Despite affecting 1 in 8 men during their lifetime, prostate cancer is surrounded by myths and misconceptions.
Common misunderstandings — such as “no symptoms mean no cancer” or “only old men get prostate cancer” — can discourage men from getting screened. In some instances, they can even delay a lifesaving diagnosis.
“Among the misconceptions I frequently hear are variations of the idea that prostate cancer always needs to be treated — or that it never needs to be treated,” says Dr. Croix Fossum, board-certified radiation oncologist at Sharp Grossmont Hospital.
According to Dr. Fossum, the truth is more nuanced. “Prostate cancer exists on a spectrum,” he says. “Many cancers are slow-growing and never need treatment. Others are highly aggressive and require multidisciplinary treatment from a team of urologists, radiation oncologists and medical oncologists.”
With appropriate screening and work-up, Dr. Fossum continues, physicians can collect valuable information to determine the next steps regarding management.
Why screenings are essential
The main goal of screening is to detect aggressive cancers early before they spread. Prostate cancer often shows no symptoms until it is fairly advanced, so screening is usually the only way to catch the disease in its early stages.
Screening guidelines vary. In general, Dr. Fossum advises most men to consider initiating screening at 50. African American men and those with a family history of prostate cancer should consider screening earlier, as they are at higher risk for developing more aggressive forms of the disease.
The most common screening methods include a prostate-specific antigen (PSA) blood test, digital rectal exam and magnetic resonance imaging (MRI) of the prostate. If there’s an abnormal finding, a prostate biopsy can be the next step.
To further set the record straight, we asked Dr. Fossum to debunk some of the most common myths about prostate cancer.
Myth: I don’t have any symptoms, so I don’t need to get screened.
Fact: Early-stage (localized) prostate cancers rarely cause symptoms. Urinary or sexual symptoms usually do not occur until the cancer is more advanced. Once the cancer has metastasized, patients can experience bone pain. At that stage, the disease is generally considered incurable, underscoring the importance of screening.
Myth: Only older men get prostate cancer.
Fact: While it’s true that age is the primary risk factor for prostate cancer, approximately 40% of cases are diagnosed in men under 65. Family history and certain genetic mutations can increase your risk of being diagnosed at a young age, which is why some men may benefit from screening earlier.
Myth: Eating certain foods or taking supplements will prevent prostate cancer.
Fact: There are no magic foods or supplements that guarantee prevention. A healthy diet and lifestyle may reduce the risk for prostate cancer but won’t prevent the disease entirely.
Myth: A high PSA test means you have prostate cancer.
Fact: PSA levels rise for many reasons, including benign prostatic hyperplasia (enlarged prostate), prostatitis (inflammation), recent ejaculation or even bike riding. Elevated PSA may prompt further evaluation, but is not, by itself, a diagnosis of cancer.
Myth: If I’m diagnosed with prostate cancer, treatment needs to start immediately.
Fact: Not all prostate cancers are life-threatening. Some are slow-growing, and many men with low-risk disease can safely choose regular monitoring with PSA, MRI and biopsy, known as active surveillance, instead of immediate surgery or radiation. This approach helps avoid side effects without compromising survival outcomes.
Myth: Prostate cancer treatment always results in unpleasant urinary and sexual side effects.
Fact: Not necessarily. While all treatments carry some risk, advances in treatment, including nerve-sparing prostatectomy and targeted radiation therapy, have significantly reduced the likelihood of long-term complications. Outcomes vary depending on a man’s age, overall health and how advanced the cancer is at diagnosis — but retaining sexual and urinary function after treatment is certainly possible.
Myth: A prostate cancer diagnosis is a death sentence.
Fact: Most men diagnosed with prostate cancer — especially when detected early — do not die from it. In fact, prostate cancer has one of the highest survival rates; more than 95% of men diagnosed with localized disease live at least 10 years after diagnosis.
Dr. Fossum also points out that there have been promising new advancements in recent years. “Tests looking at tumor genetics and molecular imaging studies, like PSMA PET-CT, aid in the selection of appropriate patients for treatment and allow us to fine-tune radiation plans to improve chances for a cure while reducing side effects.”
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