Did you know that about 1 in 8 men will be diagnosed with prostate cancer during their lifetime? According to the American Cancer Society, it remains the second-leading cause of cancer death among American men. The numbers continue to climb, with the National Cancer Institute estimating that more than 333,000 new cases of prostate cancer will be diagnosed in the United States this year alone.
While these statistics may sound daunting, Mina Fam, M.D., medical director of urologic oncology at Hackensack Meridian Jersey Shore University Medical Center and medical director of robotic surgery Ocean University Medical Center, reminds us that most men diagnosed with prostate cancer do not die from it. He weighs in on the latest advancements in early detection and why your primary care doctor is your greatest asset.
Your primary care doctor: The first line of defense
Prostate cancer continues to be one of the primary cancers impacting men today, but managing your risk doesn't have to be overwhelming. Dr. Fam notes that your primary care provider doctor is on the front lines of early detection.
"The primary care doctor is the one who knows the patient's medical history the best," shares Fam. Because men can sometimes be hesitant to bring up urinary or sexual health concerns, he encourages patients to be honest with their doctor about their fears and concerns when the topic of prostate health comes up.
While there was a brief period when the medical community drifted away from using the PSA (prostate-specific antigen) blood test to detect prostate cancer, it is once again a standard starting point for the screening process.
The goal of the test isn't to overdiagnose but rather to establish a healthy baseline and catch any potential issues early."
Mina Fam, M.D., medical director of urologic oncology, Hackensack Meridian Jersey Shore University Medical Center
When should you get screened?
"Because every patient is different, screening timelines should be highly individualized through shared decision-making with your doctor," notes Fam. He breaks down the general guidelines:
- Average risk: Men should begin screening discussions around age 50.
- Higher risk: Black men and those with a family history of prostate cancer should start conversations at age 45.
- Hereditary risk: Men with a known genetic predisposition, such as a BRCA mutation, should begin screening between ages 40 and 45.
Importantly, he points out, "A PSA test isn't a simple 'pass or fail.' It's the trend – how your PSA levels change over time – along with your age and prostate density, that is far more revealing than the absolute number on your lab report."
A high PSA doesn't always mean a biopsy
One of the most significant medical developments in recent years is how doctors handle an elevated PSA score. "In the past, anyone with an elevated PSA would get a prostate biopsy, but that's not the case anymore," Fam explains. "Today, specialists utilize advanced MRI tests, alongside new blood and urine biomarkers, to accurately determine if a biopsy is truly necessary. If a biopsy is recommended, patients should know that technological advancements have made the procedure much safer and more comfortable. While doctors are always mindful of minimizing risks like sepsis, modern biopsies are not always the highly invasive or painful procedures men might fear."
A diagnosis doesn't automatically mean surgery
Perhaps the biggest misconception men have about prostate cancer involves symptoms and treatments. Many men assume that sudden urinary issues mean they have cancer, but Fam clarifies that these symptoms "frequently point to completely benign (non-cancerous) prostate conditions. In reality, early-stage prostate cancer often presents with no symptoms at all, which is why screening is so vital."
Furthermore, an early prostate cancer diagnosis doesn't automatically mean you will need aggressive treatments like radiation therapy or surgery, adds Fam. "Depending on the specifics of the cancer, many men are excellent candidates for active surveillance, which is a safe strategy of closely monitoring the cancer without immediate medical intervention."
Take charge of your health today
"Don't let fear or embarrassment keep you from prioritizing your health," says Fam. "Routine screenings are simple, highly individualized, and life-saving."
Alcohol-linked cancer deaths doubled over three decades in America