests and annual exams to ensure the cancer isn’t becoming more aggressive. If treatment is deemed necessary, it can consist of surgery or radiation treatments, including external beam radiation therapy (EBRT), which treats the prostate with beams of radiation focused on the prostate gland emitted from a machine outside the body, and/or brachytherapy, during which small radioactive capsules or “seeds” are placed inside the prostate periphery.

In most cases, prostate cancer grows very slowly, so men typically have no symptoms for years after the cancer forms. For that reason, Dr. Neuner warns prostate screenings should not be ignored.

“Catching it sooner does make a difference,” Dr. Neuner says, “A conversation with your doctor about screenings can help stay on top of a diagnosis with as little impact on your life as possible.”