- Prostate cancer will affect 1 out of 8 men during their lifetime.
- When caught early, prostate cancer is highly treatable.
- Knowing your risks can lead to better decision-making and more proactive care.
- Screening is most effective when you start early before you have symptoms.
Next to skin cancer, prostate cancer is the most prevalent cancer among men in the United States, with an estimated incidence of 248,530 cases in 2021.
One out of every eight men will get prostate cancer. And one out of every 40 men will die from prostate cancer. However, when caught early, prostate cancer is highly curable.
Early detection can start with understanding the disease, knowing your risks by using a prostate cancer risk calculator, and planning for prostate cancer screenings before you have symptoms.
Age is a common risk factor for prostate cancer. The disease is less common in men under 50. The rate increases after men reach 60. Lifestyle factors such as diet, lack of physical activity, smoking, and exposure to harmful substances may play a role in getting prostate cancer.
Ethnicity plays a role in the risk of prostate cancer as well. In the United States, the risk is almost two times higher in black men than in white men. Black men who get prostate cancer earlier are more likely to have more aggressive cancer, or high-grade prostate cancer, when diagnosed and tend to suffer poorer outcomes.
Prostate cancer has a higher rate of occurrence in the United States, Australia, Northern Europe, Canada, and Mexico. Men from low-incidence countries like India who move to high-risk area North America experience a convergence of prostate cancer risk, as their risk increases to match the local population in just two years.
Having a close family member with a history of prostate cancer increases your risk as well. This incidence is thought to be due to a shared environment and shared genes. Patients with a family history of prostate cancer account for about a fifth of all cases.
Prostate cancer risk calculators.
Prostate cancer risk calculators, also called nomograms, use prediction models for risk assessment or risk estimates. Doctors use prostate cancer nomograms from screening through prostatectomy, chemotherapy, and radiation.
Some were designed for patients to use. The latest version, created by researchers at Kaiser Permanente, helps patients and their doctors better understand the risk of getting prostate cancer. The goal is to have more informed decision-making regarding screenings. Another, the SWOP prostate cancer risk calculator is actually multiple nomograms (six for doctors and two for patients).
Available online or as an iPhone or Android app, these prostate cancer risk calculators allow patients with no medical knowledge to safely assess their risks for getting prostate cancer based on various data points.
Prostate cancer risk calculator #1 is for patients who do not have a PSA result.
Prostate cancer risk calculator #2 is for patients with a recent PSA.
Disclaimer: No prostate cancer risk calculator is 100% accurate. Your results are meant to be shared with your doctor, so they will help interpret your results and possibly refer you to a urology specialist for further testing at a medical center or to a radiology center for a scan.
PSA and prostate screening methods.
Prostate cancer detection methods have traditionally comprised a digital rectal exam DRE and prostate-specific antigen PSA testing. Today, a magnetic resonance imaging (MRI) scan with IV contrast may be able to detect and exclude high-risk prostate cancer as reliably.
Currently, the United States Preventive Services Task Force (USPSTF) recommends that men aged 55 to 69 and their primary healthcare provider decide about screening for prostate cancer.
If you’re having symptoms of prostate dysfunction, your healthcare provider may want you to do a blood test to measure your free PSA. This will tell them the amount of PSA currently circulating in your bloodstream.
The European Randomized Study of Screening for Prostate Cancer (ERSPC) found a 21% reduction in prostate cancer mortality by measuring PSA levels. But an elevated level doesn’t always mean you have cancer. Other conditions such as benign prostatic hyperplasia (BHA) can raise your PSA to as much as 2.5 times the normal value.
Some studies suggest that urinary tract infections, prostate stimulation, and inflammation may cause elevated PSA tests.
Other types of prostate screening methods.
Elevated PSA levels may help your doctor decide when to recommend a prostate MRI. The Ezra Prostate MRI with IV contrast is a highly sensitive tool for detecting changes that might indicate prostate cancer (more on this shortly).
Prostate MRIs with IV contrast can also be a part of your prostate cancer screening routine while you’re still healthy.
Digital rectal examinations (DRE) are another type of screening that examines changes manually by palpating the gland via the rectum. Since some cancer is small and difficult to feel, results of a DRE may be inconsistent. DRE also has the potential to cause an elevated PSA.
Where is the prostate and what does it do?
The prostate is part of the male reproductive system. It is a small, donut-shaped gland deep in your pelvis between your bladder and urethra. It secretes an enzyme called prostate-specific antigen (PSA). During ejaculation, PSA aids in sperm motility (ability to move) by liquifying the semen. PSA has long been regarded as an indicator of prostate health.
What is prostate cancer?
Cancer occurs when abnormal or mutated cells begin to multiply at an uncontrolled rate. This is called proliferation. As the cells grow, they clump together, eventually forming a tumor.
Most types of prostate cancer grow slowly, while some more aggressive types accumulate faster. It’s not clear what exactly triggers prostate cancer. However, we know some symptoms and diagnostic methods.
Prostate cancer symptoms.
The presence of symptoms and their severity vary between prostate cancer patients. Some symptoms of prostate problems are:
- Erectile dysfunction
- Problems with urination
- Bloody urine and semen
- Painful ejaculation
- Inability to ejaculate
- Persistent pain (back, hip, pelvis, or rectum)
Diagnosis of prostate cancer.
A healthcare professional may suspect prostate disease if you have some or all of the following:
- Abnormal DRE
- Elevated PSA levels
- Clinical symptoms (like those listed in the section above)
- Suspicious results from a prostate risk calculator
You may be given a referral to urology and require further testing, such as an MRI or prostate biopsy. Often, doctors won’t order an MRI until after the biopsy, which is unfortunate since MRI could prevent an unnecessary negative biopsy.
Doctors use results from clinical tests to diagnose and stage prostate cancer. Staging assigns a value to the cancer which helps determine treatments and also helps provide context regarding prognosis.
One tool doctors use is the Gleason Score. After a prostate biopsy, a pathologist or cytotechnologist will look at the tissue under a microscope. They observe the biopsied cells for differences and similarities to normal cells. Cancer cells that look more like normal tissue get lower Gleason Scores.
Cutting-edge prostate cancer screening.
For prostate cancer prevention to be effective, you want to start early while you’re still healthy. Early detection means that you may be able to catch cancer when it is still low-grade and easier to treat.
Ezra offers prostate MRI in two packages: the Full Body and Full Body Plus. They offer the Prostate MRI with IV contrast as a stand-alone procedure. Prostate MRI may provide more accurate prostate volume measurements, which could lead to a quicker diagnosis.