Prostate cancer is the second most common cancer in men. According to the American Cancer Society, it affects one out of every seven men and is usually diagnosed in later years. The average age at the time of diagnosis is about 66; it is rarely found in men under age 40.
The disease occurs in the prostate, which is a gland near the bladder that makes up part of the male reproductive system. Early forms of prostate cancer usually have no symptoms and can only be detected by a physical exam or blood test.
Recommendations on when to consider screening vary greatly depending on age, ethnicity, family history and other risk factors. The American Cancer Society recommends that men who are expected to live another 10 years and are of average risk for prostate cancer begin talking with their doctors about screening at age 50. Black men and those with a family history should begin these discussions earlier, usually by age 45. For those with more than one first-degree relative who developed prostate cancer at an early age, the recommendation is age 40.
Even when prostate cancer is detected, treatment may not be necessary. Because prostate cancer is usually slow growing, physicians often recommend active surveillance, in which the cancer is watched closely to determine if it is spreading.
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Depending on the stage of the cancer, this may involve a PSA blood test every 3 months and a biopsy every year or two. This approach is usually recommended for older men, who are more likely to die with prostate cancer than from it.
However, in men who have a life expectancy of at least 10 years, treatment may be recommended. This may include radiation and surgery to remove the prostate gland. These treatment options can cause serious side effects, including incontinence, so it is important for patients to weigh their options carefully.
Although early stage prostate cancer usually has no symptoms, men with advanced stages of the disease may begin to have problems emptying their bladders or have a weaker flow of urine. However, these symptoms can also be caused by benign prostate conditions such as BPH, which is characterized by an enlarged prostate.
BPH occurs more frequently in men as they age. According to the National Institutes for Health, the condition affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men older than 80. There are a number of options for treating BPH, including surgery and medication to shrink and relax the prostate.
It is important for men to see their doctor regularly and discuss any concerns or symptoms they may be experiencing. Your primary care provider can be the best advocate for your health and can help determine the best course of action.