Prostate cancer shouldn't be a death sentence. But for a surprising number of American men,

Since 2014, the number of prostate cancer diagnoses in the United States (which has a high survival rate if caught early) has increased by 3% each year. Advanced-stage diagnoses increased by 5% compared to the previous year.

In addition to injuries, black men are diagnosed with a terminal illness at two to three times the rate of white men; 2.5 times more likely to die experts say.

This is a reality that experts like American Cancer Society CEO Karen Knudsen are “sounding the alarm on across the country.”

Death and inequality are tragic enough. Even more tragic is the Tens of thousands of American men die each year If detected early, Survival rate is almost 100%. One of the main factors, experts say, is the confusion surrounding screening guidelines issued by the Medical Task Force in 2012, even though the controversial recommendations were revised several years later.

As Knudsen points out, “The second leading cause of cancer death in men is a cancer with a high survival rate.”

U.S. prostate cancer statistics “are telling us something,” she says. “We're not detecting prostate cancer early enough.”

It's a topic that has been making headlines again recently. Announcement on February 5th Charles III has announced that he is undergoing treatment for an unspecified form of cancer that was discovered during treatment for a benign prostate condition.

Reason for the rise

In the early 1990s, the U.S. Food and Drug Administration approved: A test called PSA— or prostate-specific antigen — used for early detection of prostate cancer. A simple blood draw detects proteins produced by cells in the prostate, whose increase often signals prostate cancer. After approval, prostate cancer diagnosis rates began to rise rapidly.

However, PSA levels are not only raised by prostate cancer. Benign factors such as infections, stimulation from cycling, and intense sexual activity may also contribute to the increase, according to the study. Oncologist Dr. Bilal Siddiqui Partnering with MD Anderson Cancer Center at the University of Texas.

Inevitably, artificially elevated PSA levels led to unnecessary biopsies, along with unwanted side effects such as incontinence, anxiety, and erectile dysfunction. In 2012, the U.S. Preventive Services Task Force was concerned that blood tests could do more harm than good. Guidelines have been changed to do not recommend using it For prostate cancer testing.

After 2 years, the diagnosis rate for prostate cancer will be began a steady rise.

“Throwing the baby out with the bathwater can have unintended consequences,” says Dr. William Orr.oncologist and professor at the Icahn School of Medicine at Mount Sinai, New York. Chief Medical Officer, Prostate Cancer Foundation-talk luck.

The 2012 recommendation, or some sort of counter-recommendation, “created confusion in the minds of men as well as primary care providers,” Knudsen said.task force Recommendations updated again in 2018They say men between the ages of 55 and 69 should weigh the risks and benefits and discuss screening with their doctors, but clearly the damage has been done.

More than a decade after the initial recommendation, advances in imaging technology have reduced unnecessary biopsies, Dr. Knudsen said. Testing for prostate cancer is also safe, easy and “inherently harmless.”

There's no reason anymore do not have She added that men should discuss it with their doctors, especially if they're over 50 or have a known family history or genetic risk for prostate cancer.

“Don't wait until you have symptoms to get a prostate exam,” she says. “This is simple and provides an important discussion point with your doctor.”

“Watchful waiting” is an option for many patients.

Not all prostate cancers are the same, experts say. And that's good news for many men with prostate cancer. Many prostate cancer patients have “relatively low-grade disease” that has not spread beyond the prostate itself, and treatment may simply require “watchful waiting,” Knudsen said. he says.

Statistics show that men who catch prostate cancer early are less likely to die from it. In fact, research shows that Up to 50% of men were dissected died and Although it is prostate cancer, it is not caused by a disease called prostate cancer, suggesting that “some” cellular changes along the spectrum of prostate cancer “certainly may be a normal part of the aging process.” Siddiqui says it shows.

“There are some types of prostate cancer that will never kill a man,” advises Dr. Oh. “As we get older, some men, many men, develop small amounts of prostate cancer in their prostates. The goal for these men is not to treat them if they don't need them. It is very important to isolate people and conduct active surveillance.”

These patients are in contrast to men with a family history of the disease or genetic risk factors, who often face a more aggressive form of the disease. Although famous for promoting breast and ovarian cancer, thanks to movie star Angelina Jolie's advocacy, Deleterious mutations on the BRCA1 and BRCA2 genes Experts say it may also increase your risk of prostate cancer. People with such mutations in BRCA1 have an estimated 30% lifetime risk of developing prostate cancer. According to a 2022 article in National Cancer Institute Journal. The risk increases to 60% for BRCA2 mutation carriers.

Treatment options for patients with high-risk predispositions include radiation and surgery, and such patients should be treated “as aggressively as possible,” Oh said.

People tend to think of prostate cancer as one disease, but Oh insists that's simply not true. As Knudsen says, cancer as a whole is more than 200 different diseases, and even cases of prostate cancer can be divided into groups or spectrums.

A young patient with “highly aggressive” prostate cancer, whose father had prostate cancer and carried a BRCA2 mutation, “happened to be an 80-year-old man who had a biopsy and had very low symptoms.” This is a completely different patient than the “male.'' grade, slow-growing ‘prostate cancer,’” advises Dr. Oh.

“Those two couldn't be more different,” he added. Their treatment should also be very different.

What to look for and when to act

Symptoms of prostate cancer vary widely, and some patients may have no symptoms at all. According to the U.S. Centers for Disease Control and Prevention. However, the following symptoms may be telltale signs:

• beginning to have difficulty urinating
• Weak or interrupted urine flow
• Frequent urination
• Difficulty emptying the bladder completely
• Pain or burning sensation when urinating
• blood or semen in the urine
• Back, hip, and pelvic pain that doesn't go away
• painful ejaculation

Patients who are diagnosed in the early stages of the disease have a “greater chance of recovery” and “can continue to maintain an excellent quality of life,” Knudsen said. In fact, Siddiqui says his five-year survival rate for prostate cancer detected early is virtually 100%.

However, the outlook for patients diagnosed late is less rosy. Knudsen points out that there is no “permanent cure” for this type of cancer. The five-year survival rate for advanced prostate cancer is only 31%, Siddiqui said.

When it comes to preventing prostate cancer, “what's good for your heart is good for your prostate,” advises Oh. He advises men to eat plenty of leafy green vegetables and colorful fruits. Limit dairy products and barbecued meats, These are associated with an increased risk of prostate cancer and advanced prostate cancer.

“Exercise can also lead to better outcomes,” he adds.

And what about detection? When men reach their 40s (or earlier if they're black, have a family history of cancer, or have a genetic mutation associated with prostate cancer), Oh recommends that men talk to their doctor or urologist about screening. . The conversation he should have every 1-2 years.

“Physicians are very busy and actually have a lot of mixed emotions, especially in the cancer screening field,” he says. “Unfortunately, cancer screening is more controversial than it needs to be. Guidelines change frequently and vary by organization. It makes it difficult for the average person to know what to do.”

Doctors recommend getting a second opinion if you feel like your doctor isn't listening to you.

Oh adds: “Early detection of a bad disease is always a good thing.”