By Ryan Dorin, M.D., FACS, Chief of Urology, Saint Francis Hospital
Prostate cancer is one of the most common types of cancer affecting men, with the American Cancer Society estimating that nearly 300,000 new cases will be diagnosed in the United States this year alone. While many men diagnosed with prostate cancer live long and healthy lives, the disease can also pose serious health risks—especially if it is not caught early or if it occurs in high-risk groups. Here, we aim to help prospective patients better understand how to reduce their risk, the importance of screening and early detection, the disparities affecting minority populations, and the latest treatment options available.
What is Prostate Cancer?
Prostate cancer is a disease in which cells in the prostate—a small gland near the bladder and penis that produces semen fluid—begin to grow uncontrollably. It often grows slowly and may remain confined to the prostate, where it might not cause serious harm. However, some types are more aggressive and can spread quickly.
Prevention: Steps to Lower Your Risk
While there is no guaranteed way to prevent prostate cancer, certain lifestyle changes can help reduce your risk, including:
- Eat a Healthy Diet: Eating a diet rich in fruits, vegetables, and whole grains, while avoiding red and processed meats, may help support prostate health. Some studies suggest that foods high in lycopene (such as tomatoes) and antioxidants may be particularly beneficial.
- Get Regular Exercise: Staying physically active not only improves overall health but may also lower the risk of prostate cancer.
- Maintain a Healthy Weight: Obesity has been linked to an increased risk of aggressive prostate cancer. Maintaining a healthy weight through diet and exercise is key.
- Avoid Smoking and Limit Alcohol: These steps are essential for cancer prevention in general, including prostate cancer.
While these strategies can reduce risk, they do not eliminate it—especially for men with genetic predispositions or other high-risk factors. That’s where screening becomes crucial.
The Importance of Screening and Early Detection
Prostate cancer often causes no symptoms in its early stages, making screening a vital tool. Screening – testing performed when there are no symptoms to look for cancer before it can grow and spread – is important to identify the disease before it becomes more advanced.
Who Should Be Screened?
The American Urological Association and other health organizations generally recommend that men have a discussion with their healthcare provider about screening starting at age:
- 50 for men at average risk
- 45 for African American men and men with a family history of prostate cancer
- 40 for those at even higher risk (e.g., multiple family members with prostate cancer)
Screening typically involves a simple blood test called prostate-specific antigen (PSA). If PSA levels are elevated, further testing such as an MRI or biopsy may be recommended.
Why Early Detection Matters
Catching prostate cancer early—before it has spread beyond the prostate—can dramatically improve outcomes. In fact, the 5-year survival rate for localized prostate cancer is nearly 100%. However, if the cancer has spread to distant parts of the body, that number drops significantly.
Health Disparities: Prostate Cancer and the African American Community
Prostate cancer does not affect all men equally. African American men face a disproportionately high burden of the disease. They are:
- 60% more likely to be diagnosed with prostate cancer compared to white men
- Twice as likely to die from the disease
The reasons for these disparities are complex and multifactorial. They include genetic factors, socioeconomic disparities, less access to quality healthcare, delayed diagnosis, and differences in treatment.
For this reason, it is especially important for African American men to begin conversations about screening with their doctor early and advocate for proactive care.
Modern Treatment Options for Prostate Cancer
Thanks to medical advances, there are now a variety of effective treatment options available at Saint Francis Hospital and other Trinity Health Of New England cancer treatment centers depending on the stage and aggressiveness of the disease, as well as the patient’s overall health and personal preferences.
Localized Prostate Cancer
If the cancer is confined to the prostate, treatment may include:
- Active Surveillance: For low-risk cancers, doctors may monitor the cancer closely with regular tests and only treat it if it shows signs of progression.
- Surgery: Removing the prostate, or radical prostatectomy, cures many prostate cancers and is now performed using robotic-assisted technology for greater precision and quicker recovery.
- Radiation Therapy: High-energy beams are used to target and kill cancer cells. This can be done externally or internally (brachytherapy).
- Focal Therapies: High-intensity focused ultrasound (HIFU) or cryotherapy target only the cancerous portion of the prostate, preserving sexual and urinary function more than other treatments.
Advanced or Metastatic Prostate Cancer
If the cancer has spread, treatment becomes more complex and may involve:
- Hormone Therapy: Androgen Deprivation Therapy (ADT) lowers testosterone levels, which kills and slows the growth of prostate cancer cells.
- Chemotherapy: Used in some cases when hormone therapy is not effective.
- Next-Generation Hormonal Agents: Oral medications like enzalutamide and abiraterone can provide more effective hormonal control.
- Immunotherapy and Targeted Therapy: For patients with specific genetic mutations, such as BRCA, pills like PARP inhibitors may be used.
- Radiopharmaceuticals: Advanced IV treatments like Pluvicto deliver radiation directly to cancer cells throughout the body.
Clinical trials are also underway testing new treatments, giving patients access to cutting-edge care.
Taking Charge of Your Prostate Health
Prostate cancer is a serious disease, but it is also highly treatable, especially when caught early. Preventive lifestyle choices, routine screening, and awareness of individual risk factors play a crucial role in beating this common cancer.
If you’re a man over 40—especially if you’re African American or have a family history of prostate cancer—talk to your doctor about getting screened. Early conversations can save lives.
