How much do you know about prostate cancer? It’s certainly a topic that’s much in the news, but it can be difficult to separate the hype and myths from the facts. Don’t let a misunderstanding or misinformation keep you from taking steps to be tested or treated for prostate cancer. Here are some myths about prostate cancer and the real story.
- Myth #1: Few men die from prostate cancer. Perhaps this myth persists because people differ in how they define “few.” According to the National Cancer Institute, an estimated 241,740 new cases of prostate cancer will be diagnosed in 2012, and about 28,170 men will die of the disease. Looked at another way, about one man in 36 will die of prostate cancer, according to the American Cancer Society. Think of all the men you know, and if you know at least 36 men (include yourself in the count), one will die of prostate cancer, or about 3 percent.
- Myth #2: Only elderly men get prostate cancer. Although it’s true that nearly two thirds of men diagnosed with prostate cancer are 65 years or older, that leaves one third who are younger. Therefore, if we consider the 241,740 new cases of prostate cancer estimated to be diagnosed in 2012, approximately 80,580 of those cases will be diagnosed in men younger than 65. Prostate cancer is rarely diagnosed in men younger than 40, which also is the age at which it is recommended that men who are at high risk for the disease (e.g., black men, men with a family history of prostate cancer, those exposed to Agent Orange) be tested.
- Myth #3: A high PSA level means I have prostate cancer. Actually, a high PSA (prostate specific antigen) level means you are at increased risk for the disease, and it can occur for nearly a dozen reasons other than the presence of prostate cancer. So if your doctor says your PSA level is high (which is loosely defined as 4 ng/ml or greater), don’t panic. High PSA levels can be caused by an enlarged prostate, a prostate infection (prostatitis), urinary tract infection, advancing age, recent prostate biopsy, recent use of a catheter, recent bladder test (cystoscopy), ejaculation within the previous 24 to 48 hours, vigorous physical exercise, and riding a bicycle.
- Myth #4: A low PSA level means I don’t have prostate cancer. Unfortunately, this isn’t true. Prostate cancer can develop in men who have a low PSA level, although the risk is lower in this group of men. It’s important to remember that the PSA test is just one of several tools used to help make a diagnosis of prostate cancer, and that doctors never depend on the results of just one test to make a diagnosis.
- Myth #5: A vasectomy can cause prostate cancer. In a word, “no.” A possible link between a vasectomy and development of prostate cancer has bothered men for years, and it’s been used by some men as a reason for not undergoing the procedure. A 2009 National Institutes of Health meta-analysis of 27 studies that involved more than 250,000 men reported “no existing literature show any positive association between vasectomy and prostate cancer.”
- Myth #6: All prostate cancer treatments always cause erectile dysfunction and urinary incontinence. Although erectile dysfunction and urinary incontinence are side effects of some treatments for prostate cancer, their incidence varies considerably. For example, for men who undergo brachytherapy, urinary incontinence occurs in about 1% of patients while erectile dysfunction can occur in 40 to 60% of men. Erectile dysfunction is expected as part of hormone therapy since the idea is to severely limit sex hormone production. However, erectile function typically returns gradually after treatment is over. Following prostatectomy, the rate of urinary incontinence has been reported to be about 10% one year postsurgery. Thus the risk of impotence and urinary incontinence associated with prostate cancer treatment depends on the treatment and, of course, on the man.
- Myth #7: Surgery is the best treatment for prostate cancer. Absolutely not. In fact, for many men the active surveillance approach is best. If the cancer should grow, then men need to discuss their many options with their healthcare provider, and these may include chemotherapy, hormone therapy, external beam radiation, brachytherapy, proton therapy, high-intensity focused ultrasound, cryosurgery, and radical prostatectomy, and in some cases a combination of therapies. In any case, men who have been diagnosed with prostate cancer have many treatment options, and they should inform themselves about all of them so they can make an informed choice.
- Myth #8: I don’t have symptoms, so I can’t have prostate cancer. The fact is, men who have early prostate cancer usually don’t experience any symptoms of the disease, which is why prostate cancer screenings using PSA are important. As the disease progresses men may experience symptoms, which are similar to those associated with an enlarged prostate and with prostatitis: strong urge to urinate immediately, weak urinary stream, frequent nighttime urination, pain and/or burning when urinating, pain in the genital area, ejaculation pain, difficulty starting urination, frequent urinary tract infections, and blood in the semen or urine.
- Myth #9: Prostate cancer grows slowly, so I don’t need to worry. True, prostate cancer tends to grow at a slow rate, but this is not true in every case, nor does it mean a slow-growing cancer can’t suddenly become aggressive. Therefore, at the very least, men who have been diagnosed with prostate cancer should maintain active surveillance, which means getting regular checkups to monitor the disease.
- Myth #10: Circumcision increases the risk of prostate cancer. The evidence on this subject indicates that men who are circumcised before they engage in their first sexual intercourse actually have a 15% reduced risk of prostate cancer when compared with men who are not circumcised. The study from the University of Washington School of Medicine found a lower risk of both aggressive and less aggressive prostate cancer associated with circumcision.
Read more in our Prostate Cancer Health Center.
Grossi FS et al. Laparoscopic versus open radical retropubic prostatectomy: a case-control study at a single institution. Arch Ital Urol Androl 2010 Jun; 82(2): 109-12
Tang LF et al. Vasectomy not associated with prostate cancer: a meta-analysis. Zhonghua Nan Ke Xue 2009 Jun; 15(6): 545-50
Wright JL et al. Circumcision and the risk of prostate cancer. Cancer 2012 Sep 15; 118(18): 4437-43